Breast Implant Size Revision Surgery
Surgery to make breast implants bigger or smaller can be a simple and painless procedure by either adding or removing saline or replacing the old implants with bigger breast implants.
Implant Size Revision | Capsular Contracture | Symmastia
Bottoming Out | Ruptured Implant | Double Bubble
Women who aren't satisfied with the size of their implants may choose to go smaller or larger in size. With saline implants the surgeon can remove or add fluid to change the size of the implant. This 
is usually only meant to be used as a minor adjustment with regards to small differences in size from one breast to the other (asymmetry). By adding or subtracting small amounts of fluid you can achieve better symmetry or balance in size with the breasts. To change the size of the implant any more than 20-30cc (approx) would require purchasing new implants. With saline breast implants there is a limit that you can underfill or overfill the implant according to manufacturer specifications. With silicone or gel implants the fill volume is permanent, so a new implant would be required.
Remove and Replace Surgery for Breast Implants
Remove and Replace of breast implants can be a relatively simple and painless procedure performed oftentimes under local anesthetic with sedation as opposed to full general anesthesia. The reason for this is that in most cases the patient already has a well dissected breast pocket in which to place the implant. In cases where the patient is going with an either much larger or smaller implant than they currently have, they will need to have their breast pocket adjusted to allow for the different size breast implant.
Underfilling Breast Implants
Some surgeons choose to underfill the implant for a softer more natural looking breast. This can sometimes result in a sloshing feeling with the implant as well as it increases the chance of folds with the implant that can cause rippling, constant rubbing and potential rupture. Underfilling beyond the manufacturer specifications is usually not recommended and can void the warranty of the implant.
Overfilling Breast Implants
Overfilling the breast implants usually results in less rippling and/or folding of the implant which can be visible on the surface of the breast. Overfilling also produces a longer lasting implant because wrinkling of the breast implant is one of the leading causes of failure or rupture of the product. Overfilling beyond the manufacturer specifications is usually not recommended and can void the warranty of the implant.
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> Implant Volume / Size Revision
Patients with saline implants who aren't happy with the volume or size of their breasts can elect to have revision surgery to add or remove saline from their implants. Silicone patients would have to purchase a new silicone implant in the desired size.
> Capsular Contracture
This is the most common complication for breast implant patients. A capsule is the fibrous tissue that grows around the breast implant (as with any foreign object placed in the body).
> Symmastia
The breasts appear too close at the center and the implants can appear to be touching each other. Symmastia (aka - uniboob, breadloafing) occurs only when an implant is placed under the muscle (submuscular) and the pectoralis muscle is severed from the sternum.
> Bottoming Out
Breast implants that have bottomed out can have nipples that appear too high or an inframammary fold that appears unnaturally low.
> Ruptured Implants
Decreased breast size, uneven breasts, pain or swelling can indicate a ruptured breast implant (saline or silicone breast implants). Most ruptures are covered by the implant manufacturer, although surgical costs for replacing the damaged implant are still incurred.
> Double Bubble
When tissue hangs beneath an implant which has been placed submuscular, this is referred to as a double bubble or high-riding implant. This usually occurs with an individual who has sagging breasts before their breast augmentation surgery.
