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 11

There's always help!

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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!

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 14 reviews

Breast Revision Surgery

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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


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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.  

Silicone to saline implants

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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 65 reviews

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

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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

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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 39 reviews

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

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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.

Would like to reduce my silicone implant size.

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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.


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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 61 reviews

About Reducing the Size of Silicone Implants Over 10 Years Old and the Costs

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If breast implants either are either #ruptured, or, more than 10 years old, #consideration should be given to #replace them. 

It is certainly possible  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. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.

Other factors which contribute to the outcome are #size, #shape, and #profile.  The #profile is determined by the amount of #projection versus roundness that the you desire, as well as the #size of the implant and size of your chest. Also, the placement or incision location will also have an effect on profile.  

More women tend to choose silicone breast implants due to the natural feel and appearance. Silicone implants are now made of a cohesive gel which are anti-leak even when cut. Look and feel like natural breasts due to the cohesive silicone gel material. New generation silicone gel implants are far superior than those used in the past and have a proven track record of safety. Silicone implants have gone through more testing than any other medical device and are the preferred choice for over the muscle implant placement. 

The #costs of #BreastAugmentation are contingent on several factors. Such as geographic location, the skill and experience of the surgeon, and operating room and anesthesia fees. Also, different breast implants may have different costs. The approximate costs can be found here on the Real Self website, Surgery.org, or PlasticSurgery.org.

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. Another element to a satisfying result of your #augmentation is realistic #expectations. Talk to your surgeon at greater length and be sure to view before and after pictures and reviews beforehand to gain more reassurance of the procedure.

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.