Is it possible to keep current implants in and have a breast reduction?

Question

Breast have gotten bigger over the years and I already have an implant is it possible to keep implant in and have breast reduction?

James N. Romanelli, MD, FACS · Answer

Dear SpongeBob

Great question!  In a word, yes.

This is a very common scenario in my practice.  There are a number of considerations to keep in mind.

1). What type of implants, how long have they been in place, sub muscular or not, and how well are they positioned.  If the implants are older it might  be advisable to replace them at the time of the reduction.
2). How much smaller is desired, correlated with how much breast tissue can be removed.

It is common to remove and replace implants and simultaneously perform a breast reduction.

Some women option to remove implants and lift breasts, sometimes adding fat, in order for all breast volume to be natural.  But, and this is a big "but," implants will provide more fullness on the upper half of the breast.

The link below demonstrates a breast revision surgery that included a small reduction on the left.

Best of Luck,
Dr. Jim Romanelli

Emre Guvercin, MD, FEBOPRAS · Answer

Yes, it is absolutely possible in many cases to keep your current implants and still perform a breast reduction &mdash; but it must be done with the right technique and for the right reason.This situation is actually a classic indication for a Push-Up Lift–style reduction.How breasts get “too big” with implantsOver time, breasts can enlarge due to:Weight changesHormonal factorsPregnancySkin and tissue stretchIn these cases, the excess volume is usually your own breast tissue, not the implant itself.How reduction works without removing the implantWith a Push-Up Lift (parenchymal reshaping mastopexy), the surgeon can:Remove excess native breast tissue (the part that’s grown)Reshape and redistribute the remaining tissue upwardLift and support the breast internallyPreserve the implant in its current pocketThis allows:A smaller, lighter breastBetter shape and upper-pole balanceRelief from heavinessNo need to downsize or remove the implant if you still like the implant volumeWhen this is a good optionKeeping the implant is often reasonable if:You like the implant size and feelThe implant itself is well positioned and healthyThe “too big” feeling comes from added breast tissue, not the implantIf the implant is too large or poorly positioned, then an exchange may be discussed &mdash; but it’s not automatic.Important caveatThis is not a simple reduction and should be done by a surgeon experienced in:-Secondary breast surgery-Implant-preserving reductions-Internal support techniquesDone incorrectly, removing tissue without proper reshaping can destabilize the implant.

Daniel Barrett, MD · Answer

Dear Spongebob7488,

it is hard to tell for sure without an examination. Generally speaking, it is possible to reduce breasts and to keep the implants if they are not old. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Cihan Sahin, MD · Answer

Yes it is possible. But we should know the surgical technique for previous surgery. Or you should sent your pictures.

Jacob Carlson, MD · Answer

There are a few factors to consider with respect to your question. It is technically possible to do a breast lift or breast reduction when a patient has implants in place.
One thing to consider is the length of time your current implants have been in place. Implants are not meant to be lifelong devices, so assuming you are a young, healthy individual, you will have to do something with the current implants at some point in your lifetime (e.g. replace them, remove them). If your implants have been in place for more than a few years, it might be worth considering exchanging them for new implants (which can be a different size that what you currently have). That could potentially save you from another operation down the line; or at least extended the period for when another surgery is needed.
Another consideration would be your personal history with respect to previous pregnancy, as well as future plans for pregnancy and breastfeeding. Obviously pregnancy and breastfeeding result in changes to the breast, so if you are planning on these events happening in the future, you might consider deferring a breast lift/reduction until after those events have concluded.
The other thing I would want to know for a patient presenting with this question is the location of the current implants. If your implants are on top of the muscle, a lift/reduction may be possible but it would be more difficult in that situation than if the implants are underneath the muscle.

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