Saline Breast Implant Reduction

I have Mentor saline implants filled to 375 CC, the procedure done in 2004. I have been quite happy with my breasts and the implants, but lately, as I approach menopause, I'm wishing for somewhat smaller breasts! Can I have, say, 100 or 150 cc of the saline removed from the implants, or will I need to have complete removal and replacement with smaller implants?

Doctor Answers 16

Best choice is new implants, perhaps with a lift as well

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Downsizing your breast size is best achieved with new implants, not removing the fluid from the existing ones. In order to give you the best cosmetic appearance, you may also require a breast lift as well to tighten the pocket of the implant. Another option is a lift alone without any implants, but these options are best discussed with your surgeon so that he can discuss with you the pros and cons of each choice. Simply removing saline from your existing implants, however, is not a good choice for all of the reasons already stated.

Seattle Plastic Surgeon
4.9 out of 5 stars 155 reviews

Decreasing the size of an implant.

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If you would like to decrease the size of an implant, this will require another surgery.

You may be able to keep the same implant if you only want a small amount removed. For example, 25-50 cc, depending on the implant.

Implants have a range of saline they need inside in order to maintain their shape. If you go below this range, the implant will collapse on itself. This will depend on the implant you have and how much saline was put in during the initial surgery.

Thus, if you want to remove a large amount of saline from the implant, you will need to replace the implant for a smaller one.

John Diaz, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

A large amount of saline cannot be taken out of implants without problems

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This rather a difficult situation and several things need to be considered. In order to remove any saline out of an implant the pocket needs to be reopened and the implant totally removed from the breast , the saline removed and then the implant replaced. This is obviously a surgical procedure and may be more than you want to undertake.That said there is a recommended fill volume for saline implants and underfilling implants can lead to folds which in turn may lead to failure or leakage of the implant. I think you really need to sit down with your plastic surgeon and decide what you want to acheive. Once you have established what your goals are then a plan can be made. This plan might be (1)to remove the implants totally, (2)remove your current implants and replace them with smaller ones, either saline or silicone, (3)perform a lift without touching your current implants or (4)to remove the implants and do a lift at the same time. The most important thing is to sort out your goals and then go from there.

Susan E. Downey, MD
Los Angeles Plastic Surgeon

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Best to start fresh

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Reducing the volume of your existing implants by a noticeable amount would be likely to lead to visible rippling, and would greatly increase the odds of the implants rupturing quickly, as well as introducing the problems outlined by my colleagues.

Your best bet is to get a good handle on your goals, then meet with your surgeon and describe them to him. It sounds like you'd be best off removing the existing implants and placing smaller ones, with or without a breast re-shaping procedure (lift).

Here's hoping you get exactly what you want!

You'll need new implants and maybe more

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It is certainly possible to decrease your implant size but not by deflating your current implants by 100-150ccs. Each implant has a preset minimum volume they need to have in order not to be too wrinkly and have an increased risk of deflation. You would need an entirely new implant filled to its own proper volume. Or you could switch to gel.

The implant still needs to have a base width that fits well for your frame and this limits how small you can go without looking like "tennis balls with a mile in the middle." The other issue is whether your skin envelope will need to be tightened after downsizing the implants and this can't be determined without examining you.

And as Dr. Moelleken said, revising the pocket can be a complex procedure which is much harder to get exactly right than you might imagine.

Revision breast surgery

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Saline implants should generally not be underinflated. They tend to ripple and fail mechanically if they are underinflated.

Simply replacing a large implant with a smaller one can create a deflated, lopsided breast. It is not just an issue of placing a smaller implant in the pocket, which will still be much larger than the incoming smaller implant. If nothing is done to the old pocket, the new implant will simply sit too far down and to the side and the breast will appear deflated. Therefore, the internal capsule should be tightened as well. This is a tricky procedure and much more complex than a breast augmentation. However it is well worth it in the right patient.

Also a consideration for patients contemplating a smaller implant is whether they will require a breast lift at the same time; if the skin is saggy, breasts may appear deflated unless a lift is performed. There are complexities with this surgery as well, i.e. what is the circulation, was the nipple-areola compromised during previous surgeries (i.e. by a submammary dissection).

Many patients actually consider having their implants removed completely and having a lift. This is an excellent option for women who still have enough breast tissue.

Revision breast surgery can be very satisfying for patients, but it should be carefully planned with both aesthetic and anatomic concerns in mind.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

You cannot remove saline from your existing implants!

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Unfortunately, you are unable to remove the saline from your existing implants. You should see a board certified plastic surgeon who is experienced in breast surgery to discuss your options. You have basically three choices: 1) do nothing and accept the implants as they 2) removal of the existing implants with replacement of smaller implants (saline or silicone memory gel), and 3) removal of the existing implants without replacement.

Thanks for your question!

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

You will need to switch out your breast implants

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Unfortunately, to reduce the size of your implants, they will need to be replaced. The implants are not made to modify the fill volume after implantation. Additionally, each implant as a specific fill volume with a narrow range. Reducing your volume will take your implant out of that range.

One other consideration when reducing your implant size is the effect on the overlying breast tissue/skin. The larger implant is supporting the overlying breast tissue. If you reduce the volume of the implant, then the overlying tissue may develop ptosis (or drooping of the breast). Your doctor should be able to give you a reasonable expectation of possible results.

Good luck with your surgery!

Breast implant reduction

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Unfortunately unless your implant has a port on it (Mentor's Spectrum implants for example) (which are exceedingly rare in cosmetic cases) there is no way to reduce the volume in the implant without replacing the implant.

In addition, even if there were a way to take fluid out of the implant safely, implants are designed to have a minimum volume in them and removing 100ccs would most certainly bring the volume below that safe level and predispose the implant to rupture. (Underfilling is a very common cause of implant rupture).

I hope this helps.

Steven Williams, MD

When to Use Same Implants with Downsize

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I would not recommend this as the chance of  old implants rupturing in the near future doesn't warrant the risk of a subsequent operation in the future, plus you will probably need to make your pocket smaller, any warranties that may be in effect are voided, and putting too little saline often causes rippling/waviness and premature rupture. Check out IDEAL implants for saline implants that feel like silicone.

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.