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Breast Implants: Changing Sizes

A woman’s desired breast size might change over time. What one finds to be comfortable in youth might no longer be the case as one matures in age. To change a silicone or normal saline breast implant is generally a very simple and routine procedure. There are several situations which may make it more complex. We will discuss a few of the more common scenarios.

Loose Skin – This is one of the most common reasons for breast revision surgery. The breast implant will stretch the skin out over time. This may also be compounded by previous pregnancies, sun-damaged or aging skin. Depending on the reduction in size sought, a breast lift -or mastopexy- might be required to reduce the skin enveloped around the smaller breast implant. There are various breast lift procedures. Some are less invasive than others, with minimal incisions.

Capsular Contracture – One of the most common long-term complications of breast implant surgery, in which breast revision surgery will most likely be needed. If capsular contracture is present there is a greater chance of silicone implant rupture. To reduce the capsular contracure, the capsular scar tissue must be removed and the breast implant replaced. It could be a normal saline or silicone breast implant. Even if the breast implant was removed from the “above the muscle” pocket location, Dr. Delgado prefers to place breast implants in the sub-muscular, or “beneath the muscle” pocket location. Unfortunately, women who have had a breast contracture once face a likelihood of recurrence, while women who have not are less likely to experience contracture even with later surgeries.

Simple Breast Implant Exchange – This is one of the more clear cut cases for breast revision surgery. In many cases the implant can be simply exchanged. This is especially true if the pockets are symmetrical, the skin quality is good, and the new breast implant is not drastically different in size.

Implant Removal – In rare situations a woman might want the breast implants removed, but not replaced. A woman who has had her implants in for many years and has gained weight over this time -including increased breast volume- might only require a breast lift (mastopexy). In some cases a woman might be older with a problem such a capsular contracture and just wants them removed. A woman might have had multiple surgeries for her breast implants in the past, and due to the repeated downtime and expense, may elect to have them removed altogether.

Breast Implant Removal and Replacement with a Larger Breast Implant: It is very commonplace for a woman to want to replace the current implant with a larger breast implant when a breast revision surgery (for any other reason) is performed. Some women just want to be larger, look more “perky”, and/or fill any loose skin that has developed over time. Some women request larger implants after removal of a breast capsular contracture, or corresponding with a breast lift or mastopexy.

There are many options each time a breast revision surgery is performed. The options should be discussed with a Board Certified Plastic Surgeon who has the judgment and experience to know what would be safe and the correct procedure for you.