Wanting smaller implants & under muscle? (Photos)

Hello! I've had my implants 540cc Saline over the muscle for just over 2 years and I HATE them. I originally had them Done because I Nursed 2 babies and they deflated lol. My breasts are so heavy and sagging now . I am a 32DD-DDD cup. I wish to be a large B to a C . My hobby in life is working out and it's annoying how much they get in the way! I want under the muscle .Any opinions? Is it possible? And yes a breast lift may be in need. ALSO.. How can I get my areoles made smaller? Thank you!

Doctor Answers 9

Smaller implants with lift

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Based on your photographs and desires, it would be my opinion that a vertical breast lift with a remove and replace of saline sub glandular to silicone sub muscular implants would be necessary to achieve your goals of a smaller, perkier breast with a smaller areola as well. I would recommend that you see a board-certified plastic surgeon in your region with experience in revisionary cosmetic breast surgery. Best of luck.

Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

Smaller Implants/Under the Muscle

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You would be a great candidate for a breast lift as well as replacing the saline implant with a smaller silicone implant placed under the muscle.  As always, ensure you are having your surgery performed by a board-certified plastic surgeon.  Best of luck

Michael K. Obeng, MD, FACS
Beverly Hills Plastic Surgeon

Implant revision - implants too large!

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Thank you for asking about your breast implant revision.
  • I am sorry your implants are too large for you - 
  • A 540 cc is definitely a big implant
  • Based on your photos, you need an implant of 325 cc or less - depending on your height and weight.
  • You also need breast lift which will reduce the areolae.
  • Putting the implants under the muscle is a good idea when a breast lift is needed.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

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#BreastImplantRevision - Wanting smaller implants & under muscle?

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You may be able to accomplish everything with one procedure - removal of your existing implants, insertion of new, smaller implants under the muscle (silicone would be another option), and a breast lift.  That would give your surgeon an opportunity to reduce the areolar size.  There are advantages to staging a procedure such as this, which would mean simply removing the implants at the first procedure, and then doing the rest at a second.  But I think you can get a nice improvement with a single operative session.  You should of course discuss this in person with one or more board certified plastic surgeons who can examine you in person.  I hope that this helps and good luck,  Dr. Alan Engler, Member of #RealSelf500


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You might want to consider exchanging your implants for a much smaller size, plus a lift, or just removing and a lift. Since you were not happy with your original size, you may not be happy with just a lift. the new implants could also be placed under the muscle. I would suggest meeting with a board certified plastic surgeon and discussing all your options.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.8 out of 5 stars 18 reviews

Implant revision and lift

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Yes, it is definitely possible to perform a lift and an implant reduction at the same time.  Best to be evaluated in person. Good luck.

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

Get a breast lift when you down size

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The only way an implant will stay under the muscle will be to do a breast lift at the time of your exchange and downsize of implants.  I think your decision to down size is a good one..it will give you a much better aesthetic, and will get you much more comfortable in your own skin.  The breast lift will also address your areolar size.Good luck with your next surgery...I think you will be much happier.  Chose your surgeon well and likely don't settle for an implant bigger than 300cc in order to get what you need.

Size change

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It is possible for you to achieve your goals. You would benefit from a breast lift. This would help with the areola size and excess skin when you decrease the size of the implants. Good luck.

Jon E. Rast, MD
Kansas City Plastic Surgeon
5.0 out of 5 stars 35 reviews

Wanting smaller implants & under muscle?

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Thank you for the question and good quality photographs.  Based on your photographs, I think that you have a very good plan in mind.  Conversion of the breast implant space from the sub glandular position to the sub muscular , mastopexy surgery (which will involve decreasing the size of the areola),  and downsizing of breast implants is certainly doable. Successful results do depend, to some degree, on the surgeon's experience. Therefore, best to make sure that your plastic surgeon can demonstrate significant experience helping patients with this type of revisionary breast surgery. 

 As you mentioned, sometimes patients undergoing conversion of breast implant positioning from the sub glandular to the sub muscular space benefit from additional maneuvers such as breast lifting (depending on the position of the breast skin envelope in relation to the position of the sub muscular breast implants) and/or the use of acellular dermal matrix for lower pole support. Closing off the existing breast implant pocket is a technique utilized to help prevent the breast implant from moving back into its previous space. Patients undergoing these types of conversion operations should understand that they may experience movement of the breast implants when the pectorals major contracts (flexion or animation "deformity").  In my opinion, this is the only downside associated with breast implants placed in the sub muscular (dual plane) position.

Generally speaking, the best online advice I can give to ladies who are considering revisionary (downsizing) breast augmentation surgery is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "down 2 cup sizes” or "large B, small C cup" etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. 

3. Once you feel you have communicated your goals clearly, allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.

I hope this, and the attached link (dedicated to revisionary breast surgery, specifically downsizing breast augmentation surgery concerns), helps. 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.