The goal with your initial breast augmentation should be to select an implant size that gives you the appearance that you want and fits well with your body. However, after surgery, many women consider undergoing another operation to change their implant size. Some want to be bigger. Others want to downsize. As women go through different phases of life, its not surprising that their ideal breast implant size may vary. Changes in age, weight, appearance, lifestyle, and occupation are common reasons why women change their breast implant size.
Changing breast implant size can be straight-forward, simple procedure or it can be rather complex. A lot depends on how well the initial breast augmentation was performed, and what is the condition of the breasts at the time of exchange. It also depends on how well the new breast implant selection fits your anatomy.
When someone is requesting to move up in breast implant size, more space may need to be made to allow for the larger implants. This usually involves modifying the implant “pocket” with the electrocautery. When patients want to move down in implant size, this often requires sutures being placed in the capsule layer that surrounds the implant (in a procedure known as capsulorraphy). This helps to tighten the space around the implants. If there is too much loose tissue or skin, this may need to be removed with a breast-lift (mastopexy) procedure. Dr. Ciaravino’s technique of intentionally deflating saline implants to allow the skin and capsule to shrink is also extremely helpful in patients who have saline breast implants and want to go smaller.
It is important to keep in mind that breast implants should fit the patient’s breast dimensions and tissue characteristics. Breast implants that are too large for the patients frame or too heavy for the skin to support have a much higher chance of having a problem. Potential problems include bleeding, breast droop, asymmetry, and a host of others. On the other hand, if smaller breast implants are replaced, there may be movement of the implant, excess skin, or a change in nipple position. This may require excision of skin or a breast lift.
With careful analysis and wise decision making, it is usually possible to change breast implant size and create beautiful breasts that fit your body and look great.