How Far Can I Downsize my 450's?

I've heard that an implant >350cc's on a small frame (32A) oversteetches the skin. I have 450cc's so altho PS says I have good skin quality I'm afraid of complete explant and loose skin, esp since I'm 43yrs old. Is there anyway to downsize me to a full A? Submuscular, crease silicone May 2012 no kids never overweight. The sideboob feels like a bra strap that keeps falling off the shoulder, I keep trying to push it onto my chest but it won't go. I'm miserable and long to be as small as possible.

Doctor Answers 10

Downsizing after augmentation

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can certainly be done but you need to make sure you really want to give up what you have achieved.  Your results do not look bad at all, yet its your perception that is most important here.  If you really do not like your implants, talk to your surgeon to see what he/she could do for you.  If you walked into my office, I would be talking to you about removing them and allowing your tissue to shrink back down, hopefully to their pre-op appearances then come up with a plan that would work for you.  Implants can easily be removed in the office under local for very reasonable fees.  I hope you are able to work with your doctor as your situation suggests poor communication between you and your surgeon.  By the say, did you select the size or was this determined by your doctor?  I always let my patients choose to avoid such situations.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Downsizing Breast Implants

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Dear Fun Size,

It sounds as if you are dissatisfied with the current size of your breasts and wish to go down in size.

If you wish to return to your pre-implant size, then having your implants removed is the simplest option. You may or may not also need to have a lift procedure or accept some residual sagging, depending on the quality of your breast skin.

If you wish to have smaller breasts but retain some extra fullness, then have your current implants replaced with smaller implants. Again, you may or may not also need to have a lift procedure or accept some residual sagging.

Please see an experienced, Board Certified Plastic Surgeon for an evaluation and to discuss your concerns.

Warmest wishes,

Larry Fan, MD



Larry Fan, MD
San Francisco Plastic Surgeon

Downsizing implants

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I personally would not have used such a large implant for you and this really goes to the issue of preop communication between doctor and patient. There are several choices including re-implantation or, given your starting point, a small lift combined with a smaller implant.

Downsizing breast implants

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Overall if you want to desire to have a smaller breast size then you may need to consider a smaller implant with a breast lift.  If you simply switch out implants to a smaller one you will not eliminate your breast sagging and it is likely to be worse.  You can consider just removing the implants completely and see if this gives you your desired look.  This will give your skin and breast tissue the chance to shrink down and gives you the chance to see what you will look like without implants.  If you then desire smaller implants you are more likely to get into your desired breast cup size.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Downsizing implants

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You certainly may downsize but you will be left with less fullness which may be alright with you, it is an individual thing. However, you may ultimately need to be lifted to get you a better shape depending on how much loose skin there is after the procedure. It is really a trade off for getting what you ultimately want.

Downsizing breast implants may require a lift

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Downsizing can be tricky in terms of determining the best lift if necessary. Depending upon the skin quality, I have performed this with as little as a circumareola skin removal and they have worked quite well. More lift usually means a vertical with a lollipop closure.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Significant downsizing of implant can be a troublesome surgical plan

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Its tough to quantify what an 'A' cup is - so I avoid the terminology completely when discussing size with my patients. A couple of options for you if you'd like to go 'small'. Explant the implants and close the breast, no implant replacement. Wait a few months and see how you feel about the new look. If you want more volume at that point, you could consider a much smaller implant after your skin has recovered some elasticity. You could also consider fat grafting for breast augmentation, which we do in our clinic for patients facing the decision you are making (going from big to small...)

Downsizing Implants

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   Implants can be downsized to 350 ml, but some sort of a lift may be required.  Some of this will be based upon the new pocket that is created and whether any additional muscle release or capsulotomy can be performed. 

How Far Can I Downsize my 450's

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You can downsize to a smaller implant but expect to need a breast lift to deal with the excess skin. Your concept of a full A may not correspond with mine, with your surgeon's, or with Nordstroms' and so forth, so a good deal of communication with your surgeon will be in order. If your current native breast size is still a AA, you may need a 200 cc implant, perhaps smaller. A tightening of the capsule will also be needed to keep the implants out of the side areas.

Thanks for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Downsizing implants

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Thanks for your question and photos.  I am sorry you have not been satisfied with your procedure.  To go from a 450 cc implant to a smaller implant is possible, but may require some skin excision to remove the excess (e.g.  Benelli or donut mastopexy).  Have you considered discussing with your PS a pocket revision in order to improve the "side boob" problem?  This more than likely will still need to be done if you decide to change the inplants for smaller ones, as the implants can still go to the sides if the pocket is developed there.  Some women have completely removed the implants, and allowed time to resolve the shape and sagginess, but this is not a short tincture of time.  You are looking at several months to maybe more than a year.  I hope this helps and good luck with your endeavors.


Robert Kratschmer, MD

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.