I am downgrading from 650HP silicone Mentor implant with another lift.My PS has suggested 500 mod plus Mentor silicone . My BWD is in the 14cm range.I have suggested the idea of 450cc Natrelle Style 10 or 15 implants which have similar diameter to the Mentor 500 Mod plus but have 3.9cm projection.The Mentor Mod 500cc have 4.3cm projection.My 650Hps. have 5.7cm projection and 14.4 diameter.I would rather be smaller.Which implant would you suggest?Is 150cc going to look noticeably smaller? Hope so
Downsizing Implants from 650HP Mentor Silicone to 450 Natrelle Style 10/15 or Mentor 500 Mod Plus Silicone? (photo)
Doctor Answers (7)
Implant sizing and breast anatomy.
Before answering your questions, a few items to point out from your photo. It appears that the right implant is too high up on you chest wall, either due to inadequate pocket dissection or a capsular contracture. If your breast width is truly 14cm, all of the implants you mentioned are oversized for your breasts. The problem with oversized implants are that tissue thinning, rippling, and malposition are a high risk. What you need to do is focus less on the specific dimensions of an implant and focus more on what goals are you trying to achieve from surgery. What bra would you like to fit in? Do you want people to know you have breast implants? Is upper pole fullness a priority, or are you more interested in a natural tear drop shape? The dimensions and implant selection is something that your plastic surgeon will focus on to achieve these goals. The bottom line is any decrease in implant size will lead to a smaller breast. 150cc will certainly be a noticeably smaller breast. The bigger question is whether or not you have a clearly defined goal. If not, you may be looking for another operation in the future.
What is the reason to down size?
I would like to hear from you the reason for the implant exchange. The desired look that you posted has very large implants and very unnatural look. You will not get the same look with implant exchange alone. Please discuss your expectations with your plastic surgeon.
Downsizing Breast Implants?
Thank you for the question and pictures.
I would respectfully suggest that you allow your chosen plastic surgeon to guide you with the selection of breast implants; he is in the best position to do so given that he knows her history, has examined you, and is able to communicate with you regarding your goals ( in much more detail than can online consultants).
I would also suggest that you do not try to micromanage the selection of breast implants; you may end up disappointed with the results of surgery, given your level of experience with breast implants will likely be significantly less than that of your plastic surgeon's.
Communication and teamwork with your surgeon will be the key to a successful revision; you should feel comfortable that you have communicated clearly ( I like the use of “goal” pictures, preferably without clothing that can alter the appearance of breasts).
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Define your aesthetic objectives and then match the implant and technique
Amand123: Your current pic of 650HP silicone gel implants shows an attractive outcome but demonstrates some asymmetry both in nipple position as well as implant displacement (the right implant appears to be riding higher and the left nipple complex more laterally displaced). That being said, it is likely that these will settle a little lower with time, especially if they are under the chest muscle. By contrast, the photo of your desired outcome appears to show high profile, probably saline implants, possibly in a subglandular plane. Many of my patients also like the extremely round appearance which is characteristic of an overfilled saline implant. In the days before high profile and moderate plus saline implants, the practice of "overfilling" a standard profile (Natrelle Style 10) could simulate this "look".
Given your desire to appear "smaller", I would suggest staying in the intermediate profiles (either Natrelle Style 15/450cc or Mentor Moderate Plus/500cc). Although you haven't specified your height and weight, you appear slender and I think that a Natrelle style 10 would appear underprojected and matronly on you. Also, in my experience, combining a short scar mastopexy with a higher profile, narrow base diameter implant produces the "stylized" look you prefer. Good luck.
Downsizing can be a bit tricky. If you go too small if you did not need a lift before, you may need one after the downsizing. An exam would be critical.
Reducing implant size in conjunction with mastopexy
You photo shows that the right implant is too high, presumably due to capsular contracture. It also looks like the implants are under the muscle.
Size is a personal choice: if you want to be smaller then smaller implants are indicated. Exact size is hard to choose pre-operatively. My technique is to discuss with the patient ultimate goals using a portfolio of pre and post op pictures to get a realistic idea of her expectations. In the OR I use a series of temporary implants so I can see what looks best in terms of profile and size.
If you choose to go down in size you will probably want to have a lift to maintain perkiness, but if the capsules are properly released you may be happy with just implant exchange alone (you can always go back later for a lift).
The look is the key, and as a rule it takes a reduction of 150cc to make a noticable difference. The implant size is a guess until the fit and fill are determined at the time of surgery, though our bet would be for the style 15, and 450cc to get you closer to the lady in red. We would also consider the 'second lift' well after the new implant has settled in.
Best of luck, peterejohnsonmd.com