Best Approach for Downsizing Breast Implants? (photo)

I have 700cc subpectoral mod+ silicone. Periareolar incision. Flat chested preop, no asymmetry. I have mild symmastia & bottoming out.I want smaller implants about 350-400cc. Best approach to accomplish a great result? A staged procedure of removing implants with symmastia/bottoming out repair, then re-implanting after 6-12 months? I am 24, 5"5 and 110 lbs, no kids and don't want a lift. Skin is in great shape. Hoping it would shrink up nicely if explanting then reimplanting later.

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age 18-24 periareolar symmastia 5 ft 4 in to 5 ft 7 in silicone implant 110-129 lbs bottom out moderate profile subpectoral

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11 Doctor Answers | Asked by guest12

Doctor Answers (11)
Community Comments (1)

Downsizing breast implants

Thank you for the photos. Your current implants are out of proportion to the rest of your body. My preferred way of dealing with this problem is exactly what you proposed. Remove the implants (if it would have been saline, I prefer to deflate them), close down the medial pockets to correct the symmastia and allow your breast tissues to tighten up on their own. This will avoid further scars on your breasts with re-augmentation with smaller implants. The only down side is that you will be flat... more

Breast implant reduction in size

I agree with the other posts and your remarks that a staged approach is best. I think you have a 50% chance of needing a lift so keep that in mind. Overall, think you will be happier in the long run with a smaller more proportional size for your frame. Good Luck!

Downsizing

There may be some benefit in doing this in two stages. However, staying without implants for 4-6 months is usually not acceptable to most patients. I think a good result can be achieved in one stage where the implant is placed in a new pocket between your anterior capsule and the muscle. This will result in correcting your symmastia while at the same time closing the space from your previous implant. On another note,... more

Mini Ultimate Breast Lift and removal of implants

The best approach for you would be Mini Ultimate Breast Lift and removal of implants. At surgery your breast tissue is reshaped and displaced medially and elevated to create the cleavage and the upper pole fullness you desire. This could be done in 1 procedure or 2 if you would rather stage the procedures. The advantage of doing 2 procedures would be that with the implants removed, your skin will shrink and regain it's tone. In the 2nd surgery, less skin would need to... more

The degree of skin/tissue resiliency/contraction that will occur intraop is the main variable.

Thus, it may be sensible to allow your surgeon to make the choice between one or 2 stages at that time. Without any question, the use of Strattice is an important adjunct, but I would place it only during the same operation in which the new implants are to be placed. The use of that product makes the choice of pocket location less critical.

Staging of Breast Implant Revision

Hi there- If your priority in pursuing revision of your outcome is to avoid a breast lift, I think that the stages approach you describe MAY help, by allowing your skin time to contract after removal of the large implants currently in place. On the other hand, it is important for you to understand that i tis possible that even with this approach, a lift will be necessary to achieve your goals of a youthful and firm breast, as 700cc implants are very large and your skin has been... more

Downsizing

Hello, I would be very surprised that your skin is 'in great shape' if you were flat chested preop and now have 700cc implants. Your high resolution photos show little pink blood vessels in the skin of your breasts, indicating significant stretch injury. As you have pointed out, you are also bottomed out and have mild symmastia. I'd like to know where you nipples would lie with your arms at your side. Your situation is not simple, unfortunately. Perhaps a... more

Best Approach for Downsizing Breast Implants?

I would replace the smaller implants in a subfascial pocket and use ACD or mesh to support the glandular tissue

Staged procedure is the best approach

The only way to possibly avoid lift is to give time for your tissue to heal and retract. I routinely do deflation for saline implants before revision surgery.

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

Best Approach for Downsizing Breast Implants? (photo)

There is no absolute "best way" to manage your situation, in my opinion, because nobody can predict with certainty the outcome of a given procedure or series of procedures. My approach would be to explant, perform bilateral capsulorrhaphies diminishing the size of submuscular pocket and adjusting position to accommodate your new size. Depending on skin thickness, may supplement with acellular dermal matrix or fat grafting, but if highly cohesive gel implant is selected, unlikely... more

Breast implant revision

This is a tough situation because removing the implants and say exchanging for those 1/2 the size may require a lift to deal with the loose skin. If you remove the implants, then you will have to wait several months to have new ones placed, and there is no guarantee how the breasts will look when the implants are removed other than that they will be deflated. But they may also scar down.