Breast Revision with Internal Bra and Lollipop Lift, I Want to Go Down a Cup Size, Would It Look Strange to Go Smaller? (Photos)

I have 300cc saline filled to 350L/375r, Moderate, 34D/DD. 5'6, 128lbs I want to down size to a Mid to Full C! I feel very top heavy. I'm having an internal bra with a lollipop lift, but the surgeon I consulted is highly against me backing off more then 75cc's, I feel that won't make a dif? He says "I may look odd" he also advised against high profile which is fine, but I really want to go smaller... If I would look strange going smaller, then I won't...but, I'm unhappy with my size..

Doctor Answers (11)

Breast Implant Revision Surgery

+3

Thank you for the question in pictures.

I think your plastic surgeon has a good plan for you. Unfortunately, given the different variables involved  with your surgery including the adjustment of the breast implant pockets with capsulorraphy ( “internal bra")  and the adjustment of the skin envelope ( “lollipop lift”)  it is not possible to know what size implant will be necessary. It may be in your best interest to allow that decision to be made intraoperatively with the use of temporary sizers, with you  in the upright position. This will allow for more precise implant size selection than trying to predetermine the size of implant that will best fit after all the adjustments are made.

I hope this helps.


San Diego Plastic Surgeon
5.0 out of 5 stars 680 reviews

Internal Bra, Lollipop Lift and Downsizing- Easily done

+2

Typically what we recommend for patients that want to decrease the size of their breasts, you have to do a minimum of 100 cc’s to make a visible difference.   The lollipop lift would include an incision around the areola, going down vertically to the bottom of the breast and then under the breast, in the infra-mammary crease.  In doing this, we could decrease the size of your areolas if desired,  and we would be able to use the smaller sized implant of your choice. There will definitely be excess skin that was stretched from the previously used larger implant, so the lift is definitely going to be necessary.  In making this incision, we would contour the skin to the smaller size implant, move your nipples to the correct position, and using the internal bra, we would be able to place the implant at the level at which you desire.  Use of the internal bra enables us to create more cleavage and prevents the breasts from sliding off to the sides or drooping.  When going from larger to smaller implants, you will definitely have excess skin, and using this internal bra with this type of incision as will definitely help you to achieve maximum results with the firmness and smaller size look you desire.

David M. Godat, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 8 reviews

If you really want to go down a full cup size, breast implants need to be at least 150 cc's smaller.

+2

Hi.

1)  Going by your pictures you have a difficult problem which really needs detailed analysis.  You have already had an unsatisfactory lift (Benelli) with asymmetric large areolas.

2)  You need implants in the 200 cc range.  I recommend using sterile implant sizers during surgery to make sure which is the best size.  Then, the actual implants are opened from the operating room inventory.  Deciding in advance is just an educated guess.

3)  It looks like you need moderate PLUS profile, round, smooth walled, cohesive silicone gel implants under the muscle.  The folds under your breasts need to be reinforced.

4)  We are big advocates of the vertical (Lejour) breast lift with a lollipop scar.  But I don't think that may  do it for you.  There is deformity and a lot of stretched skin.  You are the very rare woman for whom I might use an old fashioned inverted T scar to be able to remove all the stretched skin.  You want this to be your last breast operation.   If you are unhappy after wards, it will not be because of an  extra scar.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

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Mastopexy with smaller implants

+2

To achieve a smaller more proporioned look, you will need a mastopexy(uplift) and smaller implants. You should consider silicone implants, which are moderate or moderate plus profile, placed under the muscle.  Based on the photos and the info you have provided, smaller implnts in the range of 250CC -275CC would most likely create a mid to full  C cup. If you are seeking a full C small D,  you might be hapier with a 300CC silicone implnat.  The difference is small and not worth fretting over.  Follow your heart and go smaller.  You will be happier, and look more natural.

Beverly Friedlander, MD
Short Hills Plastic Surgeon
5.0 out of 5 stars 6 reviews

Breast Revision with Internal Bra and Lollipop Lift, I Want to Go Down a Cup Size, Would It Look Strange to Go Smaller? (Photos)

+2

Very hard to be accurate over the internet. I would OK the use of a 275 cc with a lift. But in person examination is best. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Breast imlant revision with lift

+2

The answer is no you would not look strange -in fact,  you would look much better.  Your implants right now are disproportionate to your breasts.  You should go with smaller, more proportionate implants and a lift to correct the double bubble that is present on each side.

Gary D. Breslow, MD
Paramus Plastic Surgeon
5.0 out of 5 stars 29 reviews

Revision breast implant and lift

+2

Dear Lulu,

I think that a lift and smaller implants is a great idea.  If you are not comfortable with the surgical plan, then I recommend that you seek another opinion.  Good luck.  Jonathan Staiano

Jonathan J. Staiano, FRCS (Plast)
Birmingham Plastic Surgeon
5.0 out of 5 stars 8 reviews

Downsizing Implants

+2

Based on your pictures, I would recommend the downsize like you are suggesting with a mastopexy (lift) and placement of your implants under the muscle.  I would likely suggest a moderate profile or moderate plus profile implant for a more natural look.

 

Good luck with your surgery.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 54 reviews

Smaller does not look strange

+2

The pictures which demonstrate your goal look fine and you certainly will not look worse for going smaller than you are. We think a drop of 100cc is needed to be noticeable and get you closer to the C-cup. The vertical lift will help reduce the lax skin envelope, and the high profile is a bad idea. But if you are getting mixed signals about your choice you may want other opinions.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 26 reviews

Revisional breast surgery is the best time to get the breasts you want

+2

LuluMyLu: Assuming that the photos on the right represent your aesthetic ideals, I agree that you should choose an implant, whose base diameter more closely approximates your chest width.  Assuming that your current implants are subglandular, which seems likely because of the double bubble on the left inferomedial breast, converting the implants to dual plane will assist with enhancing the upper pole (i.e. distance between your collar bones and nipples) as well as adding additional soft tissue (the pectoralis major muscle) over the implant.  The axis as well as the diameter of your nipples will be improved by the lift. 

In my series of revisional breasts which require internal bra (acellular cadaveric/porcine dermal matrix = Strattice), patients generally prefer high profile implants, which have narrower base diameters, but still adequate anterior projection, giving the impression of full breasts.  From a surgeon's perspective choosing a narrower, smaller implant improves the chance that the breast implants positioning and roundness will remain.  Good luck

Lavinia Chong, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 33 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.