Risks of Needing to Reduce Pocket Size when Going Down in Implant Size?

I currently have 700cc in each breast, Moderate Plus profile implants. I want to go down to about 450cc in a Moderate profile - which would require stitches to decrease the size of my current pockets. I've had the 700s in for 4 years. I am told that if I elect for 550cc moderate instead I don't need to touch the pockets, but ideally I would like to have less width, thus 450cc. What can I expect if I get internal stitches to reduce the pocket size? Risks? Will it look good? Thanks.

Doctor Answers 7


When  changing to smaller size implants, I usually do not perform internal suturing unless there is considerable asymmetry.  If you have good symmetry, but just want smaller implants, you should be able to undergo a simple exchange.

San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Downsizing of Breast Implants and Capsulorrhaphy?

Downsizing of breast implants and capsulorraphy requires significant technical expertise in my opinion. The risks of this procedure include breast asymmetry, recurrence of implant displacement/malposition problems ( asymmetrical implant movement concerns), unsatisfactory skin redraping,  as well as the usual risks/potential complications associated with breast augmentation surgery in general.

I would suggest that you select your plastic surgeon carefully; ask to see lots of examples of his/her work helping patients with capsulorraphy surgery.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Revision Breast Augmentation


There is no formula that dictates if internal plication of the pocket is necessary when reduction of implants are contemplated; every case deserves its own consideration and is up to the opinion of the surgeon.  Regardless, choosing the size of the new implant should not be based on the details of the surgery required to perform the task, but instead on other factors like your subjective feeling of how big you are, how big you want to be, and the surgeon's expertise in knowing how much to reduce.

You should make your decision on implant size and the surgeon either will or wont perform an internal plication.  If it is necessary, plication stitches are effective at reducting the pocket size, lifting the position of the implant, and preventing lateral migration of a smaller implant. 

Revision surgery is more complex than primary surgery, and should be performed by those that have an excellent reputation in this type of surgery. Be sure that your doctor has had extensive experience in revision surgery of this nature.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

Breast Revision to Include Smaller Implants

It is definitely possible to #downsize to smaller implants and also alter the positioning; if possible. However, decreasing is size may also require a Breast #Lift to to #tighten loose skin, better optimize the end result. Any #revision has risks of unhappy outcome or other complications. #BreastAugmentation without a #BreastLift is usually a mistake looked back on by many patients. Most breasts will look larger and more droopy.They will sag more and sooner because of the excess weight altering the longevity of the results. The shape will usually not be satisfactory and sometimes results with “Snoopy” breast or double bubble. .A #mastopexy or breast lift operation is designed to improve the shape and position of the breasts without reducing their size. It is the most suitable for #breasts which sag or droop (ptosis) as a result of development, aging, pregnancy, breast-feeding and weight loss . Some patients will experience better results to restore superior fullness if an #implant is used at the time of mastopexy; better known as #AugmentationMastopexy.
With both implant types there are choices when it comes to size, shape, and profile. The criteria best to suit you will be discussed in full detail at your breast augmentation consultation. Also, the right implant for the revision is contingent on shape of body and your desired outcome.
Altogether, the surgery will create an elevated, more youthful breast contour. Also, the nipple and areolae of the desired size and correct heightmay also be addressed. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.The best method and #technique for your #procedures will be discussed in greater length during your one-on-one consultation with a board-certified plastic surgeon.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Revisionary breast surgery

Decreasing the size of breast implants by almost half would most likely require plication of your pockets and even a lift if you are to have favorable results. Look for someone who has extensive experience with revisionary breast surgery. He/she should be able to give you a good idea as to what to expect in your case. Risks are mostly the same as breast augmentation surgery. Recovery would include wearing an underwire bra 24/7 for an extended period of time to give new pocket a chance to heal.

Kind regards,

Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

Reducing implant size and risks of surgery

Generally speaking, revision surgery is more complex than primary augmentation. Not only the surgery is different but also the post operative recovery and instruction are different. The outcome of surgery depends on several factors; how you conveyed what you wanted to the surge , your expectations and the experience of the surgeon.A consultation with a board certified plastic surgeon and addressing all the above issues is important for satisfactory outcome.

Moneer Jaibaji, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Revision breast augmentation

Changing the volume of the implants to be smaller may not only require a capsulorrhaphy as you describe but also a breast lift in some cases.

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