Breast lift after implant exchange

It is difficult to give you an answer without seeing you. If your breasts are sagging now and you want to go to a smaller implant, it is more likely that you will need to combine the exchange with a lift procedure.

To scribemjp,

Hi! I have seen any number of women in your situation. So I think I can visualize you even though I have not seen you. I will predict that you need smaller implants (maybe 100cc smaller) and a good lift.

You need a lift with either an incision around the nipple only (doughnut scar) or, at the most, a "lollypop scar". HOW the lift is done is critical. The breast tissue itself needs to be moved up on your chest without relying on skin tension. If the lift is done by just tightening the "skin bra", then you can end up with wide scars and a poor long term shape.

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Scribem,

When you downsize breast implants, you usually will need a lift. This is because replacing the implants with a smaller volume implant will lead to excess skin since the implant is no longer filling the full volume of the breast and stretched out skin. However, breast lift is not the end of the world.

The incisions tend to heal very nicely and if there is any asymmetry between your breasts, this can be improved at the same time as well.

One technique that you can do to help avoid the breast lift or minimize it is to have your plastic surgeon "pop" your implants with a needle several weeks before your implant exchange surgery. This can be done since you have saline implants.

When the implant is deflated, the surrounding skin will retract due to the elasticity of the skin. When the new implants are placed, the skin envelope will be smaller than if the original implants were still stretching the skin. However, this all depends on the quality of your skin.

I hope this is helpful.

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As you stated you currently have saline implants, in the past I have had patient stand in front of a mirror on the day of the surgery and with a syringe and needle, puncture the implant and draw saline fluid out of the implant until you get to the volume you desire. 

That way you can participate in the decision and get an idea of what the breast might look like simply with a smaller implant.  Of course at that point you are comitted to changing the implant and you would proceed to the operating theatre.

You do not necessarily need a lift, and I would try to avoid it if at all possible as it would require extra scars.  Depending on how much smaller you want to go, you may be able to avoid a lift entirely.

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You are right - you will need a lift at the same time as the reduction in size of your implants.

My technique called the "Tear Drop Augmetation mastopexy" is ideal for this problem. This technique involves the lifting of the breast tissue from above the breast which yields exact results with durability. The incision is only around the areola - not a lollipop incision- and the shape is great.

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