Is downsizing both profile and diameter a complicated procedure? (photos)

I got 400cc High profile mentors 1 1/2 years ago. I'm 38 and 130 lbs. I have been unhappy with my result because they feel too big for me and my active lifestyle. I went from flat to a 32 DD. I feel like they stick out (profile) and that they go way out to the sides. I feel a mass under my underarms. Is it possible to minimize the profile and the width for my frame and still have a good result? Or should I just consider explanting to minimize risk? Are the revisions I'm wanting unreasonable?

Doctor Answers 4

Breast Revision with Smaller Implants

It is certainly feasible to #downsize to smaller implants and also alter the positioning; if possible. However, decreasing is size may also require a Breast #Lift to to #tighten loose skin, better optimize the end result. Any #revision has risks of unhappy outcome or other complications. Also, the right implant for the revision is contingent on shape of body and your desired outcome.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Is downsizing both profile and diameter a complicated procedure?

I am sorry to hear about your concerns after breast augmentation surgery. Yes, you should be able to undergo downsizing of breast implants without too much difficulty or risk (I would not classify this as a "complicated procedure"). Of course, every procedure does carry some risk that you will need to consider prior to making a decision which way to proceed.

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 will be necessary will mainly be dependent on your physical examination and how much smaller of a breast implant is used; 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. I have found that the use of words such as “natural” or "down a cup size” or "C or D 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 breast surgery, specifically downsizing breast augmentation surgery concerns), helps. Best wishes.  

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

#BreastImplantRevision - both profile and diameter

Doing the procedure is not necessarily that complicated if you simply had smaller implants put in...except that you may also need to have the lower portions of the pockets sewn off (if you go too small) and no matter what you do there are risks of infection, capsular contracture etc.  It depends on how unhappy you are.  You appear (from the photos of course; you need to be assessed in person by a board-certified plastic surgeon) to have a very nice result even if the implants are somewhat large for your frame (while many women would be very happy with that result, you're the one who has to be happy).  I would probably advise you to leave them alone if you can since you risk opening a "can of worms."  But if you decide to have smaller ones put in I'd probably recommend about a 275-300 to maintain volume without reducing too much.  This, too, should be discussed in person with your PS (have him or her show you what 400 cc is, 300 etc., so that you can get an idea of it).  I hope that this helps and good luck.  Dr. Alan Engler, Member of #RealSelf500

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Breast implant revision or removal?

Thank you for asking about your breast implants.
  • I am sorry you have had such a disappointing result.
  • A 400 cc implant is very large for a woman of 130 pounds.
  • High profile implants do stick out - they are designed to give volume on a small chest.
  • You could have a pretty result with a much smaller implant and a revision of the pocket to keep the new implant centered on the chest and away from the side.
  • A round moderate plus implant in the 280 - 320 range is a reasonable place to start.
  • But the decision requires measurements, sizers and a thoughtful discussion of implant size with your surgeon to be sure the new implant suits you and your life.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 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.