I Have 450ccs High Profile Under Muscle & Want to Downsize?

I've seen 2docs & both say I can downsize from 450ccs to 300ccs without needing a lift. I have 3 babies, I'm 28yrs old & weigh 130lbs. 5'7" tall. I wish to downsize cause 450ccs puts me at wearing a 34DD & I wish to be at a 34C. 1doc said he wasn't sure if he'd recommend the high or moderate plus profile due to width being small on high pro & he suggests I go down to 280ccs. Does pocket need to be "fixed" altered when downsizing? Will I really not need lift & acheive my goal of a smaller look?

Doctor Answers 11

I Have 450ccs High Profile Under Muscle & Want to Downsize?

Whether you would need a lift or any pocket revision depends on your anatomy...your current pocket size, your skin "envelope" and its tone and elasticity, etc. Answering your question would be difficult without a careful examination.  Just in terms of Mentor implants, for example, your 450cc High Profile implants are the same width (12.8 cm) as the 375cc Moderate Plus implants and the 300cc Moderate Classic implants.  And some small decrease in width may be acceptable as well without having to "close down" your pockets.  How well your skin may "spring back" after a significant volume decrease depends on your skin tone, and even with examination this may still represent an educated guess.  You could always change to a smaller implant, give your skin plenty of time to redrape, and only proceed to a lift later if it was needed.  If your skin is already pretty stretched out (and was very deflated prior to your augmentation), you may already have the answer and could proceed to a lift at the time of implant exchange.

Seattle Plastic Surgeon
4.9 out of 5 stars 87 reviews

Concerns about Downsizing of Breast Implants and Capsulorrhaphy or Breast Lifting?

Thank you for the question.

Unfortunately, without direct examination and a full communication of your goals it is not possible to give you precise advice. I think your best bet is to carefully select a board-certified plastic surgeon who can demonstrate significant experience helping patients achieve their goals with revision breast surgery. Communicate your goals (and any concerns such as breast implant movement/displacement) clearly with your plastic surgeon in person.  Any other concerns such as “sagging” or position of the nipple/areola complexes should also be addressed.

This communication will be critical in determining which operation and 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 “34C” 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.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,502 reviews

Breast Revision with Smaller Implants

It is certainly feasible to #downsize to smaller implants and also alter the positioning; if possible. However, decreasing is size may also require a Breast #Lift to to #tighten loose skin, better optimize the end result. Any #revision has risks of unhappy outcome or other complications. Also, the right implant for the revision is contingent on shape of body and your desired outcome.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Downsizing implants, what are the pros and cons?

There are several problems that can occur when you downsize implants.  It is possible that you may need a lift or a revision of the implant pocket.  The decision of between the two depends upon a physical examination and an understanding of the diameter of your existing implant and the replacement implant.   

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Downsizing of Breast Implants?

I think it’s a good question but a difficult one to answer without clinical examination and a full communication of your goals. However depending upon the quality of skin and the current location of NAC it may be possible to give you smaller breast without lift by closing some parts of your implant cavity. Which parts should be closed depends upon where exactly the new implant should be placed. These are only the guideline that I would follow if I had a situation like this.

Ashok Govila, FRCS, MCh, MS
Dubai Plastic Surgeon
4.7 out of 5 stars 88 reviews

Downsizing to a smaller implant

It is difficult without seeing your breasts to make a surgical plan.  Whether or not you need a lift is greatly determined by the quality of your skin and the thickness of your breast tissue.  For example,  women with stretch marks across their breasts will not have a lot of skin contraction when moving to a smaller implant because of the existing damage.  It truly depends on where you are starting out.  I would recommend discussing your concerns with your PS.  I hope this helps you. 

Neil J. Zemmel, MD, FACS
Richmond Plastic Surgeon
5.0 out of 5 stars 107 reviews

Downsizing breast implants

I am rather surprised and disappointed in the responses I see posted at this point. This issue really has nothing to do with tissue tone and everything to do with how implants behave like a foot in a shoe. 

Implants do not lift the breast and removing volume or removing them does not make them sag. Properly fitted implants do not stretch or distort the breast and removing them, like removing a pillow from behind your head, does not require tissue or skin "recovery" or a lift if you didn't need one before. 

An implant is sized by the width to fit the width of your breast. For round implants this also determines the height of the implant. The only proper choice is the forward profile ranging from low to medium to high (for the same width). Your tissues will accommodate this forward volume within the range if the diameter fits the width of your breast. If you want to reduce the volume of an existing implant you can drop from a high to a medium or low profile but not more than that. The width has to remain the same or very similar as the pocket size (and the width of your breast) is not going to reliably shrink. Only the forward tissues allow for this. "Fixing" the pocket dimension is not only difficult and expensive but the implant will still not fit the breast if it is too narrow for the width of the breast. 

You (or the surgeon) can't just "pick a size" and make it work putting an implant in and you can't do it when you go to reduce the size of the implant. The implant has to be sized properly to fit and look right and there are only three choices of forward profile in gel-filled implants (four in saline-filled). Find out what profile you have now and the width of the current implant. See what your profile options are for downsizing while keeping the same diameter implant. That will tell you what your size/volume options are in cc's. 



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

Downsizing implants

 Just like adding implants minimally alters the shape, just the fullness, downsizing also usually not not affect the shape though by going to medium profile it would be less full at top of breast.

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.4 out of 5 stars 27 reviews

Downsizing implants

Downsizing is possible without requiring a lift in some cases. Often, the capsule has to be adjusted for a smaller implant.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Concerns about down-sizing with Breast Implants - do I need a lift?

Thank you for your very important question.  It is always possible to reduce your implant volume.  What's important is to assess your breast tissue and skin - elasticity, excess.  You would need to have your Plastic Surgeon examine you carefully, take measurements and work out what would be best implant volume and projection to achieve your desired size.  Then assess your skin to determine if you will need some adjustment to give the optimum result.  Hope that this is helpful and good luck.

Christopher J. Inglefield, MBBS, FRCS(Plast)
London Plastic Surgeon
4.8 out of 5 stars 20 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.