How much smaller could I go without complicating things and will the cc come back?

Dear Luminous8667,
capsular contracture happens. In fact, every implant has a capsule form around it, its just a certain percentage develop thick capsules. There is a lot we don't know about it actually. Some think that bacteria that gets on the implant during insertion can increase the risk. Thats why we use a Keller Funnel in our practice to reduce that possibility. Our capsular contracture rate is less than 2% because we use a keller funnel as well as meticulous operating room techniques.If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Dear Luminous,
I must not second guess your plastic surgeon as we all have different techniques to most surgeries. I can only tell you the options I would suggest to a patient with your history.
Number one, yes, I always replace the implants when a CC is present...there may be a Biofilm which causes another re-occurrence.
Two, I prefer submuscular as there is a lower incidence of capsular contracture.
Three, a total capsulectomy is paramount.
Four, consider using an ADM (Acellular Dermal Matrix...ADM) in patients with recurrent CC
Five, Intraoperative antibiotics and irrigation and post operative oral antibiotics (not really indicated but I still use them).
The use of textured implants is physician preference. The size is up to you...if too large, drop by a minimum of 50cc's.
Best wishes,
Dr. Taranow