I Am Wanting to Have Large Implants Exchanged for Smaller Ones, What About the Risk of Loose Skin?

i am 5'2 and have implants which were overfilled to 350 cc. i have been measured and told i am 32DD. i feel this is too large for my frame and want to be a small c. my questions are 1)how much less cc's do my new implants need to be approximately to achieve my desired cup size? 2) i have good skin elasticy but will i likely have loose skin? 3) besides reducing the pocket is there anything else that can be done to help appearance? i have had these implants for 11 yrs.

Doctor Answers 18

Removal and Replacement

When breast augmentation patients are unhappy with breast size, the majority would like to have larger implants.It’s unusual for patients to want smaller implants, but never the less this occasionally does happen.This may occur for a variety of reasons, but when it does happens, it represents a surgical challenge.Although these cases are challenging, with careful attention to detail, results can still be excellent.
The presence of larger implants results in stretching of the overlying soft tissue and increased breast pocket size.When undergoing removal and replacement with smaller implants, these issues must be dealt with to obtain an optimal result.In some cases, the breast pocket will need to be adjusted to avoid excessive implant displacement.This type of movement can be minimized by utilizing implants with wider base dimensions.This will also tend to create a more natural appearance and will hopefully address this concern as well.
Breast size is also an important issue, but discussion is always difficult because cup size means different things to different people.For this reason, we strive for harmony, balance and proportion when selecting breast implants.
It’s important to discuss all of these issues with your plastic surgeon before proceeding with this procedure.With careful attention to these details results can be excellent.

Reducing implant size through a circumareola incision

If your current size is 32 DD and you desire a C, that is 3 cup sizes smaller.  For a 32 inch chest that corresponds to 300 cc's.  Your 350 cc implants can be removed and excess skin resected through a circumareola approach.  Without the implants, your breasts will droop and you will need a mastopexy.  Depending on how ptotic it is, it is possible that it can all be done through the circumareola incision.  It is important that your remaining breast tissue is lifted on the chest wall and your nipples horizontally aligned to give you more youthful perky appearance.

Best of Luck,

Gary Horndeski, M.D.

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

Deflate the implants - helpful tool for some

The two unknowns in your situation are 1) what size of implants should be placed? and 2) will you need a lift after downsizing the implants?

 Here is a counter-intuitive idea for you that I have used several times....deflate the implants.

This is a very simple awake office procedure with basically no pain.  You will instantly be able to start over in the decision process regarding size and need for a lift.  It is much easier to "simulate" addition of volume to pick your implant size.  You may discover that you are a small C cup without implants and a lift is all that is necessary.

Of course, a component of the eventual surgery requires implant removal which is quite easy. 

York Jay Yates, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 154 reviews

Decreasing My Breast Implant Size-Will I Need A Lift?

Dear bj1994,

It is always easier going up in size than down in size after a breast augmentation.  This is because there are so many variables to consider such as pocket size, skin elasticity, implant size differences, etc. 

Since your implants are saline, I would recommend you consider allowing your surgeon to deflate your implants with a needle place under local anesthesia and allowing the skin and the breast tissues to shrink back to their baseline.  This baseline will different than where you were 11 years ago due to the effect of having the larger implants for years, aging, and the normal effects of childbearing, nursing, etc.  It usually takes a few months to reach your new baseline and then you and your plastic surgeon can decide if you will require a breast lift and also the size of the new implants to achieve the look and size you desire.

I hope this helps and best of luck.

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.6 out of 5 stars 68 reviews

Increasing Implant Size with Your Breast Revision

Yes, it is possible to #increase your implant size with a #revision. However, the #pocket will need adjustment and a lift may be necessary; to better #support the new implant. Additionally, a mesh for further support may be helpful depending on the #implant size and skin #elasticity.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 further revision surgeries. 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.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Implant Exchange

Thank you for inquiry.Your first step is to be properly examined by a Board Certified Plastic Surgeon.He/She will be able to tell you if it is feasible for you to get smaller implants without any lifts or internal sutures.They will have to check for several things.For instance, if you have stretch marks on your breasts, this might be an indication that you have some skin laxity.They would have to see how much smaller you want to go with your size and what your nipple position is currently and if that will change with the smaller implants.So, I think a consultation with your Plastic Surgeon is indicated here to accurately answer your question.

Eugene Kim, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 50 reviews

Need for breast lift is probable

If your current bra size is 32DD and you want to go down to a 32C size, then you will need to exchange your 350 cc implants for much smaller implants.  With smaller implants, it is highly likely that you will have drooping of your breasts.  I think that you will need some kind of mastopexy, or breast lift.  Exactly how much of a lift you will need will depend on your physical examination.

James Tang, MD
Houston Plastic Surgeon
3.3 out of 5 stars 16 reviews

Smaller implant exchange

Exchanging your implant to smaller ones, may cause your skin to be looser. An exam is helpful but the final determination may require it to be performed in the operating room.

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

Smaller implants and loose skin

It is certainly possible to go to a smaller volume implant.  Your body does not like empty space and, if you have good skin elasticity, should tighten down around the new, smaller implant just as it does when we remove fat during liposuction.  As to the question about which volume implant will give you the cup size you are looking for, this is something you will have to work out in conjunction with your plastic surgeon.  Bra manufacturers do not make standard cup sizes.


Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 23 reviews

Going smaller with implant exchange

If your implants have been in a long time the skin envelope may be loose, however if the nipple is not ptotic or drooping you might get by without a lift. The size implant you need is a guess without examination, and it could be possible if you really are a DD and want a small C you might not need an implant at all.

Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 39 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.