After double mastectomy & reconstruction with implants, my implants are too big. Is it possible to have smaller ones put in?

Question

Before double mascectomy I was a 32A. I'm small, 5'5" and 110 pounds. After reconstruction and implants put in 2 months ago I'm a 34C. I wanted to stay small, no larger than a 32B or 34B. Staying in the A cup size would have been fine also. I just don't know if it's possible to small again. Getting very depressed about the larger size.

Roger Khouri, MD · Answer

Hello dear. Yes it is possible to downsize your implants. A very good option is to replace the implants with your own fat. Your fat cells are extracted during liposuction, in the same procedure, and then injected back into the breast area. You may be able to completely be implant free, or perhaps have a very small implant surrounded by your own fat. So you definitely have options. 
Make sure you see a board certified plastic surgeon and preferably someone with experience with fat transfer to the breast. Good luck!

Ritu Chopra, MD · Answer

The answer is yes! You can downsize the implants as well as tighten up the internal pocket as well as the skin. By doing these things you should be able to achieve your goals. The best thing is to talk to your surgeon. I hope this helps!Ritu Chopra MD

Hisham Seify, MD, PhD, FACS · Answer

It is still early in the
healing process.It is best to wait for
the wound to settle down.Revisions are
more risky in reconstruction patients.It is ideal to wait and then discuss your concerns with your Plastic Surgeon.

Mark Shashikant, MD · Answer

Yes, smaller implants are possible.  There are two items to addressed in downsizing.  3One is the internal pocket.  When placing a smaller implant the internal pocket will need to be "shrunk" to contain and control the position of the smaller implant.  This can be accomplished with capsular flaps from your own existing scar tissues or biologic meshed - usually both are used.  The second item to address is the external skin.  Depending on how much skin is "extra", sometime it may contract on its own or need to be removed.Consult with a board certified Plastic Surgeon and do whatever you can to communicate your size expectations - pictures of what you consider an ideal breast size can be helpful.

Maria M. LoTempio, MD, FACS · Answer

It is often difficult to deal with the process of breast cancer let a lone breast reconstruction. The one thing to remember you always have options. Going smaller, larger , removing the implants and placing your own body tissue are all viable options. Take your time, speak with your current surgeon and let them know you would like a smaller size, he or she may need to remove some skin to make you look even and shapely.

Andrew Kornstein, MD, FACS · Answer

Reducing your implant size with a smaller pocket is certainly possible;the use of ADMs make the newer smaller pocket stable and long lasting.The one outstanding issue is the amount of skin excess you have. After a mastectomy the skin circulation is compromised and therefore a conventional lift MAY be an issue. I have used non invasive skin tightening successful to avoid a lift(required to reduce the amount of skin excess).Hope this helps

Steven Wallach, MD · Answer

It should be possible to use smaller implants if you are unhappy with the overall volume that you have. Best to be seen in person to be properly evaluated.

Mark A. Schusterman, MD, FACS · Answer

Yes it is very common for patients to either get smaller or larger implants after surgery.  Going smaller should not be a problem.

Robert Whitfield, MD · Answer

I have had several patients recently that had undergone breast reconstruction in the past but after there implant exchange to permanent implants became unhappy.  There are a variety of reasons for this.Most commonly I have seen patients with implants that a little wide for their chest which gives them a boxy appearance with to much upper pole fullness.

Joseph Rucker, MD, FACS (retired) · Answer

By all means yes and in most cases your insurance will cover the procedure.  You may have stretched your skin envelope with the placement of the larger implant and if that is the case the following procedural goals would be recommended: Exchange to smaller textured anatomical implantReduction in the internal size of the implant pocket and the external skin envelope (Breast Lift)Outpatient Procedure: 2 hrsRecovery 2 weeks.  Good Luck

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