Replacing Breast Implants Using Same Breast Pocket?

depending on the magnitude of the size change,a smaller implant will roll all around the pocket and might be more prone to rippling as well. The overlying tissues may also "sag" due to less structural support from the smaller device and can be improved with a lift.. The pocket needs to be changed or altered with sutures to keep the defvice in the right position.

When placing a smaller implant, with few exceptions, we repair the old pocket. While the pocket may accommodate to the new smaller implant, the bottom and sides of the pocket are usually too low and too laterally placed for the new implant, resulting in a bottomed out appearance.
Pocket repairs are technically difficult and the repair process imperfect. However, experience and conservatism combined with realistic expectations and patient cooperation with the delicate healing period typically yield very nice results.

Of course your surgeon should have discussed this with you, but I have found that the pocket will most often adapt to smaller implants. I usually use suction drains to help with this. Ocaasionally it is necessary to use internal stitches, called a capsulloraphy, to reduce the pocket in specific ways, such as raising the bottom fold or along the outside in order to make sure the space between the breasts remains the same with smaller diamter implants. This is a separate question though from what happens to the rest of the breast. A lift is sometimes required.