Options for Reducing Breast Implant Size?

I had a breast lift and breast augmentation w/ 375cc implants. I was originally a saggy B but now (7 days post-op) I am mortified at how big they look. I feel like a porn star. My husband is freaking becuase of the money we've already spent but I just couldn't go through life like this. What options do I have? Can the current implants be "deflated" in some way?

Doctor Answers 16

Initial swelling may contribute to larger appearance

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Hello Ell,

Speaking from 23 years of experience as a plastic surgeon, it is most important for you to calm down and take a deep breath. There are many reasons why you look bigger than anticipated.

For the first couple of weeks following your surgery, it is expected that you will experience bruising and swelling which definitely contributes to a larger appearance. Not only do you look bigger, but I am certain you FEEL bigger due to the features of an augmentation and breast lift.

Over the next three to four months the muscle and skin will stretch and the implants will settle to a slightly lower level. See your plastic surgeon on a frequent basis and discuss your concerns with him--maintain your trust and confidence.

If after three-four months you still feel too big, only then should you consider exchanging the implants for smaller ones. Typically, this is a much smaller and easier operation.

Thanks for your question.

Englewood Plastic Surgeon

Don't panic

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Hi there-

I understand your anxiety, and you should know that it is not uncommon for people who have spent hard earned money to improve their appearance to feel that sense of panic when at first it doesn't look like they got what they were hoping for. However....

It's really way too early to be worried. I usually tell my patients not to evaluate the shape, position, or size of their breast implants for at least the first 3-4 weeks, as it will be this long before swelling and muscle spasm (if your implants are under the muscle) subside. Most often, once this has occurred, everything looks great and more like what the patient was expecting and wanting. I bet this is what you will experience too, but I agree with the other surgeons below that the best thing would be for you to share your concerns with your surgeon.

I am not as optimistic - 375cc is large

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To Ell,

I am sorry to offer a negative note. But , in my experience with women who have lost weight, large breasts may make you feel overweight again. And you do have large implants.

So here is my advice: Try not to think about your breasts for several months. They will feel smaller once they have been incorporated into your body image (when you have gotten used to them). And if you still feel too large, it is usually fairly simple to exchange the implants for smaller ones. Your surgeon would probably do this at a minimum cost to you. But I would wait at least 6 months.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Hang tight for a bit

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At only one week postop you are swollen and distorted. Given time, the implants will settle and the tissues will accomodate. Although I don't know what your body looks like, in general a 375cc implant is not huge and should result in a size you are confortable with. You will know what this implant will look like at the 4 month point. If it is still too big, you could work with your surgeon to decrease the size.

7 days is early

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You are almost certainly still quite swollen at 7 days after surgery. I would recommend relaying your thoughts to your surgeon so that he or she can be aware of your concerns, but I think you have a very good chance of the size going down.

I would discourage doing anything drastic at this point-- implants can be dowsized, but I would wait several months before entertaining this option, and the liklihood is that in the meantime the size will become more acceptable to you.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 155 reviews

Time is your friend

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Thanks for the question Ell - Many people who have breast augmentation notice that their breasts seem larger for the first 2-4 weeks after surgery. This is typically because of swelling and positioning of the implants.

Around 4 - 6 weeks later, as the swelling comes down and the implants settle, many patients utter the famous "I could have gone a little bit bigger." That being said, you should give yourself some time for the shape and size of the implants to improve (at least 6 weeks but 6 months would likely be a better amount of time).

If at that point you are still unhappy with the size you face a difficult choice. There is no way to reduce the size of most saline implants (although there are a few different types that allow for adjustment of size through an injectable port). This means that an adjustment in size would mean additional surgery. Discuss the issue with your surgeon.

If you are truly unhappy there may be things he or she can do to lessen the financial burden.

I hope this helps.

Breast implants often look large early post-op

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I don't usually experience this with my patients. I think it is because of the long discussion and interaction with my patients to choose the right implants for them. We go over this in great detail. This being said, your implants may look quite large right now, but it is still early post-op and as the swelling subsides, the implants will look a bit smaller. In fact, often the opposite occurs. Some patients like how they look early post-op because of the swelling, and state months later that they wish they had gone larger.

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

Give it some time

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I agree with what everyone has stated. Patients often go through different phases after breast augmentation where they first feel they went too big, but then over time get used to the size (especially after the swelling comes down). It is often not uncommon for a patient who felt they went too big at first, to end up feeling they went too small. Therefore, I would give it several months time before doing anything at all.

Leonard Lu, MD
Chicago Plastic Surgeon
4.5 out of 5 stars 28 reviews

Give it a few months and then re-evaluate

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It is not uncommon to feel your breasts are too large within a few weeks of surgery. Then later many women feel that they are too small. Let your body accomodate to them and then re-evaluate things before rushing into more surgery.

You will likely need new implants though if you do go for more surgery, as the fill tolerance of most saline implants is very small. Under filling can encourage early rupture not to mention a poor "feel."

John P. Di Saia, MD
Orange Plastic Surgeon

Are my breast implants too big?

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I clearly understand your predicament and have had this scenario occur frequently. Typically in the end patients are generally satisfied with the size; rarely, do patients seek to downsize their implants and in my personal practice I would say it occurs infrequently at a rate of probably 5 out of over a thousand patients.

Give it time. Studies have shown that at this point in time you are likely exhibiting a 10% component of swelling. For example if your natural breast is 175 and you breast implant is 375, your augmented breast should be 175 +375 = 550. However, special cameras will likely your breast at 600 or more. This may take 6-9 months to resolve but reassure yourself and your husband that this is the case.

In the event, you feel, they are still too large then surgery may be contemplated but do not rush into this. More often then not when the swelling has subsided patients feel that the size is satisfactory and frequently smaller than they would prefer.

Altough some have expressed comments that your implants were large. I recently informally contacted the breast implant manufacturer and a representative told me that approximately 85% of implants chosen fall between 325-375. Given this I would say that you are in the range of "normal". Clearly, there are other factors such as the profile and your pre-existing breast tissue.

Take a deep breath and give it some time. The additional swelling that occurs in the early postop period (3 weeks) can create the impression of bigger breasts. Some patients describe the implants as "sitting under their chin". As the implants settle, they will drop slightly and this will give the appearance of a smaller breast. IF you have ever built a house, you will know that the house settles...how much?....It varies and is unpredicatble.

I hope this helps.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 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.