What Should I Do when my Breast Implants Appear to Be Getting Smaller?

When a question such as this arises, it is of course best to see your doctor for an examination, to rule out rupture or scarring around a breast implant. Some times breasts begin to appear firm and small. This may indicate capsular contracture, or hardening around an implant, particularly if the implants were placed above the muscle. Over time, breast tissue diminishes in a patient with a stable weight. Patients may think their implants are shrinking when in fact it is their own breast tissue. However, as native breast tissue diminishes, implants become more visible. The answer may not be to go larger, since those implants will tend to be more and more visible, more palpable, and have more rippling. The larger a given implant is in the same patient, the more these problems tend to occur. You may want to consider these variables with your doctor, as well as discussing above vs. below the muscle placement. Good luck!

Since it's been about a year after your surgery, your implants would have had settled already. As a result the only reasons your implants would decrease in size would be as a result of weight loss (in which case your natural breast tissue would be decreasing but not your actual implants), hormones, or rupture. Another reasons may be swelling, which could have been extensive and is just now subsiding. Whatever the case, it is important to visit your surgeon to rule out rupture. Best of luck!

The most likely explanation is that the initial swelling associated with surgery has completely resolved and your true size after augmentation is now apparent.  Usually, most swelling in the breasts will resolve by around 6 months.  Another possibility is that your native breast tissue is decreasing in size either due to weight loss, hormonal changes, etc.  This type of change is normal as women age.  Finally, leaking implants can potentially lead to a decrease in size.  However, it is rare that both implants would leak at the same rate and at the same time.  Usually when saline implants deflate, the saline is absorbed by your body rather quickly and eventually the implant is completely flat.  Silicone implants do not "leak" like saline implants and any silicone that does escape the shell of the implant is usually contained within the capsule that forms around your implant.  An ultrasound or MRI may help determine if the implants are leaking.  The best course of action would be to visit with your plastic surgeon.

It is possible that your implants are deflating. There is a major difference with saline and silicone in this respect. Usually when saline implants rupture the fluid is dissolved by the body and the breast goes flat. Silicone implants usually do not leak like saline implants do; instead the breast remains mostly full. You should speak with your surgeon about your concerns and ask him about your options. Most implants come with a 10 year manufacturer’s warranty and if you bought the extended warranty you could have a stipend for your surgical costs.

Change in your breast size and shape is normal during a woman's life - even after breast augmentation.  Within the first year after breast augmentation the breast does change slightly.  Usually the breast starts out being somewhat firm and it softens during the first 6-7 months.  Sometimes this is perceived as "getting smaller" because the shape of the breast also loosens a little.

Your breasts may just be getting smaller as well.  If you have lost some weight that may be the issue.

It is unlikely that the implants are deflating (especially both implants).  Saline deflation is not subtle.  You will wake up one morning with a "flat tire".

Breast size will continue to descend for about 6 months from the time of an implant placement.  Changes in the size of breasts one year after implant placement is more likely due to hormonal changes and or weight loss. 

A saline implant that leaks does get smaller but eventually ends up totally deflated.  Having 2 deflate at the same rate is almost impossible.  Silicone gel implants don't get smaller even when they fail because the capsule that forms around the implant contains all silicone.

Check back with your surgeon.  If you have lost weight, your breast tissue might be smaller in volume.  I doubt, however, that there is a problem with the implants.

If you notice your breasts getting smaller you should visit with your surgeon. He/she can assess you and see if there is concern about leaking. If you have saline implants you can simply wait and see if the problem continues. If you have silicone implants your surgeons may order an MRI to see if there is leakage from the implant. Either way you will likely need the implants replaced. If they were placed in the USA you should have a warranty (as funny as that may sound) on your implants. You will be entitled to new implants and probably an allowance towards the surgery to replace them.

I hope this info helps!

I have noted patients with similar concerns who have actually gained weight which resulted in an increase in the natural breast tissue. They percieved this as a decrease in size of their implants when it actuality the implants were intact but relatively smaller given the overall increase in breast volume.
It would be HIGHLY unlikely that BOTH of your implants got smaller.
If they are SALINE and it is a slow leak, you will definitely notice a change in size.
If they are SILICONE, see a physcian and an MRI may be advised.

You do not specify if your breast implants are saline implants or silicone implants. If they are silicone breast implants, even if ruptured, they should not change size. This is because your body forms a capsule or sheath around the implant. If the breast implant ruptures, the silicone stays within this capsule. If your breast implants are saline and ruptured, then the volume would almost completely go down to your pre-implant size. You really need to go see your plastic surgeon for an exam to determine if anything needs to be done.
Good Luck.
David Shafer, MD
Shafer Plastic Surgery
New York City