Which implant size would you recommend for revision of these subglandular 365cc implants to a dual plane position? (Photos)

Hi, My implants are 365cc round smooth subglandular. I'm hoping to have a revision to go a little smaller (330-340cc) with a dual plane placement. Do you think this small change in size would create loose skin?

Doctor Answers 7

Smaller implants

Going with implants that are only slightly smaller will probably not create loose skin.  The implant size to recommend would depend on how much smaller you want to be, and the look you are trying to achieve.

San Francisco Plastic Surgeon
5.0 out of 5 stars 4 reviews

Which implant size would you recommend for revision of these subglandular 365cc implants to a dual plane position?

Although, it is possible that switching to a smaller implant can create a situation of loose skin and/or breast sagging, from your photos, I don't believe going to a 330-340cc will result in a problem.  It appears you do have slight capsular contractures and your surgeon may want to address this issue when they change the position of the implant to the dual plane.  Best wishes, Dr. Lepore.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.9 out of 5 stars 49 reviews

Plane switch procedure for breast implantsa #plasticsurgery

An exact answer would require a physical exam and measurements, but you could consider using the same sized implant in the submuscular (dual plane) position - implants generally look 'smaller' when behind the muscle.

Implant Size Recommendation for Subglandular to Dual-Plane Placement?

Thanks for your question. Keeping as close as possible to you existing volume has real advantages in trying to avoid excess skin laxity following this type of pocket change. That being said, the degree of retraction of the breast tissues is always somewhat unpredictable. Sometimes, a mastopexy (lift) and/or modest increase in volume is necessary to make this change successful. In a complete consultation & breast exam, your surgeon should be able to guide you in this regard. I am not a fan of subglandular placement. Given your lean stature, I believe that partial submuscular positioning is a very good thing to consider. Best of luck to you.

Michael F. Bohley, MD
Portland Plastic Surgeon
4.9 out of 5 stars 15 reviews

The right size for you

t is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon.

Revision Breast Augmentation

Hello,You will likely not see much of a difference in size with a 9.5 % reduction in volume, even going from over to under. You will likely need a breast lift to take up the skin excess though. Go visit a few ABPS certified/ASAPS member surgeons that specialize in revision breast surgery.Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 78 reviews

Which implant size would you recommend for revision of these subglandular 365cc implants to a dual plane position?

Thank you for the question.Sometimes, patients undergoing conversion of breast implant positioning from the sub glandular to the sub muscular space benefit from additional maneuvers such as breast lifting (depending on the position of the breast skin envelope in relation to the position of the sub muscular breast implants) and/or the use of acellular dermal matrix for lower pole support. Closing off the existing breast implant pocket is a technique utilized to help prevent the breast implant from moving back into its previous space.
Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery (regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup” etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery ( after the use of temporary intraoperative sizers). Viewing the patient's chest wall in the upright and supine positions, with temporary sizes in place, help select the best breast implant size/profile for the specific patient. I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps. Best wishes.

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.