Downsizing Breast Implants, Concerned about Potential Sagging, What are my Options?

I had a breast augmentation a year ago (1st December 2010) I am now 19 and I've never been happy with the size, I always wanted natural medium sized breasts 30d/c but have a very small frame, I was recommended 280cc high profile implants which I find to big 30E/F I was wondering if it would be a possibility to downsize to maybe 200cc implants and if this would have any risks of sagging since it has been a year, or if the pocket created would fill with scar tissue or what? options? risks?

Doctor Answers 5

Downsizing Implants - Potential for Sagging

Since you are young and your implants have not been in for a long time, your skin has greater potential to retract if you want to downsize your implants. Also, you may not need a "high profile" implant if you have saline implants as they can be overprojecting depending on manufacturer. If you do have saline implants, you can consider having them pre-deflated. This will give you skin a chance to retract for 3-6 months before having your implants replaced. 

Kirkland Plastic Surgeon
4.8 out of 5 stars 53 reviews

Downsizing breast implants

Breast implants are pillows. Properly sized and positioned breast implants do not distort the breast and they do not lift the breast. Removing them will not make them sag and they should return to the size and shape they would have been if the implants were not there. At one year I would expect them to look like your preoperative pictures if you removed the implants entirely. 

Downsizing implants is similar to the choices for putting them in. The width of the implant should match the width of the breast and you don't want to put in implants that are too wide or too narrow for the breast base width. If the implants are already in you cannot scale the width of the implant down reliably as it will be too narrow for the breast and too small for the pocket which will not reliably shrink down. In putting implants in the forward projection of implants can be varied from low to medium to high profile and the tissues will accommodate this. The same happens in reverse, so if you have a high profile implant now you can scale it back to a medium profile (not called that in gels) or even a low profile (not called that in gels) without any problem as long as you keep the width of the implant about the same. This corresponds to dropping about a half cup size to medium and one cup size to low profile from a high profile implant. Sagging or true change in tissue tone should not occur. 

Scott L. Replogle, MD
Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

Difficult to know


The possibility of going without a lift is present but it will be difficult for you to really know without a face to face consultation and examination.


Best Regards,


John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 27 reviews

Young skin

You are blessed with the advantages of youth, so it is likely that your skin will snap back into shape once the implants are removed. The absolute safest thing would be to remove the implants and wait a few months before having the next set put in. I understand that this involves two operations, more expense and a period of time with smaller breasts but this will yield the most predictable results. However, with a properly experienced and certified plastic surgeon I think that, with one operation swapping out your implants, it is very likely that a lower profile implant of similar width would sit very nicely without the need for an uplift. Discuss the options with your plastic surgeon and best of luck

Breast Implant Exchange for Smaller Implants

Thank you for your question. Given your age, your skin will most likely spring back to its earlier condition without sagging. The pocket  may need to be adjusted  to fit the smaller implant. You may find that a more moderate profile fits your expectations. Make an appointment with a Board Certified Plastic Surgeon in your area to be evaluated in person. They can help you decided what your best next step will be. Best of luck.

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 116 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.