I Feel Like my 450cc Implants Are Too Large (D Cup). What are the Risks of Going Smaller?

I had my breast augmentation 3 years ago and was VERY specific that I did not want to be too large (I am 5'5" and 115). The implant size I chose prior to surgery was 350cc smooth round high profile, but when the surgery was complete the final fill was 420cc. That puts me in a 34D or 32DD cup! I have had no complications, and the surgeon did a beautiful job, but I still have feelings that they are too large, and would much prefer to be in a medium C cup. What are the risks of going smaller?

Doctor Answers 13

Decreasing Size of Implants

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The right size is very important to your self image. It is reasonable for you to consider adjusting the size of your implants.

You would see less upper pole fullness and perhaps a little relaxation of the breast skin

Denver Plastic Surgeon
4.7 out of 5 stars 45 reviews

Sagging is a concern

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Aside from the surgical risks, your breast contour may be affected by sagging if you go smaller. This may make a lift necessary.

Decreasing implant size

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It sounds like you are thinking of going down about 100cc or so in size and, in my experience, the size adjustment is generally well tolerated unless you already have some pronounced droop to your breast with a low nipple position or your skin/tissue quality is poor and not elastic.  Some adjustment may need to be made to the scar capsule pocket around your breast implants, but, most of the time, the capsules accomodate unless the downsize is considerable.  Your surgeon can always make the size adjustment and reevaluate any need for breast lift down the road if it is not immediately clear that you need one. 

Decreasing volume

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If you go into surgery and decide to get a smaller implant, you may need a lift.  This will leave more scars on your breast.

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

Removing or downsizing implants will not necessarily cause breast ptosis (sagging or droopy)

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There are relatively few addtional risks to going smaller and I have been generally impressed with the degree of skin contraction following implant removal. Although a lift may be necessary, I would first try implant removal and replacement with good supportive garments after surgery, followed by 6-9 months of observation.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

As long as your goal is changing the size of your breasts, rather than the shape,

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your chances of success with another operation to reduce the size of your implants are very good.  Communicating with your surgeon before surgery is critical, as your situation illustrates.  You should be as specific as you can with your surgeon about your goals and wishes before electing to proceed with exchanging your implants for smaller ones.  That being said, after only three years, you should be able to decrease the size of your implants and keep the shape you like...

Michael H. Rosenberg, MD
Mount Kisco Plastic Surgeon

Breast augmentation sizes

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The risks of using a smaller size are insignificant.  The one that comes to mind is droopiness.  With large reductions in size (massive weight loss, post partum state, large reductions in implant size), breasts may become more ptotic (droopy).  An experienced plastic surgeon will be able to predict this prior to downsizing.  Implant sizing is difficult and is unique to each individual.  Remember that implants are not permanent.  The smaller ones tend to last longer and are associated with fewer complications.  

Good luck! 

Jason Hess, MD
San Diego Plastic Surgeon

Breast implants and the risks of going smaller

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There are no risks to going smaller other than the normal risks of surgery.  It should be a very simple matter of making a small incision and removing one implant and exchanging it for a smaller one.  You are very small and would need no more than a 300 or 350 cc implant.  Your skin should shrink down to fit the new implant.  

Gary H. Manchester, MD (retired)
San Diego Plastic Surgeon

Cup sizes are not predictable

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You can't predict cup size by implant volume so how much smaller would it need to be to make you happy?  If your result was a "beautiful job" I'd advise leaving it alone.  There are risks of revisions, possibly infection which would require removing the infected implant!!  Your skin might be a little droopy too.  Sounds like you should continue to try to adjust to the size you have.

Risks and Pitfalls of "Going Smaller" AFTER Breast Augmentation

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It is very hard to scientifically and accurately predict a woman's future cup size after augmentation based on her cup desire or the size of implant chosen and your case illustrates this fact. Once "too large", deciding to "go smaller" involves taking on the small and potential risks of another operation (bleeding, infection, anesthesia complications etc) as well as issues specific to breast implant exchange surgery (need to change the size of the implant pocket, potential need to lift a somewhat deflated breast and dealing with breast asymmetries). You should discuss your options with your surgeon. Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

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.