I'm glad to hear you're downsizing your implants. Implants as large as the ones you have at present can have long-term problems with malposition (downward descent of the implants to due progressive stretching of the breast supporting ligaments) and dimunition of skin elasticity.
After your operation, without a lift you will certainly look as though you have extra skin on the breast. If you are young and the skin still has good elasticity, the skin may shrink to an acceptable appearance. This could take several months. If you have many stretch marks, the skin may not shrink as much as needed. If you don't wish to wait that long to see the results, in some cases a circumareolar mastopexy (incision just around the areola) can be used remove the excess skin at the time of implant exchange.
Your best bet is evaluation by a board certified plastic surgeon to determine what's the best option for you.
Hope this helps. Best of luck.,
Write a comment on this question