Would There be Extra Skin if I Went Silicone and Smaller? (photo)

I've had my saline implants for 24 years. They have always been firm, but they looked great and I felt there was no reason to change them. Now I've lost a lot of weight and they are too tight. I would like them to be softer and bouncier. Should I go a bit smaller and wouldn't there be extra skin that would look weird? Any suggestions?

Doctor Answers 11

Extra skin after smaller implants

Your photographs show capsular contracture, asymmetry and nipples pointing laterally.  I recommedn you have implant replacement in the retro-pectoral position, if they are not there already, and a mastopexy to move the nipples more medial.  All this can be done through a peri-areola incision.  This would remove the excess skin that you are concernced with.

Best of Luck,

Gary Horndeski, M.D.

Texas Plastic Surgeon
4.7 out of 5 stars 208 reviews

Revision breast surgery

Based on your posting, it sounds like you are experiencing some degree of capsula contracture (scar tissue forming around your implants).   I think you would benefit from removal of this scar tissue and revision augmentation with silicone breast implants.  Please visit with a board certified plastic surgeon to learn more about your options.

Dr. Basu

Houston, TX

Breast implants

It appears you could go smaller without worrying about loose skin. What needs to be determined, however, is whether you have capsular contracture which is making the breasts feel hard.  If so, you might need a more involved procedure than a simple implant exchange.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 24 reviews

Removal of 24 Year Old Breast Implants?

Thank you for the question and picture.

Yes, based on your description of your goals, I think you will benefit from revisionary surgery. Exactly what operation you will benefit from will depend greatly on your physical examination and a full communication of your goals. I would suggest that you meet with well experienced board-certified plastic surgeon in person for more accurate advice that can be obtained via online consultation.

Best wishes.

Implants after 24 years

By your description it sound liek you  may have a capsular contracture.  It would be best to hae an exam and then an appropriate replacement implant can be chosen for you.  Good luck. 24 years without another surgery is a pretty good deal! Hopefully the new ones will last as long!

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Breast revision after 24 years

By the look of the one photo you have some asymmetry with the right appearing a little larger and the right nipple sits a little lower than the left. Also, by the sound of you it, you have a capsular contracture which is a tightening of the scar around the implant. It also looks like your implants are above the muscle which is accentuated by your weight loss. You have many options for revision surgery but the best option is to meet with a board-certified plastic surgeon and after they have examined you they can outline your surgical choices.

Dr Edwards

Smaller implants more skin?

The excess skin would really depend on how much smaller you decided to go. Not knowing the size of your current implants it would be difficult to give you an idea as to how much smaller you could go and still have a reasonable result.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 31 reviews

Would There be Extra Skin if I Went Silicone and Smaller?

One posted photo limits the degree we can respond. Seek in person opinions from boarded PSs in your area. 

Implant exchange

Losing weight would not make implants too tight I agree with Dr. Minnitti that the absence of overlying fat has revealed what are probably capsular contractors. You should see a board certified plastic surgeon who can make a diagnose and recommendations. The photographs do reflect what may be capsules but this can only be eludicated on clinical examination.

Changing Breast Implants


Congratulations on having saline implants for 24 years without a rupture/deflation!  I think your implants feel tight because the scar tissue around them, called the capsule, has tightend up over the years.  This is known as capsular contracture, and is the most common problem with breast augmentation.  Your weight loss has decreased some of the fat in your breasts, unveiling the underlying firm implants.

I think your plan for smaller silicone implants is a great idea.  The softer, bouncier part will be achieved by the complete removal of the scar capsules around these implants though.

Best of luck!


Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 78 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.