What is the technique used and the cost of deflating Saline Implants (350cc's over the muscle w/unilateral Grade 3 capsule)?

Intentionally deflating a saline breast implant can be a very useful tool in the management of a woman who isn't sure what her breasts will look like without her implants and is considering going without them all together or downsizing, as you are.  Any board-certified plastic surgeon who performs breast augmentation surgery should be capable to managing this for you for relatively little cost in the office.  Though the process of putting a needle in the implant is simple, I would only move forward with the procedure after developing a plan for treatment thereafter with a plastic surgeon you trust.  You may not need to know exactly what will be done in the future, but you should have a conversation about the likely possibilities as well as their cost and risks before beginning the process.  With regard to the profile of the new implants, the moderate or moderate plus implants may give you a more natural-appearing shape than you have had with the high profile implants, but your contracture may be contributing to the overly perky and projecting shape you are likely seeing now.  I would choose the volume and profile of your new implants based on your base diameter (measurement of the width of your breast) and your goal breast shape. 

In office breast implant deflation is a useful procedure for patients with your goals. This procedure is generally done under local anesthesia and sterile prep. Costs should be minimal. As you mentioned in your question, going this route will allow your breast skin envelope to retract and for you and your plastic surgeon to get a better idea of whether breast lifting would be helpful or not. Keep in mind, that capsulotomy/capsulotomy will also be indicated, given  the presence of thickened capsule in your case. I hope this, and the attached link, helps.

Deflating saline implants with a needle can be easily and safely done in the office under local anesthesia.  However, with a deflated implant, there may be irritating wrinkles and corners.  You might want to consider  having the implants removed.  This can also be done in the office under local anesthesia, and eliminates the need for removal later.  If you do have a grade 3 capsule, the capsule will also need to be removed.  You may not be able to tell your final shape after just deflating if the capsule is not removed. This is not done under just local anesthesia, but with sedation or under general anesthesia. I do suggest having a board certified plastic surgeon doing the procedure, and not "just any doctor."  If the doctor is not familiar with the anatomy, he might place the needle in a dangerous location.  Deflating saline implants is not a very costly procedure.

The short answer is that the implants can be deflated by anyone who is willing to insert a needle through the skin and into the implant.  In and of itself, it's not that complicated.The larger issues are (1) can the person who is doing this take care of you in case there is a complication (such as bleeding or infection which, while rare, can occur even with a simple deflation), (2) what are you going to do with the deflated implants in there and (3) what is going to be required to give you the most aesthetic result?You should, of course, have one or more consultations with a board-certified plastic surgeon to discuss this, as it is not a simple issue.  I would favor a plan in which you have them deflated and then proceed to having smaller implants inserted, probably with a lift.  But you'll need to have all of this done under the supervision of a surgeon you're comfortable with.The deflation is an important step but it's just the first in an even-more important process.I hope that this helps and good luck,Dr. EMember of RealSelf 100