Replacing 421cc implants with smaller ones? (Photos)

I had a breast augmentation in February 2013 and got 421cc mod+ silicone implants. I went from an A to a DD, which at the time seemed like a good idea. Though I have never regretted the decision, I do feel like I want to go smaller and achieve a more natural look. Now the question is, how realistic is it for me to downsize the implants from a 421 to a (approx.) 300cc implant, with minimal scarring & and a natural look. Will I need a lift for sure? What are your experiences with implant exchanges?

Doctor Answers 3

What happens when you choose implants that are too big?

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Based on your photos, I believe that you are a simple exchange. Remove the existing implants from the old incision and put in smaller ones. Your skin looks like it will do just fine. You don't need a lift for sure. The skin has a tremendous ability to retract in many cases--especially if you are young and if you have tight skin. Older patients and saggy breasts are another story and often require some form of a lift to obtain a satisfactory result.

Downsizing breast implants.

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Yes, you should be able to undergo downsizing of breast implants. Keep in mind as you are thinking about your goals that sometimes adjustment of the breast implant pockets (capsule adjustments) may be necessary to achieve the outcome you are looking for.   Whether or not the adjustment of the breast implant capsules (capsulorraphy) and/or breast lifting will be necessary will mainly be dependent on your physical examination and how much you choose to downsize; specifically, factors such as the amount of redundant skin and quality of skin elasticity will be important.    

Generally speaking, the best online advice I can give to ladies who are considering revisionary (downsizing) breast augmentation surgery is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful.  For example,  I have found that the use of words such as “natural” or "down a cup size” or "C cup" etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. 

3. Once you feel you have communicated your goals clearly, allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.

I hope this, and the attached link (dedicated to revisionary, specifically downsizing, breast augmentation surgery concerns), helps. Best wishes.  

Downsizing breast implants

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Thank you for your question.  It can usually be straightforward to exchange breast implants. The implant size difference is what will determine whether additional procedures and/or incisions will be needed.  Sometimes it is not possible to see exactly what is going to be needed until the implants have been exchanged.  The bigger the difference in the implant size the more likely you are going to need additional procedures and/or  incisions. Given the size difference that you have mentioned I think there is a high likelihood that you may need additional incisions to take up the excess skin and breast tissue.  

Gerald L. Yospur, MD
Mesa Plastic Surgeon
5.0 out of 5 stars 4 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.