The Surgeon Minute

Reasons and Methods to Downsize Breast Implants

Reasons and Methods to Downsize Breast Implants

“Implants are not permanent products,” explains plastic surgeon Dr. Christine Hamori. In all likelihood, they will need to be replaced following a primary augmentation. What Dr. Hamori is finding in her practice is something that seems to be a national trend: patients who originally got their breast implants in their 20’s and are coming back in their 40’s to have them replaced are wanting to downsize their implants. Below, she describes the reasons why and the methods to achieve a great revision augmentation.

Reasons for Downsizing Breast Implants

If a plastic surgeon has been in business long enough, they will begin to see their breast augmentation patients coming back in to replace their implants. As Dr. Hamori explains, breast implants are not permanent. “They wear out similar to a tire on the street,” she shares. It used to be that the average lifespan of a breast implant was about a decade, and now with technological improvements, it’s closer to 15 years.

Although the implant may wear out, most of the time patients are concerned for other reasons. Other more common implant problems include:

  • loss of shape
  • drops out of position
  • no longer fits the patient’s current lifestyle


Tastes & Bodies Change with Time

Just like with fashion, patients’ tastes change with time. What may have looked good at 20 no longer fits their lifestyle at 40. Furthermore, age takes a toll on the body. As women get older, they tend to gain weight, especially during menopause. This can cause breasts to become too large. Pregnancy and breast feeding can also can leave their mark on the skin and tissues of the breast, making them weak and stretched to the point where they can no longer hold the breast implant in it’s original position.

Patients come back into the office seeking ways to maintain or restore the shape of their breasts. This typically entails:

Going Smaller – Not Always a Simple Exchange

Dr. Hamori and her colleagues are finding that many of the patients who got their first implant in their 20’s want to go smaller in their 40’s. “It’s very common that people are coming in with a D, DD and they want to go down to a small C. And it’s challenging” explains Dr. Hamori. The difficult part is the breast envelope may be too wide for a smaller implant. It’s important for patients to understand that it is rarely as simple as exchanging the larger implant for a smaller implant. The surgeon must also “tighten the pillowcase” in order to put a smaller pillow or implant inside. This usually requires a breast lift.

The Deflation Technique for Downsizing Saline Implants

If the patient has saline implants, Dr. Hamori will often do what is called a “deflation.” This procedure is performed in the office under local anesthesia. Once the patient is numb, Dr. Hamori will pull out the saline so that the patient will see the breast deflate. Since this can be kind of scary to the patent, she will sometimes just take a little bit out and then send her home in a tight sports bra. Over the next few days, the breast will continue to deflate.

This deflation technique allows the surgeon and the patient to assess the extent of your natural breast tissue so that you can see, with external implants, what size best fits your body and current aesthetic.


Dr. Hamori will typically perform the deflation about 6 weeks before an implant exchange. This way, the breast skin has time to retract and the capsule to shrink a little bit. The technique allows her to give patients a better result, especially if they want to go smaller.

Patients are really happy with the results from downsizing their implants, as long as they understand what to expect. A breast lift can be critical for tightening the breast envelope. There will be some scarring, but the end result is a more youthful, perky looking breast. Patients don’t want to feel matronly! They want to wear a sundress without a bra and this procedure allows most to do exactly that.

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