Best method for downsizing breast implants? What happens to the scar tissue/capsule thats formed around the 1st implant?

Question

1 of the pockets holding my implant has stretched according to my surgeon & is causing a lot of pain & unevenness. It's making me want to downsize. What is the best method a surgeon can take while downsizing implant size during surgery to make sure the pocket won't stretch/possibly bottom out again? & when downsizing/exchanging new implants, what happens to the scar tissue/capsule thats formed around the 1st implant? Does it stay in the body or does it come out when putting in a new implant??

Gary M. Horndeski, MD · Answer

The
best method for downsizing implants depends on the patient’s desires.  Unfortunately, you have not told us your bra
size or provided photographs.  The
technique I usually recommend is explantation using The Bellesoma Method.  The implants are removed, your breast tissue
is reshaped creating upper pole fulleness, elevated higher on the chest wall
and more medial to increase your cleavage. 
Vertical scars are avoided, nipple sensation and the ability to breast
feed are maintained, if not injured during your previous surgery.  At the same time or later, fat transfers can
be performed if additional volume is desired. 
At the time of surgery, the capsule may or may not be removed depending
on the surgeon’s discretion.  Implants
are not lifetime devices and half are removed by 9.5 years.  Fat transfer is preferred to small implants.Best Wishes,Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

Hello,Implant malposition leading to dropout or lateral displacement can be due to many factors: the creation of a pocket too large, or in a way that destabilizes the surrounding tissues (blunt dissection), the use of smooth implants, the use of 'very large' implants (no official designation for what size implants these constitute), the use of saline implants, and the use of implants that were objectively too large for the patients anatomy.  The repair of this depends on what factors were implicated and the degree and direction of malposition. Either capsulorrhaphy is performed (most commonly), or the creation of a neo-subpectoral pocket. Scar capsule is usually not removed for implant malposition. More important than the chosen technique is the surgeon executing the procedure. The best chance of a successful outcome is by choosing an ABPS certified/ASAPS member surgeon who specializes in revision breast surgery and has at least a decade of experience doing revisions on a regular basis. Best of luck!

Anthony A. Admire, MD, FACS · Answer

You can definitely downsize your implants at any time. If the pockets stretch (which they usually do over time), then downsizing to a smaller implant usually requires a capsulorrhaphy - internal tightening of the pocket to make the pocket smaller. This is usually done to the lateral and sometimes inferior pocket. As for removing the capsule, it depends on how thick the capsule is over time. If it's thin, then it's usually left in place. The capsule can help support the internal tightening. Lastly, often a lift is needed to give better shape to a smaller implant and breast.

Daniel Barrett, MD · Answer

Dear jmhig218,it is hard to tell for sure without an examination. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jason Pozner, MD · Answer

Its difficult to answer your questions without some photos. For downsizing, sometimes its as simple as placing smaller implants while other patients with stretched skin or very large implants will require a lift and possibly mesh support. the capsule can stay or be removed

Best method for downsizing breast implants? What happens to the scar tissue/capsule thats formed around the 1st implant?

Answers (9)

Answer: Implant replacement

Answer: Implant replacement

Answer: Implant downsizing

Answer: Implant downsizing

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Best method for downsizing breast implants? What happens to the scar tissue/capsule thats formed around the 1st implant?

Answers (9)

Answer: Implant replacement

Answer: Implant replacement

Answer: Implant downsizing

Answer: Implant downsizing

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Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.