Extra Skin After Downsizing Breast Implants?

Question

Will I have extra skin if I downsize my implants from a 380cc to a 300cc? I have had 360cc implants filled to 380cc for 8 years. Over time, I feel they are too far apart and too big. I have a surgery this month to fix the pockets and bring them closer together. However, I'm also thinking about downsizing to a 300cc implant filled maybe to 325cc. I just want to be slightly smaller but I'm afraid I will have extra skin or tissue, will this happen? Can I downsize this same implant?

Raffy Karamanoukian, MD, FACS · Answer

Reducing the size of your breast implants may make the excess skin around your breast more evident.  You may consider a breast lift with skin tailoring.

Kevin Brenner, MD, FACS · Answer

Downsizing your breast implants can cause breast laxity. Ultimately, it all depends upon the amount of integrity that you have in your breast tissue and overlying skin. For patients that wish to have their saline implants downsized, it is possible to do so as long as you maintain at least the minimal fill volume requirement for that particular implant.

Farbod Esmailian, MD · Answer

Difficult question to answer as I dont have any pictures to go by. However, you are having what sounds like a capsulorrhaphy to tighten the pocket which will help bring the implants more medial to give better cleavage.

	I would have to see some pictures to really be able to tell, but it really depends on how much loose skin you have right now as well and where your nipple and areola position is.

	Hope that helps.

Tom J. Pousti, MD · Answer

Unfortunately, it is not possible to did you precise advice without direct examination.

	What your breasts will look like after downsizing of breast implants will depend on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back),  the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation). 

	Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will  potentially influence the factors discussed above. If you take these factors into consideration and apply them  to your specific circumstances you may get a good idea of what to expect after the implants are removed.

	Again, consulting with a well experienced board-certified plastic surgeon in person may be helpful.

	Best wishes.

Pat Pazmino, MD, FACS · Answer

It is possible that you may have extra skin after exchanging your current breast implants with a smaller set. For this reason, it is important to discuss your concerns with a board-certified plastic surgeon who is very experienced in breast implants and breast lift surgery. During your consultation, the plastic surgeon will evaluate the quality of your skin and may be able to tell you if they feel that the skin will retract enough so that the smaller implant will not create sagging. If your surgeon believes that the skin will not contract sufficiently, they will typically recommend a small breast lift at the same time. Some patients are reluctant to receive a breast lift because of the additional scarring. If you choose not to receive a breast lift, keep in mind that after the healing process you may be dissatisfied if there is indeed extra skin and dripping of the breast and this will require a breast lift at a later date.

Steven Wallach, MD · Answer

It is diffiult to say what the breasts will look like after you have a downsizing of your implants. You may very well need a breast lift to compensate for the reduction.

Lavinia K. Chong, MD · Answer

Snicole, about 5 years ago, I noted that the more women started to ask for "pilates or yoga" breasts.  These patients who had elected "plus" size implants and wanted a more athletic frame, without external scars taught me how to choose different style implants and use a technique called "capsulorrhaphy", which originated in the breast reconstruction O.R.  This is a technique where the normal limits of the breast are restored by suturing the tissues down preferably with a permanent suture, thereby redefining the outside and base limits of the breast. 
The technique was assisted by choosing an implant, whose base diameter or foot print was smaller than the older implant but projected (stuck out) more, thereby taking up the slack on the breast skin but not pushing on the capsulorrhaphy repair. 
Some individuals were able to avoid external scars, but if their skin elasticity was poor, some short scar mastopexy was needed to tighten the loose skin. Be explicit with your PS about your expectations and be open to his/her explanation of approach. Good luck.

Michael C. Edwards, MD, FACS · Answer

It may be as simple as an implant exchange or it may require tightening of the interal tissues and last, possily tightening up the breast skin in teh form of a breast lift. Your board-certified plastic surgeon should be able to give you their opinion and advice at your next appointment.
Dr Edwards

Extra Skin After Downsizing Breast Implants?

Answers (8)

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