I want to downsize from 400c implants to 300cc/325cc. Will this be a big enough change for me to go do surgery again? (Photo)

Question

I am 5’9” 130lbs, and I recently got a BA (starting 34a to 34DD) they put in 405cc implants which I’m devastated about. I wanted to be a full B, small C at biggest, I went into surgery wanting 300cc. I absolutely hate my boobs now but am paranoid when I leave surgery again I will still not be happy. I want to make sure I’m having the right size put in

Nathan Eberle, MD, DDS, FACS · Answer

swap out current implants for implants 75-100cc smaller, may have to change profile/style of implant at same time FYI

Christopher J. Morea, MD · Answer

Thank you for your question and providing photos. It appears that you have a very nice result and your breasts do not look to big for your frame. I understand you want to be smaller. This can easily be done without significant down time. You should see a decent reduction going to 300cc's. I always recommend you go at least 100cc's smaller to see a difference. This will most likely require changing the profile of your implant as the width is very important. Best of luck

Shlomo Widder, MD · Answer

Dear Floridian,   Thanks for posting your before and after pictures. From observing your before picture, your breasts appear to be small A cup size. 300 cc implants will bring you to 34 full B cup size. For 34 small C cup size , you will need implants with volume of 340 cc.    Your post operative picture appears to be 34 full C cup size, which is very attractive and natural looking, however, this is a very personal preference . If smaller size will make you comfortable and happy, than , there is nothing wrong with getting a smaller size implant.    Discuss it with your surgeon, though, I hope that the communication issue was not his fault, because if it was, you might want to consider consulting with other experienced board certified plastic surgeons.                    Best of luck,                                     Dr Widder

Daniel Barrett, MD · Answer

Dear 1237188,I understand your concern and it is quite normal to be concerned about the outcome following a breast augmentation surgery. However, you might still be in the very early stages of the healing process.Your will need to be patient at this moment and follow what your surgeon has instructed you to do post operatively.At the early stage of the healing process, the tissues around the implants are still swollen. Once the swelling subsides and the implants drop to their final position, you will be able to see the final result of your breast augmentation surgery.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

At
size 34, each 100 cc of implant corresponds to 1 cup size change.  To decrease from 400 cc to 300 cc will only
take you down 1 size to a D.  You will
need at least 200 cc to go to a C.  Also,
your breasts are pointing outward and you may benefit from a modified Benelli
lift.  Using a circumareola approach,
your breast tissue is reshaped, elevated higher on the chest wall and more
medial to increase your cleavage.  Through
the same incision, the implants can be exchanged for small ones.Best Wishes,Gary Horndeski, M.D.

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. Sorry to hear that you are not happy with the outcome. I do not know how long ago your surgery was, but if it was less than 3 months ago, I would encourage you to be patient and not do anything drastic right now! Early after surgery, implants can ride very high and be swollen and most patients who initially are concerned about the implants being too large are usually very happy (or even wish they would have gone larger) once they wait 3-6 months for the swelling to go away and for everything to settle. That being said, if at 3-6 months, you are still unhappy with the size, changing to a smaller implant is a relatively straightforward procedure. I think that you should work to communicate openly and honestly with your plastic surgeon. It always worries me when I hear patients say something like "they put in 405 cc implants." In my practice, we take a significant amount of time with patients evaluating their goals and reviewing different types and sizes of implants. I also use 3D modeling to help patients get a better idea of what a possible outcome will be. By the time we go to surgery, the patient has chosen the implant THEY want (with my guidance) and are comfortable with that decision....no surprises. If you said that going into surgery you were "wanting 300cc" and that is not what you got, then you and your surgeon did not do a good job of communicating! Make sure you fix that problem going forward before you do anything else. And please please make sure you are seeing a plastic surgeon who is board certified by the American Board of Plastic Surgery.Hope this helps!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Thomas Trevisani, MD · Answer

This situation is unfortunate and can be avoided. In our Practice we review the implant size and have the patient sign an additional consent indicating agreement on the implant size. This is done only after extensive sizing process, which is unique to every Practice. Exchanging implants- is a surgical procedure and depending upon when it is performed you may need pocket adjustment which in my opinion- is best done under General Anesthesia, because it's safer and offers the Surgeon your guaranteed comfort and his/her ability to deliver the best service.

Tom J. Pousti, MD · Answer

Given your concerns/goals, you seem to have a reasonable plan. 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.  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.
 The 100 cc you are considering downsizing will likely make a "noticeable difference"; what cannot be determined online is whether it will be the exact difference necessary to achieve an outcome that you will be pleased with.
My best advice: more communication.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 "full B, small C 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 helps. Best wishes.

Jason Pozner, MD · Answer

Based on your photos, 100cc less should get you the size you are looking for. Should be an easy surgery with quick recovery.

M. Jude LaBarbera, MD · Answer

I'm sorry to hear you are unhappy with your implant size and results.  You didn't mention how long it has been since your surgery.  If it hasn't been at least 6 months, I would recommend holding off on any revision surgery for now.  There are many changes that go on during those first months, and the final result can be quite different than things look after the first month for example (the skin and muscle relax and stretch out, the whole look of things appears softer, and the patient gets used to them when initially they can feel so big).  If you are truly unhappy with things after 6 months or so, I think decreasing size down to 300cc or so would be appropriate given your stated goal size.  Please keep in mind, pictures are no substitute for an in-person physical exam.  Best of luck to you moving forward.

I want to downsize from 400c implants to 300cc/325cc. Will this be a big enough change for me to go do surgery again? (Photo)

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