Breast implant revision, downsizing?

I have two year old UHP 325cc, 11.1 width and 5.1 projection. Would like to downsize to Medium profile 200cc, 11.1 width and 3.3 projection. Does the pocket have too be adjusted by the downsize??

Doctor Answers 6


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Yes, often when placing a smaller implant, you will need to "close the pocket".  

I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with and who is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery.

Best wishes!

Dr. Desai
Harvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon


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Often with downsizing the pocket has to be readjusted.  A capsulorrhaphy or suturing the borders of the pocket is often helpful.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Implant dimensions

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Changing implant dimensions as part of an exchange always requires a flexible approach. Properties of the existing pocket, such as volume, shape, and stretch are difficult to predict until the patient is in the OR, and so it's prudent to be ready to make adjustments to the pocket if necessary.  Furthermore, it may also be a good idea to have more than one implant size available as an option, and use intraoperative sizers to determine the best fit.  This will require a discussion with your plastic surgeon so that there is a clear understanding of your goals, as sticking to an exact implant dimension may limit the ability of your surgeon to deliver the result you want.  In order to get a qualified, expert opinion on your surgical options and expectations visit a plastic surgeon certified by the American Board of Plastic Surgery.

Best of luck,
Keith M. Blechman, MD
New York, NY

Implant exchange

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Downsizing will almost always involve some adjustment of your pocket, as the new implants are smaller and will likely not give you the result you want without some capsule work. 

Implant revision

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You would think similar dimensions should fit exactly, but this is not always the case. During the surgery, any adjustments would be made for best results.

An exam and consultation with a/your plastic surgeon is recommended to discuss your options and expectations.

Breast implant revision, downsizing?

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Thank you for your question.

Your question is a very good one; however, whether or not removal/replacement alone will achieve your goals is hard to know without physical examination and a complete communication of your goals.  Sometimes,  additional work such as “capsule work” (capsulorraphy)  is necessary to improve the outcome of surgery when patients undergo downsizing of breast implants. Also, there are cases where patients benefit from removal of skin (breast lifting) along with downsizing of breast implants. Much will depend on how much you downsize,  the position of your current breast implants on your chest wall, and the quality of the overlying skin/tissue elasticity.

Please make sure that your plastic surgeon has a significant/demonstrable experience with revisionary breast surgery. Make sure that you communicate your goals carefully as well. Working together, you will come up with the best plan to achieve your goals. You may find the attached link, dedicated to downsizing breast implant concerns, helpful to you as you consider options. Best wishes.

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.