Risks and Side Effects of Downsizing Breast Implants

I had 500 grams silicone high profile implants place about 3 months ago. They feel a little too big and firm. I would like to downgrade them to maybe 425, maybe same projection but lesser diameter, since my ribcage is rather small. I am not necessarily looking for a conservative look; I just don't want to look too big.

I'm also concerned, can reducing the breast implants damage tissues or result in a large area of stretched out skin? What are the side effects or risks to doing this? I would probably do it in a couple of months.

Doctor Answers 23

Smaller implants will not lead to tissue damage

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To mariana,

I hardly ever use 500cc implants. They are too big for most women and they look worse as you get older. Try 400 cc. You will still be nice and full.

The implant pocket can be made smaller during the revision. I would not worry about stretched skin, because the skin usually contracts snugly.

Manhattan Plastic Surgeon

You can exchange breast implants now with little damage

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Since your implant was inserted only 3 months ago, it is possible to change to a smaller implant with little effect on the skin and breast tissue. Hope that helps!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

High profile is the narrowest to start

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Reducing your implants by 75 cm will do little to create a sag. And you are correct that moving from 500 to 425 in the Natrelle line will not change the projection, only the width.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

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Reducing the size of breast implants is usually not a problem

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Reducing breast implant size from 500 cc to 425 cc should not cause a problem. The breast envelope should re adjust naturally to the smaller implant. With the size difference you mention I think any stretch mark or skin thinning would be very unlikely.

The skin should tighten naturally around the new implant. I would also suspect that the breast will look more natural with the smaller implant.

Loose skin from downsizing or removing implants

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This depends on several factors:

  • Your age
  • The prior condition of your breasts
  • Assuming no weight gain/loss in interim
  • Hormonal factors
  • Skin Elasticity
  • Tobacco use
  • Submuscular vs Subglandular placement
  • Textured vs smooth surface

Without being aware of these factors, as well as other issues, It is very difficult to predict what the shape of your breast will be or the condition of the skin envelope when you downsize.

With that being said, downsizing from 500 to 425 with a different profile should generally not cause a significant amount of skin laxity or breast ptosis (sagging).

This is a relatively modest change and may be barely discernible to you. So I would not be overly concerned about any dramatic difference. In the event that you experience a minor amount of ptosis, a breast lift could be performed at a later date but that will most likely be unnecessary, in my opinion.

During the recovery process, I would encourage you to wear a supportive bra 24x7 to support the mammary parencyhma (breast tissue) and encourage contraction of the loose tissues in their new and smaller position.

I hope this helps!

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Side Effects of Removing Implants Vary Depending on Size of Implant Reduction

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The consequences of downsizing breast implants varies depending on the size of the implant reduction.  When minimal reductions occur there’s virtually no impact on the implant pocket or overlying breast tissue.  Under these circumstances simple exchange of implants is appropriate.

                  Unfortunately, a 75cc reduction wouldn’t significantly impact breast size or breast aesthetics.  In this situation, the risk benefit ratio may not justify this type of procedure.

                  When larger implant reductions occur, a more aggressive procedure may be indicated.  This may involve remodeling the dimensions of the breast pocket by performing a capsulorraphy.  Under these circumstances significant changes in the size and shape of the breast may occur.  In some cases breast sag may occur and a breast lift may be necessary. 

                  If you’re considering this type of implant exchange it’s appropriate to consult your plastic surgeon.  Your surgeon should be able to help formulate a treatment plan that addresses your concerns.   

Reducing Size of Implants Not Risky

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The relatively small volume change you are considering will not likely create any problems for you. When you visit your surgeon and discuss your concerns, he/she can show you that there is just a few millimeters of difference in dimensions between the sizes you are considering..

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 45 reviews

Reducing breast implant size is risks and benefits

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The amount of difference in the volume other breast implants you mentioned is very small only 75cc, less than 3 ounces, so I don't feel that this implant exchange is likely to help you with your concerns. 

Also, you concerns regarding the width are unlikely to be helped unless the breast implant that you have now is significantly wider than the one you thinking of removing.

So, the risks seem to outweigh the benefits.

You need to have a thorough discussion with your plastic surgeon about your concerns, so you can make an informed decision on how to proceed.

Fredrick A. Valauri, MD
New York Plastic Surgeon

Downsizing risks and complications

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Mariana, reducing your volume 75cc but keeping in the same "profile" and plane, will probably not cause problems with skin laxity and excess.  With regards to an overly enlarged pocket, I doubt that you will require modification of the pocket to reduce the space.  What is of concern is your description of the implants as "firm".  While firmness may be a consequence of how recently you have been implanted, do remember that the risk of capsular contracture starts again, with the new implant.  That being said, it's also possible that by downsizing your breast will actually feel softer, as the overlying tissue has already been pre-stretched.  Good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Downsizing a breast augmentation

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Reducing the size of your implant by less than one hundred cc's seems reasonable. It is possible that you may need a small nip/tuck to reduce some skin excess and laxity. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.