Specialist Who Has Done Hundreds of Reduction Implant Exchange Larger to Smaller? (photo)

My present surgeon is suggesting removal and compression because I want to go from 550 cc High profile to 300cc Moderate Plus because my frame cannot handle weight. He does the internal bra daily but has only done a few cases like this with such a large reduction. He suggests removing the implants & compression first for minimum 3 months to a year :0( than doing the revision with less complication. How many cases have you done 200 ccs or more in reduction? Thoughts?

Doctor Answers 10

Seeking a Surgeon to Downsize Implants

It is definitely possible to #downsize to smaller implants. 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.Your procedures should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Implant Exchange Larger to Smaller

While going bigger is the more common breast implant revision, going smaller is a common procedure. Potentially, you may need a breast lift. To determine the appropriate surgical plan, consult with 3 - 4 board certified plastic surgeons who are experienced in large reductions.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 36 reviews

Implant reduction using the Mini Ultimate Breast Lift

Hi Shelly,

Thank you for your question.

Implant reduction and lift can be successfully accomplished by making the capsule smaller (if under the muscle) or placing the smaller implants under the virginal muscle. Then a Mini UBL can drape your breast tissue directly over the new implant creating a natural round and perky appearance. This technique does not require a vertical scar. The only scar you will have is around the areola. Your ability to breast feed in the future will not be compromised. Vertical scars weaken a lift, especially when there is an implant involved. That is why I never use a vertical scar in any of my lifts regardless of size or degree of sagginess.

Kind regards,

Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.7 out of 5 stars 208 reviews

Breast implant downsizing strategies

Everything depends on the physical exam.  It is especially important to determine the thickness of your remaining breast structure.  In general if there is a decent amount of your own breast tissue, then a lift of some sort should be done with your downsizing.  I am skeptical about the ability of breasts to adequately contract with this amount of downsizing, unless you get a capsular contracture, which is not desirable.


My usual strategy for a patient like you would be to remove the existing implant, modify the pocket as necessary and do a variation of a vertical lift.  A beautiful breast shape, in my opinion, trumps other considerations.


I hope this information is helpful.

John Q. Cook, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 12 reviews

Implant reduction

A reduction in implant size can be done but you may need a lift to go with it. It is difficult to say without an exam.

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

Exchange for smaller implant

Exchanging implants for a smaller size is a common scenario (although going bigger is more common!!). The question is whether your skin will contract enough to not require a breast lift.This depends on a number of factors including age, pregnancies, breast feeding, hormones, skin elasticity etc. In your case i would follow your surgeons recommendation for exchange for a smaller implant with breast compression and waiting to see if the tissues contract to your liking. For someone with poorer skin quality I would do a simultaneous lift but in your case I believe your skin quality looks good enough to wait and see before adding scars.

Jason Pozner, MD
Boca Raton Plastic Surgeon
4.7 out of 5 stars 41 reviews

Decreasing implant size

If I understand your question your surgeon would not be doing a lift. He will remove the implants and let your skin and breast tissue contract naturally over a certain period of time. I think that is an excellent idea because it may save you significant scarring associated with a lift. Most patients don't want to do that because of the time without implants

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


Thank you for the questions and photos.  I have done many cases like yours with excellent results.  I do not recommend you remove the implants and wait 3 months before replacing them.  The reduction/lift can all be safely done on the same day.  In fact, if you review my website photos under "breast lift", review case #2009 and you will see an example of someone I operated on with similar problems.  Your case is actually much easier than hers because her nipples were pointing downwards and yours aren't.  In fact, I think you would have less scarring as well, but I would need to see you in person to be sure of that.   If you'd like to talk on the phone or have more questions, please let me know. 

Implant Revision - Decrease Size

Implant size reductions are a routine procedure. There are many factors that contribute to a final result. Skin elasticity is the primary issue when going to smaller implants. After looking at the photos, a 200cc reduction in the size of the implant should produce an acceptable result.

Stephan L. Ralston, MD
Ogden Plastic Surgeon
4.6 out of 5 stars 23 reviews

Downsizing implants...

are done on a regular basis.  If you must downsize due to physical issues, removing your implants is certainly an option if you have gel implants.  If your implants are saline,  a simple intentional deflation done in the office will remove the volume from your implants and allow your tissue to shrink over time.  The shell is harmless but does constitute perhaps 30 cc's and should be accounted for when you re-size.  Depending on how your breasts shrink, you may or may not desire a lift and as you can see, there are many ways to lift a breast.  If you choose the Benelli periareolar technique, you should understand there is flattening of the projection and extreme risks for your scar stretching out down the road.  Good luck with achieving what you desire.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 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.