What to expect when swapping out textured anatomical implants?

I am curious to hear various doctors opinions about what one could expect when swapping out a textured anatomical implant for the same implant that's a third smaller. A 305cc TM+ for a 205cc TM+. Is it hard to extract a textured implant as I'm assuming it's texture sticks to the capsule. Do I have a greater risk of rotation, CC or nipple sensitivity? Anything you can think of I would love to hear as I need to weigh out the options due to this decision I am considering solely for work purposes.

Doctor Answers 6


Thank you for your question and a new pocket will need to be created for the smaller implant in order to avoid a rotational deformity.  So be sure to see an expert in your area with lots of experience creating a neopocket

Dr Corbin

Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews

Capsular contracture breast implants textured implants implant exchange

Technically, it is not that difficult to remove a textured implant. It is much more difficult to remove an implant that has ruptured. Therefore, textured anatomic breast implant exchange is relatively straightforward. 
There is no significant increase of capsular contracture. There is no significant increase of nipple sensitivity. There is, however, an increase for a rotational deformity when one breast  implant is exchanged for a smaller breast implant. This is due to the original implant pocket size. If you are changing breast implants to a smaller size, the pocket must be reduced also. This is achieved by placing sutures along the lateral (side next to your arm) aspect of the breast implant pocket. If there is any excess breast skin, a mastopexy should also be preformed. This two manuevers minize anatomic breast implant rotation.
Good luck.
If you have any questions, please contact me. 
Dr. Katzen

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 196 reviews

Downsizing implants

I understand and appreciate why you wish to decrease the size of your implants. Removing a textured implant is not difficult at all. There is always a risk of capsular contracture anytime an implant or implant pocket is touched or manipulated although this risk is quite low with a textured implant in the submuscular position. Your nipple sensitivity should not change. 
If you are going to downsize your implant size 30% I would recommend you switch to a round implant. After downsizing, the risk of implant rotation is significant as your pocket may be too loose to hold the shaped implant in proper position and may require internal pocket suturing.  Obviously, a physical examination is critical in determining your risk for this problem.
The good thing about simply downsizing your implants is it can be done under minimal sedation with a virtually painless recovery. I hope this information helps!
Thomas Taylor, MD, FACS
Pasadena, CA

Thomas S. Taylor, MD, FACS
Pasadena Plastic Surgeon
5.0 out of 5 stars 10 reviews


Not a good idea. Leave the driving to us. Patients should not be involved in implant selection because they do not know all the indications. Never go smaller with a shaped implant. It will move and shift. Ask you surgeon. 

Jay H. Ross, MD, FACS
Palm Harbor Plastic Surgeon
4.6 out of 5 stars 31 reviews

Implant Exchange

Hi it is difficult to answer you precisely without examining you or  without  seeing any photographs nevertheless there are some general principles which apply.

Please consult with a board certified plastic surgeon to give you the best outcome.

If you are having a reduction in the size of your implant then you may require a breast lift.

I am assuming you are referring to a textured silicone gel filled implant.

Textured silicone shell Implants are not difficult to remove, there usually is some adherence of the capsule  but not tissue ingrowth.

If they are polyurethane coated then his outer shell does have considerable tissue ingrowth and this  generally is not excised and forms part of the new  capsule.

It is important  for your surgeon to consider  modifying  the capsule to the size of the new implant. This is achieved with internal stitches.If this is not done there is an added risk of implant rotation or displacement.

Your surgeon will also consider whether it is necessary to change the pocket of your implant ( either in front  or behind the muscle) and whether the capsule should be excised. This why you seek a consultation with a board certified plastic surgeon.

CC should not be a problem just because you have an implant exchange. It is more likely following complications such as infection or bleeding.

If the same incision is used then it is unlikely nipple sensitivity will be affected.

Good luck with your decision

Peter Laniewski, MBBS, FRACS
Sydney Plastic Surgeon
4.3 out of 5 stars 8 reviews

Swapping Anatomical Implants to Smaller


Textured implants do stick to their capsule, but are easily freed with the sweep of a finger, leaving the intact, albeit irregularly surfaced capsule intact. 

In preparation for the new implant that is a 1.5 cm shorter and narrower, it is important to modify the limits of the capsule along it's lateral and inferior border so that it properly supports the new implant in the same was as the old one: snug.

This modification is accomplished by sewing the unwanted regions of the capsule closed using permanent suture material. Some surgeons cauterize those areas first to encourage contraction and coaptation of the surfaces.  Additionally, two rows of sutures can be used to support the closure.  This technique is known as 'capsulorrhaphy'.

Done by a surgeon who is experienced with these techniques, you shouldn't have any problems.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 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.