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 21

Removal and Replacement

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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
4.6 out of 5 stars 230 reviews

Deflate the implants - helpful tool for some

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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 189 reviews

Smaller implants and loose skin

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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
4.6 out of 5 stars 26 reviews

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

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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
4.7 out of 5 stars 88 reviews

Smaller implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You most likely will need a breast lift pending how much smaller you go in implant size.  See a board certified plastic surgeon to evaluate you.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 51 reviews

Downsizing has risk for skin being loose.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi bj1994, To keep it simple, you can downsize for sure and yes, there is a risk your skin will be loose (your breasts have aged 11 years since your augmentation as well as being stretched by the implant). That can be corrected with a breast lift. All of your other questions and concerns can really only be addressed by surgeon that sees you in person and sort out many other variables. I will tell you this:  Patients focused on a bra size often end up with outcomes they are unhappy with and don't understand why they don't look the way they thought they would.  My best advice is to be concerned with what you look like with a specified amount volume. What cup size or implant size you end up is really not as important as how happy you are with what you look like. (You have already found that out the hard way.) Show your surgeon what you are visualizing for yourself with photos of other patient's outcomes and open the lines of communication. They will be able to best advise you on the procedures needed to achieve that outcome, including type of lift, if Capsulodesis, Capsulectomy, is needed and recommendations for implant size. Make sure your surgeon is board certified plastic surgeon and has experience doing a lot of downsizing surgeries. Good luck!

William Aiello, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

Timing the exchange of breast implants.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This is a good question and not uncommon after augmentations done years ago.  A good way for you to be more confident of your new cup size, after the exchange, is to buy an underwire bra with a soft fabric cup for your Plastic Surgeon to put the implant sizer in.  This allows the surgeon to determine the implant style and size more accurately and meet your expectations.

David M. Creech, MD
Chandler Plastic Surgeon
5.0 out of 5 stars 10 reviews

Exchanging breast implants to a smaller size

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The procedure is more complex as the excess skin needs to be resected. Moreover, the breast pocket need to be carefully adjusted. Consult an experienced and expert board certified plastic surgeon to understand your limitations, risks, and options. 

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Increasing Implant Size with Your Breast Revision

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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
4.9 out of 5 stars 116 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.