Can the Pocket Under the Breast Accommodate a Smaller Implant? (photo)

I'm 60 years old and like most older women want to lose the matronly look that my 30 year old large implants give me. I'm curious if the pocket (behind the muscle) can be too large for a smaller implant. I know a lift is needed as well. One Dr says I have a lot of natural breast tissue to just explant with a lift and another says I would need an implant for best results.

Doctor Answers 7

Downsizing your Implants

Dear Newmeaug13. Several factors need to be considered when deciding to remove an implant and perform a breast lift versus downsize the current size of your existing implants. This includes the amount of breast tissue that you have, the size of your current implants, the size of implant pocket, as well as your desired expectations. Several different surgical options exist that can satisfy your goal. I recommend seeking a formal consultation with an ASAPS (American Society for Aesthetic Plastic Surgery) plastic surgeon to discuss your goals and desires to determine the correct implants and surgery you will need.

Orange County Plastic Surgeon
4.8 out of 5 stars 30 reviews

Explant with Mini Ultimate Breast Lift is all natural

You are an excellent candidate for a new technique called Explant with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to remove the implants, reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.  Aligning the areola and breast tissue over the bony prominence of the chest wall maximizes anterior projection, which will allow you to go without implants.  This technique is all natural, avoids the ugly vertical scars of the lollipop or boat anchor shaped incisions and eliminates the complications of implants. 


Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.7 out of 5 stars 209 reviews

Can the Pocket Under the Breast Accommodate a Smaller Implant?

I might agree that exchange to smaller implant with a full lifting is indicated. But ONLY IN PERSON examination allows a more definitive response. 

Adjust pocket for a smaller implant

Your surgeon might be correct in that if you remove your implant all together you will miss the upper fill that the implant provides. Your pocket can be reduced and adjusted to keep a smaller implant centered in the breast as the pocket is indeed likely to be too large.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 40 reviews

Changing to smaller implants

There are several surgical options that could be used...the best one would depend on the type of result you want,  how much breast tissue you have, and where it is located in your breast.   Some women have natural fullness, but not in the most desirable places.  Ask to see examples of your surgeon's work on patients like you...this is an operation that requires experience.

Leonard T. Yu, MD
Maui Plastic Surgeon
4.3 out of 5 stars 25 reviews

Pocket Adjustment Needed For Smaller Breast Implant?

Thank you for the insightful question and pictures. Yes, it is often necessary to reduce the size of the breast implant capsules, as well as perform a breast lift, when downsizing breast implants. If this adjustment of breast implant pocket capsule is not made, patients may end up with a breast implant displacement problem postoperatively. I think that the use of the breast implant capsules as a layer of  “support” may help improve the outcome and longevity of the breast lifting procedure as well.

 You may find the attached link helpful to you as you learn more about this type of revisionary breast surgery.

 Best wishes.

Can the Pocket Under the Breast Accommodate a Smaller Implant?

        If you want a smaller implant or no implant at all, neither presents a technical challenge for an experienced surgeon.  Sometimes, an implant can help with superior pole fullness, which may improve the cosmetic result.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations, breast lifts, and breast augmentation revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

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.