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

I had breast implants a year ago, and recently, I have noticed them getting smaller. What should I do or what could be causing this?

Doctor Answers 26

See your doctor, but here are some issues to think about

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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!

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

How small is "smaller"?

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There are several reasons why you may perceive that your implants are getting smaller. If your implants are saline filled it is possible that they are leaking and are indeed getting smaller. For both implants to be leaking simultaneously is EXTREMELY rare and for both implants to be leaking at the same rate is even less likely, but it is conceivable that this may be the case. If they continue to diminish in size over the next few weeks to months, then this is likely the cause and you should see your board certified plastic surgeon.

Implants over time may recede somewhat by exerting a constant pressure on the ribs and chest wall and actually pushing into the rib cage. This phenomenon usually occurs as a matter of millimeters and is not noticeable, but again it is conceivable that this might be a cause of your observation.

Finally, implants can be compressed by the scar capsule that forms around them. When this happens the breast can become very hard and the implant may appear to decrease in size due to the compression that occurs. Again, your board certified plastic surgeon can easily make this diagnosis and advise you from there. Good luck.

Breast Size Change May Be Normal

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The changes you are seeing are most likely the normal "settling" that occurs after breast implant surgery.

Other causes can include weight loss or hormone fluctuations.

Deflating saline-filled implants will cause the breast to become smaller, but having both deflate at the same time is unlikely.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 45 reviews

Implants getting smaller or are you getting bigger?

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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.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

You need to follow-up with your surgeon

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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

If they are saline implants they could be leaking.

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If you have silicone implants, it is not likely that they are getting smaller, because even if leaking, silicone stays in place. It could be a change in your brest tissue. In any case, see your plastic surgeon promptly.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Unless they are ruptured saline, the implants don't get smaller

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Unless you have saline implants which are both ruptured (highly unlikely), your implants can't get smaller. However, your body can change and lose volume especially if you are losing weight or body fat. The swelling after surgery was gone by 6 months, so the changes you are experiencing are most likely in your own breast tissue volume. The only ways to change this are to either gain back some weight if you have lost a lot or to have new implants placed.

Breast Implants Decreasing in Size

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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!

Breast size change one year after augmentation

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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.

Naveen Setty, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 78 reviews

Breast impants deflating

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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.

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.