Is Pocket Revision Always Necessary?

I'm 5'2 105lbs was 32C prior and recently had a BA. My surgeon chose to use 400cc(R) and 425cc(L). In 12wks (I am 3wks out), I would like to downsize to 250/275, same mod+ profile. My surgeon says I won't need a pocket revision since my skin is so tight and my pecs were tight too (I work out alot). I consulted another PS for a 2nd opinion and was told no matter what if someone downsizes by more than 100cc a pocket revision is ALWAYS necessary. Both surgeons are Board Certified!

Doctor Answers 6

Breast Implant Exchange

Never say never or always.  It depends on the situation.  When the plastic surgeon gets into the case and sees what your pocket looks like, then he/she will decide.  Usually we exchange implants for a larger size.  If the implant is getting smaller then the skin may need to be adjusted or lifted. 

Palm Harbor Plastic Surgeon
4.6 out of 5 stars 31 reviews

Is Pocket Revision Always Necessary?

No, pocket revision is not always necessary. You do not post photos, so it is impossible for me to comment on your specific case though.  If your implants are behind the muscle, and have a good position now ( not too high or too low) and the diameter of your new implant will be the same or nearly the same, you will not need a pocket revision.

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 107 reviews

Pocket revision with breast augmentation

Pocket position does not have to be modified everytime you have breast augmentation surgery. Breast pocket modification is necessary if there are contouring issues, thinned out tissues, h/o of breast infection, etc.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 68 reviews

Is pocket revision really needed when downsizing implants

The short answer is no, and the chance is less since you are only three weeks out from breast augmentation and the skin envelope has not given fully as yet. Much will depend on how the original pocket is shaped and centered in the breast. If the pocket was set correctly at the fold, and the pocket was not extended to the side of the chest, the smaller implant and a conforming surgical bra should do. Of course sutures to reduce the pocket can be very helpful depending on what is 'found' at revision, and either way, it is not much of a 'deal' to an experienced surgeon.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews


When downsizing with implants, sometimes it is necessary to make the pocket smaller...but not always.  It really depends upon the size of the original pocket, and the dimensions( especialy the base diameter) of the new implants.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Pocket revision

This is a very difficult question to answer without being able to examine you. The 400/425 CC implants are large for your frame.  Were they put in as an attempt to overcome ptosis(droop), or did you indicate a desire to be large?  At 3 weeks out, you are still swollen.  At 4 months out(when you are considering the revision) the swelling will have resolved and you may be satisfied with the result.    Let things heal first.  You may find that if you do do wish to downsize that you are looking at more than an implant exchange to create the best aesthetics.

Good luck

Beverly Friedlander, MD
Short Hills Plastic Surgeon
4.8 out of 5 stars 16 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.