Replacing Implants with Smaller Ones?

Question

I had BA when I was 18 and am now 20, 5'8", 125 lbs and 34D. I had almost no existing breast tissue. They are saline implants and feel too large, unnatural and uncomfortable. I'd like to downsize significantly, perhaps even to a B, and am considering silicone instead. Because I am young, can I expect there to be a higher chance that I will recover well and won't have issues with excess skin or sagging? Is this procedure more expensive than the initial BA? Is the recovery time shorter?

Gary M. Horndeski, MD · Answer

At size 34 D each 100 cc’s of implant corresponds to 1 cup size change so a 200 cc reduction would take you down to approximately a B.  I always recommend silicone gel implants placed retro-pectoral since they look and feel more natural and are less likely to ripple.  Unfortunately, you have not provided any photographs so you may benefit from a simultaneous lift.  There is a new technique called Implant Exchange with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to exchange the implants, excise excess skin, reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.  Aligning the areola, breast tissue and implant over the bony prominence of the chest wall gives maximum anterior projection with a minimal size implant.  Smaller implants are more stable long term, less likely to have complications and need revisions. 

	 

	Best Wishes,

	 

	Gary Horndeski, M.D.

Vincent N. Zubowicz, MD · Answer

I think for someone small like you I think silicone gel is a much better choice the prosthesis. Without a picture it's difficult to say but my suspicions are you will do fine without any adjustment to the skin envelope.

Armin Moshyedi, MD · Answer

Being younger will decrease the chances of having excess skin or sagging (especially if you've never been pregnant or had children or nursed).

	This procedure is typically LESS expensive than the initial breast augmentation.

	The recovery time is typically shorter.

Jeffrey Zwiren, MD · Answer

Without an examination it is hard to predict the degree of elasticity of your breast skin and the degree of contractility. A moderate change in breast implant size is likely to be okay. You will really notice the difference between the old saline implant and the new gel implants.

Steven Wallach, MD · Answer

Most likely you will have excess skin when you downsize. Sometimes just a circumareola lift may be all that is necessary for some women but without an exam, I can not evaluate you properly.

Jourdan Gottlieb, MD · Answer

Without photos my guess will be based on incomplete info, but it is likely that your skin will still  have sufficient elasticity to avoid the skin sagging that can occur. 

	Fee should not be more than the first surgery, recovery should be easier. Making the pocket and stretching the muscle contribute most to the pain, and that has already been done. 

	All the best.

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