Breast implant revision needed. Wondering the best option to go forward? (Photo)

I had BA with McGhan Style 68, size 360 saline implants in 1995 above the muscle. Left one ruptured and was replaced in 2001. The right implant ruptured last week. Other than the ruptures (they had a long happy life! lol), I have never had any issues or problems with them. Ideally I would like to go a bit smaller. I would like to be a C cup. Old implants made me a DD. I am 5'2 and weight about 120 lbs and have nursed 5 kids. Having larger breasts have felt matronly the past few years. Advice?

Doctor Answers 10

Going smaller after deflated right implant

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Thank you for your question and photos posted.

Sounds like you had a good run with your previous saline implants. Going smaller is not a problem. All you will likely need is a smaller implant placed on each side. I also recommend coming in to have the left side deflated in the office and allowing the pocket to contract over a few weeks. That way the capsule will have equal time to contract so that a smaller implant is not floating around in a much larger pocket.

I hope this helps.

- Dr. Bryson Richards (Board Certified Las Vegas Plastic Surgeon)

Seek a Board Certified Plastic Surgeon for a BA Revision

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Your procedures should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

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

Going smaller with implants

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Typically, when you go smaller with your implants, you should consider a mini-lift to tighten up your stretched out skin and improve your nipple/areola and breast position; from your photos it is difficult to assess the later. Please see examples below.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 99 reviews

Deflate saline implant before replacement if going smaller

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Consider having the other implant deflated (easy to do in the office), so the skin envelope has a chance to shrink a little bit. It might then be easier to determine which replacement implant will fill what you have in order to avoid having to do a lift. It will depend on several things, especially how much smaller you want to go.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 56 reviews

Revision Breast Augmentation

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Time for silicone gel under the muscle! Go visit a few ABPS certified/ASAPS member surgeons that specialize in revision breast surgery. Best of luck! Instagram: drgeraldminniti

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 97 reviews

Breast implant revision needed. Wondering the best option to go forward?

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Thank you for your question and your photographs.  You appear to have adequate breast tissue and nice anatomic shaping and should do well with placement of a smaller implant.  If the implant chosen is too small than a skin reduction becomes necessary with surgical incisions which I would prefer to avoid for you.  One option would also be to deflate your opposite implant to allow your skin to tighten slightly before undergoing an exchange of implants.  Meet with an ABPS board-certified plastic surgeon to discuss your options and consider changing to a cohesive gel implant to avoid these repeated deflations.  Good luck and best wishes,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews


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This question requires a consultation and examination to provide you with the proper information and advice.  Generally speaking, exchanging for a smaller implant can be done with our without a breast lift depending on your examination, and the degree to which you want to go smaller.

Hope this helps.

Dr. Ali Mosharrafa

Ali Mosharrafa, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 16 reviews

Breast revision options

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Your best option is to meet with a board-certified plastic surgeon who can examine you and go over your options. Implants over the muscle may benefit from being moved to partially below to improve coverage (site change) and you will most likely need a breast lift after your pregnancies. 

I hope this helps

Dr. Edwards

So go smaller

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going smaller is always a personal choice. IF that is your desire, then do it, nothing stopping you from that. You can likely just downsize and not have too much other major surgery, if you have done well with that pocket then putting a new implant back in the same pocket would seem more than reasonable. 

How large do you have to be?

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You could simply have explant and fat grafting if your size does not have to be increased by a lot or you do not need a convex upper pole.  Otherwise downsizing is certainly feasible.  To improve results, I would recommend deflating your left side and allowing the capsules to shrink for a month, especially if your pockets are too large to the side.  Discuss your goals with your surgeon and with the information you've gained from here.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 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.