Would like to reduce my silicone implant size. Want to know if I can go to saline. How difficult a surgery & cost? (photo)

I am 58 years old. I originally got 500cc silicone implants placed in 1987. They had to be replaced in 2000 due to both were ruptured. The doctor said that I was not a candidate for saline & that it would be best to stay with silicone. I was afraid of losing feeling in my nipples and having ugly scars. Very frustrated. Is there any help out there for me ?

Doctor Answers 10

You have options for the type of breast implants

You will have the option of going with either silicone or saline breast implants.

To ensure that you are receiving quality work at the most cost effective prices, consult with board certified plastic surgeons that own their own nationally accredited facilities. The quality must be maintained at the highest level to maintain accreditation. The surgeons also have incentive to hire and train quality staff (to ensure that surgery is efficient and enjoyable), to ensure comfortable and private facilities (to encourage referral), and to eliminate waste (to ensure that these facilities can compete effectively).

Consult with 3 experienced and expert board certified plastic surgeons to understand your options.

West Palm Beach Plastic Surgeon
4.5 out of 5 stars 37 reviews

There's always help!

Do not despair.  You can always go with saline implants. I have found that patients find them less natural feeling, so what you may want to investigate is the Ideal Implant. It is a saline implant that feels more like a silicone implant but is only available with certain board certified plastic surgeons.  Regardless, the implant choice is up to the patient.  With downsizing, you would most likely need a mastopexy so your breasts don't become deflated-looking. But it should be a smooth surgery in the right, qualified hands.  Best of luck to you!

Whitney A. Burrell, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 8 reviews

Breast Revision Surgery

Not sure why you are seeking to exchange your implants from silicone to saline, however of course it's doable. Keep in mind your photos indicate that you have ptosis ( sagging breasts) therefore you might want to consider a lift (after bilateral explant)  with smaller implants. In my opinion, that combination of procedures will make your breasts looking the best

Thomas Trevisani, Sr., MD
Orlando Plastic Surgeon
4.9 out of 5 stars 57 reviews


You could have the implants changed for saline implants.  This would involve removing the current implants and capsules and replacing them with saline devices. A more involved procedure would add a lift to the breasts so they are not so ptotic.  

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 49 reviews

Silicone to saline implants

Thank you for your question

you can change your implants out for saline. It is important to know before surgery if you have capsular contractures. Capsular contractures result in hard breast . 

     If you do not have a capsular contracture one exchanges the silicone implants for saline implants. I like to get the input from the pt. in order to help determine the final size . 

      If the pt. , has a contracture the surgeon needs to remove the scar tissue before placing in the saline implants .   It is not uncommon for my pt's to be driving 2-3 days after surgery . Different surgeons use different techniques to perform this surgery.

I utilize the finesse technique , that I invented . This minimizes pain and bleeding.

        Cost can only be determined after your examined .

Joshua Halpern, MD, PA
Tampa Plastic Surgeon
4.8 out of 5 stars 61 reviews

Would like to reduce my silicone #implant size. Want to know if I can go to saline.

As far as I can tell from your pictures, you have healed excellently from your previous surgery.  While going from silicone to saline is certainly an option, I am curious as to the reason why.  Choosing between saline and silicone is really about cost (saline is cheaper) and feel of the implants (silicone feels more natural in most cases), and has nothing to do with choice of volume/size, scarring, sensation changes, etc.  To clarify your concerns and your goals, your best bet is to consult with board-certified plastic surgeons and have an OPEN conversation.  When downsizing implants, it is not uncommon to need to do some additional work such as tightening the capsule or implant pocket, changing the pocket and/or removing the capsule if you have contracture, breast lifting, etc.  There is much to discuss so schedule some consultations in-person so you can start teasing out what you want and your surgeon can help you choose the best option for you!  Make sure to schedule consults with board-certified plastic surgeons. Good luck!

Megan Jack, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 15 reviews

Saline replacing silicone

You can exchange the silicone implants and replace them with saline. If you go smaller additional techniques might be needed. The surgeons price might start around $6,000 plus OR and anesthesia,depending on many variables. Seek a consultation with a board certified plastic surgeon.

Laura A. Sudarsky, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 36 reviews

Would like to reduce my silicone implant size. Want to know if I can go to saline. How difficult a surgery & cost?

Exchange to salines alone could be very simple in the $4,000 ranges. But if you need exchange, capsule surgery, a lift than fee is in $8,000+++ ranges. Best to seek only in person opinins.

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 170 reviews

Would like to reduce my silicone implant size.

Yes, you should be able to undergo downsizing of breast implants. 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. Breast lifting may also be necessary. Much will be dependent on your physical examination; 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” 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, specifically downsizing, breast augmentation surgery concerns), helps. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,448 reviews


The new cohesive gel implants are the most recommended.  There is no reason to think
you will lose feeling or have bad scars.  Discuss your concerns with your surgeon.           

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 57 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.