Considering downsizing my 500cc, moderate plus, silicone implants. I am petite, 5'1, 110lbs, 34 A pre-op. (photos)

Ever since my BA 2 years ago I have felt that this size does not suit me. I hate all the upper pole fullness and my right implant sits higher than the left. I find myself buying clothing to hide my new breasts rather than flaunting them. Do my breasts look terrible? Should I get a revision? What size should I be?

Doctor Answers 8

Implant exchange

You may be able to just decrease the implant size by 150cc and do a small amount of capsule plication on the lower implant pocket to get the results you desire. There are several other options that you can do as well and please seek out a board certified plastic surgeon in your area. Good Luck!

Richmond Plastic Surgeon
4.9 out of 5 stars 53 reviews

Implant Size

Thank you for your question and photos. No, your implants do not look awful. I suspect they would be the "wish pics" of many patients, but if they feel too large to you and you don't like the look or feel of them you should definitely consider an implant exchange. If upper pole fullness is a concern shaped implants may be a good choice for you, but many women achieve natural looking breasts with round implants. The attached link will give you some examples of patient results with smaller implants.

Sarah A. Mess, MD
Columbia Plastic Surgeon
4.7 out of 5 stars 18 reviews

Considering downsizing my breast implants.

I am sorry to hear about your concerns after breast augmentation surgery. 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.   Whether or not the adjustment of the breast implant capsules will be necessary will mainly be dependent on your physical examination; specifically, factors such as the amount of redundant skin, quality of skin elasticity,  and how much you downsize 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” 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 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 breast surgery, specifically downsizing breast augmentation surgery concerns), helps. Best wishes.  

Breast augmentation revision

Hello and thank you for the question and the photos. I would agree that your implants are on the large size, especially for someone 5'1". 

Having said that, they don't look terrible at all. The left does look very slightly larger, but that would need to be compared to your preop pics. That might also be due to the position of the implant lower on your chest. 

When someone says that one breast sits higher, I am concerned that there might be a capsular contracture developing. If it's "hard" or firm, you might have that issue. This would require additional steps to remove the inflammed scar tissue. 

The wish pics you show are reasonable. You don't want to go too small because there might be an issue of loose skin. Something in the 350-375 cc modplus range would be a good choice. . I would however, avoid the nipple incision. Other that using the keller funnel, there's no easy way to do this procedure without causing significant stress on the implant forcing it through such a small incision. The nipple incision has a higher risk of capsular contracture as well. 

You should seek several consultations with board certified plastic surgeons before making any final decisions. 

As always, best to be healthy, no smoking and make sure any health conditions you have are managed by your primary care md. 

Best to you. 

Bennett Yang, MD
Rockville Plastic Surgeon
4.9 out of 5 stars 10 reviews

Breast implant downsizing

Thank you for your question and posting appropriate pix. It does seem you would benefit from downsizing and pocket revision. I like switching to textured silicone gel implants to help with breast retraction. Typically recommended at least a 100cc reduction per side. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 84 reviews

Implant exchange

If you are unhappy with the overall size, then you might want to downsize a bit.  The post-op recovery is often easier than after the first one.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Breast implant revision

Thank you for your question.  If you are not happy with your breasts and your BA did not meet your goals or expectations, you may certainly consider revision surgery.  As an option, you can exchange your implants to a smaller size and have a pocket revision to improve symmetry.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck! 

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 14 reviews

Downsize Implants

If you feel your implants are too large and you are covering them up, then you should downsize. It might be wise to remove the implants and allow the pocket to decrease in size. A second stage and a new plane could then be used for new smaller implants. If you do not like the upper pole fullness, consider anatomical shaped implants. 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.