Is There an Increased Risk of Infection for Secondary BA Surgery Than Primary to Downsize Implant?

I had implants too large put in 6 months ago. I have visible edges and distortion of the implants as they were too wide for my breast width. Is the replacement with smaller implants an easy surgery? Are there higher risks of infection then in the initial augmentation? Does the implant need to be surgically excised or does it release easily from the pocket on exchange? Thanks.

Doctor Answers 8

Risk of infection

I don't believe you are at increased risk of infection from a second operation to decrease the size of your implants.  You should go to a plastic surgeon who has expertise in breast surgery to decrease your risks further.  Good luck with your operation.

Los Angeles Plastic Surgeon
4.8 out of 5 stars 50 reviews

Implant exchanges

Implant exchange surgery is usually fiarly straightforward at six months after a previous procedure.  Sometimes in exchange for smaller the implatn pocket needs revision.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Infection Risk from Revision Procedure

Every time you have surgery there are inherent risks, and infection is one of them.  However, a second procedure doesn't mean the percentage of risk for infection (about 5 percent) goes up.  Choose a board-certified plastic surgeon that has extensive experience in breast revision procedures, not just breast implant procedures to perform your second operation.  There is a bit more work involved with a revision procedure.

Norman M. Rowe, MD
New York Plastic Surgeon
4.9 out of 5 stars 58 reviews

Risk of infection during secondary breast surgery

Your risk for infection during a secondary breast surgery is the same as the first procedure and full surgical precautions should be taken to prevent an infection.  This can include the use of a surgical soap scrub the night before surgery as well as the morning of surgery.   If the implant is too large then the capsule will also be too large and will require a capsule reduction procedure at the same time.  This procedure is know as a capsulopexy or capsulorraphy.  This will keep the implant from falling off to the side.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews



There is still the 5% chance of infection just like the primary surgery. There is a little more work involved because of the capsular but at 6 months there should be too much. You should be fine as long as your doctor is a certified PS.


Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon
3.3 out of 5 stars 9 reviews

Infection risks for secondary augmentation

In general, most things are easier the first time, though with a secondary breast augmentation infection risks are similarly as low as with the first procedure. The implant is quite easily removed, and the 'ease' of the fit with the new implant will depend on the breast envelope and pocket size. What you describe just might need adjustment and repair of the breast pocket, not so easy, but can go very well.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Risks of secondary breast surgery

The infection risk of a second procedure should be no higher than that of the primary procedure. Typically the implant comes to very easily. The decisions he need to make with her surgeon is the amount of downsizing. I find this to be the most difficult sizing decision and implant surgery as there are no mechanical aids to assist as there are for patients having primary enlargement or secondary enlargement. However since you know your preoperative breast width that should be a useful guidance using the appropriate implant. If this implant is a lot smaller than the initial one consideration may need to be given to reducing the size of the capsule and possibly to reducing the skin envelope, although after only 6 months I would expect that her skin elasticity hasn't been permanently altered. Thank you for requesting and best wishes

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Risks Associated with Downsizing of Breast Implants?

Thank you for the question.

 No, the risk of infection is not necessarily greater with revisionary breast augmentation surgery. Generally speaking, the breast implants be removed quite easily ( no need for “surgical excision”).

The questions that will need to be answered during direct consultation will be:
1. Which of the breast implant sizes will most likely achieve your size goals;  I prefer the use of goal pictures to help with this communication process.
2. Is the overlying skin/breast tissue elasticity sufficient to “bounce back”  over the smaller breast implants?
3. Do the breast implant pockets themselves need to be adjusted (internal suture repair) to appropriately accommodate the smaller breast implants?
 I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 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.