Can I swap 800cc implants for 500cc? I don't mind saggy skin!

I have 800cc breast implants over the muscle for one year now, they are saggy but I love it, they look so natural. They are very soft and hang~ 1 cm over my lowered crease. Now I want them smaller. Can I exchange them for 500 cc although my breast have sagged? Would not do a breast lift and if they would hang lower I would not mind at all, I just don't know whether this is possible.

Doctor Answers 8

Not enough information to accurately answer

Hi,

Thanks for posting your question. I am happy to try and help you. It is important to remember that a board certified plastic surgeon will be your best resource when it comes to an accurate assessment of your situation, and concerns.

Pictures allow for a true evaluation of your current situation. Please be so kind as to resubmit with photos from the side views of each side and from the front. Ideally, have someone else take the photos so that you can rest your arms at your sides.

Having said that, as a rule of thumb you will not be able to see a difference in breast implant appearance unless you go up or down at least 75-150 cc. The height, weight, frame and current implants and desires are what really pushes the meter.

So a small framed women with 300cc ranged devices should be able to see a change with 75 cc. This would be the case if she wanted to fill out the bras better and not necessarily go to the next bra size. If she wanted to go up a size and fill it out, it may be 150+ cc to achieve that.

A larger women with the same sized implants would probably not even notice the 75 cc bump. So their scale would shift and she may need 125 cc to notice some difference and even more to go up and fill the next bra size.

So it is not a cut and dry situation. You would be best served going to see a plastic surgeon personally to get the best advice after examination and discussions about what your goals are.

Best wishes,

Dr. Michael J. Brown
Northern Virginia Plastic Surgeon

Downsizing is generally possible, but can be more complex with implants over the muscle

Miamia,

The answer is that it depends...  The key factor in whether this will work is going to be the size of the existing pocket relative to the size of the proposed replacement implant, and whether you will have too much space inside the breast skin.  Implants over the muscle tend to lead to significant sag, particularly large implants, and internal pocket tailoring is not nearly as easy over the muscle, as the transition from implant to chestwall is abrupt with implants over the muscle.  With implants under the muscle the transition is much easier to hide and the pockets only need to be closed laterally in most instances, if it is necessary at all when going smaller. You should see an experienced B-C Plastic Surgeon to review your options.  Also, it is possible that a lift may be needed if you have too much skin   I hope that this helps.  An example of 150cc downsizing in a small patient is shown at the link that is found below.

Thomas M. DeWire Sr., MD (retired)
Richmond Plastic Surgeon
4.3 out of 5 stars 35 reviews

Breast implant revision

I appreciate your question.
You swap these out and decrease the internal pocket
I would recommend a lift

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

best of luck!

Dr Schwartz

Downsizing breast implants

It is relatively simple to place smaller implants into a pocket that has already been surgically created. If you don't mind additional sag, then that is all I would do.  Depending on your age and the length of time the implants have been in place, there may not be that much additional sagging.

Paul W. Loewenstein, MD
Milwaukee Plastic Surgeon
4.8 out of 5 stars 27 reviews

Downsizing breast implants

Yes you can downsize your breast implants. If you do not want the extra skin removed there may be some sagging. You may need to alter the breast capsule which is done on the inside. Depending on the elasticity of your skin some retraction of stretch may occur. Good luck. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

Can I swap 800cc implants for 500cc? I don't mind saggy skin!

  Yes, you should be able to undergo downsizing of breast implants. Keep in mind as you are thinking about your goals that sometimes adjustment of the breast implant pockets (capsule adjustments) may be necessary to achieve the outcome you are looking for. Breast lifting may or may not necessary.  Much will be dependent on your physical examination;  specifically, factors such as the amount of redundant skin and  quality of skin elasticity will be important.

Generally speaking, the best online advice I can give to ladies who are considering revisionary (downsizing) breast augmentation surgery 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 "down a cup size” 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 chosen plastic surgeon to work with you in determining the best plan to achieve your goals.

I hope this, and the attached link (dedicated to revisionary, specifically downsizing, breast augmentation surgery concerns), helps. Best wishes.

Breast Implant Revision

Thank you for your question about breast implant revision.

In general, yes it is possible to change 800cc breast implants for 500cc; and yes, they will likely hang a lot more.

It is a 37.5% reduction in breast implant size.

To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 150 reviews

Depends on your skin

How well you will do will depend on many factors including the condition of your skin, the ratio of soft tissue vs. implant volume, pocket size, etc.  Depending on the results you are looking for, you may do fine with or without pocket modification.  You will lose upper pole fullness and depending on your soft tissue, the smaller implants may swim in your pocket without modifying your breast pocket.
Best Wishes,
nana Mizuguchi

Nana N. Mizuguchi, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 45 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.