Smaller implants- lift needed

Almost certainly you will want to consider a lift at the same time as your replacement surgery with a smaller implant.

If the skin is already loose (droopy), this problem will only become more pronounced once a smaller implant is placed.

A board certified plastic surgeon can go over the options with you.  You will certainly want to discuss where exactly the implants are (above/below the muscle) , what type of lift will give you the best appearance, whether a complete vs. partial capsulectomy is planned, drains, etc.  If possible, you can make this easier if you obtain records from your first surgery, so you know the exact cc size of the first implants.

When downsizing the size of an implant, small increments can do well if the skin and other tissue around the breast implant is youthful- this tissue can then contract a small amount for a good aesthetic outcome.

You are describing a situation where you already have some "ptosis," or drooping of your breast form, and so it is likely something else will need to be done. It sounds like 10 years after your last operation, your are thinner, leaner, and likely healthier and want a more proportionate, athletic type of breast form.

Some of the important issues that will be involved in your surgery are the position of your implant with respect to your muscle and breast tissue, the location of the crease below your breast (your inframammary fold), and the current width of your chest wall.

I'm going to bet that with a replacement of your current implants with something smaller, and additionally a lift of your breast tissue to reshape it and replace it to a more youthful, higher position, you will be thrilled with the result.

Make sure you are evaluated by a ABPS board certified plastic surgeon who can take into account all of the important nuances involved in this kind of revision surgery.

Breast lifts and Breast implants accomplish complementary tasks. In a breast lift, the position of the breast and breast nipple is elevated. It does not add volume to the breast.  In a breast augmentation, the volume and projection of the breast are elevated. Often, these two procedures are performed together to accomplish both tasks.

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Every situation demands a customized solution.  There are a multitude of factors that determine how your breasts look with implants:

• Location above or below the muscle
• Whether you have round or shaped implants
• The relationship between implant width, projection, and volume
• The position of the implant relative to your inframammary fold
• The relationship of your fold relative to your chest, etc.

Skin tightening can be achieved in various ways although if done to a significant degree usually requires a vertical incision between the areola and the inframammary fold. You should try to see if you are a candidate for a vertical lift instead of the inverted-T or anchor incision lift, which it sounds like you might possibly be. It all becomes an issue of compromise and trade-offs.

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