Would exchanging 450 CC saline implants to 405 CC gel implants deliver a noticeable difference in size?

Dear Terrific509044,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You should know that we have no idea about cup sizes; it's impossible to predict and any formulas you may come across are completely made up. Your proposed size change from 450 to 405 is a 10% reduction in volume, and will likely be unnoticeable. This is especially the going from a lower to higher projecting device. As an aside, why would your surgeon recommend a profile change? Is she concerned you may sag? You should keep the current profile and drop at least 15 to 20% in volume to see a small change. It is true that swapping saline for silicone can lead to the appearance of a smaller device even when the volumes are the same, modern highly cohesive implants with more optimal fill will not have that same effect.

Many patients present to our clinic wanting to revise a previous surgeon's implant result. In general, however, a change of 45cc will be difficult for the patient or surgeon to appreciate once swelling resolves. Some patients benefit from seeing this result for themselves using 3D imaging technology such as the VectraXT. You may find you are looking for a different plan.
Best wishes,
-Dr Hoy

I would suggest going down to 300-350 cc's, since about 150 cc's is an increase/decrease in cup size in the average bra. Only going down 45 cc's will still keep you in the same bra most likely.

Reducing an implant by 50cc's is a noticeable difference. Dropping a full size may require at least a 75cc-100cc reduction (depending on the size of the implant presently in place).
Saline implants appear 30-50cc's larger than the same sized silicone implant.
So, yes...going from a 450cc saline implant down to a 405 silicone should be a noticeable difference.

Generally you need to go down at least 75-100 to notice a change, but going smaller will rarely add upper pole fullness. Best to really check these expectations again with your surgeon.