What to expect? Downsizing after 3 years. 285 UHP to 200-220 MP. Sebbin. Sub-muscular. No lift for me. 32y/o no kids (Photo)

I'm very short and I always thought these are a little too big for me. I'd be keeping the width of the implant or making it slightly wider (only 0.5 cm). As for the projection, I'd be losing 1.5 or 1.6 cm. I'm scared of the nipple being too low afterwards. In a way, it is convenient that my old surgeon chose UHP: being so narrow, now the pocket doesn't need any reworking to accommodate a smaller implant. It would be a simple swap. Should I choose the bigger 220cc to compensate for projection?

Doctor Answers 12

Changing implant size

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No one can answer your question specifically based on Internet pictures but in general downsizing projection in same width implants will lower nipple height.  The difference between a 200 cc implant and 220 cc implant height is negligible

No one can provide a 100% accurate prediction but my advice is 200.

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Take this advice with a grain of salt. If you are truly unhappy with the size/volume, your choice to go through a surgery for only a 65 cc difference is a lot of effort for a subtle difference. If you truly want a difference choose the smaller size. In my experience, I believe your skin envelope should contract nicely. You will no doubtedly be left with more ptosis (sag) than you currently have but I do not believe it will be any worse than your non-implant appearance.
I must inquire about your weight. Has your weight increased from the pre-operative status? I appears so in the photographs. Small differences in weight can produce significant differences in breast size. I only ask this because, you may not see the degree of decreased volume that you anticipate. Your true breast tissue may be even more than when you started. To place this in context, if you decrease your implants down to the 220 cc size, you are only decreasing your volume by just over 4 Tablespoons (4.3 to be exact) or about a 1/4 of an 8 oz cup. Place that in a glass to understand what this means.
The difference between a 220 cc implant and a 200 cc implant is a Tablespoon plus a Teaspoon.     

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

Change to smaller implant

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Pictures are not great indicators of elasticity and the ability of the skin to shrink to the new implant size.  That said, as far as I can tell you should do fine.  The nipple may be a couple of mm's lower but not significant enough for a lift to be indicated.  

Your current implant is 10 cm wide by 4.6 cm projection, you are looking at a style 40 Natrelle that is 10.2-10.5 by 3.5-3.6 cm projection so there is no significant difference in projection.   I like the expansion of the breast base that the wider implant diameter would give you a little more so I would give a slight nod to 220 cc.   If you like a little more roundness you may consider Inspira 210 cc moderate profile which has the same dimension but a higher fill ratio to add more fullness to the top. 

York Jay Yates, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 189 reviews

Breast Implant Downsizing

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When downsizing there are many considerations, and a physical examination is an important part of trying to predict the future. No matter what the experts are predicting, your result will be your results. 

From what you are describing, your breast implants are a good diameter, so reducing projection is the best way to down size. This has the best chance of preserving your shape while reducing the size of your breasts. Reduced volume also means reduced support, so the results are dependent on the amount of reduction, the elasticity of your skin and the amount of breast tissue that remains. The amount of breast tissue is likely smaller than it was three years ago.

Do not drive yourself crazy about 20 cc's. You will be unlikely to see the difference between 200 and 220. Pick whichever size makes your brain happy, because your breast are unlikely to show the difference.

So, without an exam, the plan sounds reasonable. If you are looking for confirmation, you will need to see another plastic surgeon, in person, to go through the details.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 17 reviews


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I agree that you have a very nice result, but beauty is in the eye of the beholder. If you are wanting to go smaller with less projection, I would caution you that 65-85cc downsizing won't reduce your breasts much, maybe a half cup size so you would be a very full C cup. If that is what you are looking for, then I think that you would be happy. But if you want to go smaller, you may want to consider something in the 175cc range. As long as the diameter of the implant is close to what you currently have, no pocket work should be necessary and you should not need a lift. Your nipple position should stay the same. Since you are considering getting pregnant in the next year, you could even consider saline implants, that way if your breasts grow considerably during pregnancy or breast feeding, you could simply have them punctured to allow them to deflate. Of course that would destroy the implants & render them unusable, but could save you from getting excessive stretch marks & loss of skin elasticity from enlargement during pregnancy. You would then need to re do your breasts after childbearing. Good luck with your decision!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 109 reviews

Downsizing of Breast Implants

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Thank you for the question and the photographs indecisa83. While pictures cannot take the place of an in-person examination, your breasts appear elastic and therefore should be able to adapt to the new smaller implant without a noticeable change in nipple position and so a mastopexy (breast lift) should not be needed. I would agree that the pocket will not require to be "reworked" to accommodate the smaller implant, as the base width will remain in essence unchanged. I would recommend to go for the 200 cc implant if this is what you desire. The difference between a 200 and a 220 cc implant is negligible. I hope this helps. Best wishes.

Revising Breast Implant

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This is a modest change in size..  200-220  is a minimal difference.  only a tablespoon 
the nipple position should remain good and I believe your tissue should shrink. I would wear a tight bra post op. The smaller size should suit you better.  
Talk to your doctor about capsule adjustments, issues of skin laxity and wrinkling

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews


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Hello C,

Thank you for your invitation.  Your photos are quite helpful. Reading your text I think you have a good understanding of the concepts.  Although I don't have the results of a physical exam to confirm, I think your breast tissue is quite elastic, and will contract down to the smaller implant. I do not believe a lift is necessary.

You are correct, because of the base width being roughly the same, a capsulorrhaphy is not necessary and a quick swap out would be fine. My recommendation is to get as close to 200 cc as possible to achieve a reduction that you feel was worthwhile.

Additionally, you should consider form stable implants to achieve a long term good result that looks natural.  I am aware of the fact that most surgeons shy away from them, and the vast majority of them would shudder to exchange a smooth round implant with a form stable textured implant for fear of rotation.  Those of us who do these exchanges will tell you that proper pocket management (capsulorrhaphy) will keep the implants in place. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

What to expect? Downsizing after 3 years. 285 UHP to 200-220 MP. Sebbin. Sub-muscular. No lift for me. 32y/o no kids

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Bonjour Christine. En general c'est la taille des implants qui est  le plus important pour la patiente apres une augmentation mammaire. Il ne faudrait pas compliquer excessivement les choses avec d'autres considerations telles que le profil et les autres dimensions. Meme si vos mammelons sont legerement plus bas avec des implants moins projettants, c'est plutot la taille des seins qui va vous interesser en postop. Il est evidemment plus difficile de choisir une taille quand il s'agit d'une diminution, plus facile de choisir quand on veut augmenter (dans ce cas il faut simplement rajouter des 'sizers' a ce qui existe deja). En general, quand la patiente veut reduire et voir une vraie difference, il faut reduire d'au moins un tiers. Dans votre cas on arrive a 190cc. J'espere que ce ces propos vous ont ete utiles. Meilleurs voeux.

Downsizing Breast Implants

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In general nipple and areola position does not really change after down sizing.  Now that is not exactly true either.  If there is a significant decrease in projection there may be a small change in the location of the NAC.

Judging by the photos, you are considering a significant change in projection so the way the breast sits will change, meaning you may have a slight bit of more settling of your breast on the chest/crease.

Another option that I may consider would be to go to an HP implant instead of going down to MP.  It really depends on how much smaller you want to be.

You do have a very nice result right now, so err on the side of caution.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 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.