Implant Exchange (Downsize), Breast Lift and Capsulorrhaphy - Marietta, GA

In 2006 I had BA and went from small B/C range to...

In 2006 I had BA and went from small B/C range to full D/verge of DD. Doctor used 425cc round saline implants filled to 500. Over the years I felt this was too big for me and decided to go smaller. I am 5'8 155 athletic/slim build. I switched to 320cc smooth moderate classic silicone, had breast lift and lateral capsulorrhaphy to decrease the pocket size. It is only a week post op but I am already much more comfortable with the size (I feel in the end it will be a nice full C) but it will take months to know the final results. I could not find a lot of info on people who downsized, so hopefully this might help others considering this procedure.

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Attached are a few before pics and some 1 week...

Attached are a few before pics and some 1 week post op pics (with shirt on). The nipples looks a little lumpy under the shirt due to being surrounded with tape. I will update soon with some post op pics without the shirt to show progress. The doctor decided to do a little bit of lipo under my armpits on my sides right around the bra line during the procedure to remove some of the excess fat and tissue that was present as a result of going smaller. That has been the most painful of the whole procedure. I actually don't really have any pain at all on the incisions themselves (of course they are still mostly numb) but the lipo area is SO sensitive and bruised. I do feel very tight, feels kind of like I can't stand up straight yet or else I might pull the crease incision apart. It may also be a combo of the capsulorrhaphy being on the sides as well, although the doctor said that should not cause much pain since he used existing scar tissue which has no nerve endings to close the capsule. On about day 3 I noticed some purple bruising on the nipples and started to freak out thinking it may be the start of necrosis. I had my first post op appointment and the doctor said it was normal bruising and everything looked good. They changed the tape over the incisions and after seeing the entire nipple, I felt a lot better and could see the tissue looked healthy. (The incisions are closed with internal dissolving sutures and covered in skin glue with tape on top). He advised me to change the tape every 5 days, and I will go back for a 2nd post op in about 2 weeks.

6 Comments

You look almost exactly the same as I did before mine were drained yesterday. 425/450cc salines - full anchor lift with 325cc silicone implants scheduled in 2 weeks. Awesome results for you!
Thanks so much! They are coming along slowly but surely. Good luck on your upcoming surgery. I am sure you will do great. :)
Added a few 8 day post op pics. You can still see quite a bit of bruising on the sides from the lipo. Everything seems to be healing well. The swelling in the cleavage area is starting to go down quite a bit. The tape in the crease is much longer than the actual incisions, they don't go all the way to my armpit!
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Just added some new 15 day post op pics. Things...

Just added some new 15 day post op pics. Things seem to be healing well. I changed the tape over the incisions today (doc said to change about every 5 days, not sure how long this will go on though). It is the 3M millipore tape in tan. Supposedly this helps to keep the incisions flat and prevent too much scar tissue from building up, as it tricks the skin into thinking it is scar tissue (at least this is what I have read!) I think I may be having the start of a few spitting stitches on the left breast in the vertical incision. I can feel some wiry edges poking out but no pain or anything, so I will leave them alone for now. I have another post op in about 4 days so we will see what the doctor says. The dark/bloody edge under the left nipple you see is just dried blood mixed with skin glue, it's hardened and isn't oozing; I will just wait on it to fall of naturally, as tempting as it was to just pull it off! On my sides on the rib cage right where the bottom of the bra line is it still feels kind of hard and very tender. I think this is where the lipo was because it's outside of where the incisions are and I think it's further out where he did the internal capsule repair. I will ask about this at the next post op. It also seems that my back around the sides where the bra sits is kind of puffy too right around the bra area but I am not having any unusual pain, leakage, or anything that seems out of the norm so I am sure this is typical.

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You pics are progressively awesome! I can't wait for my surgery. I'm drained right now and a bit grossed out by my breast. I took pics the day before I was drained, won't take any now but will take some after surgery and post all at one. Again, awesome results and happy healing :)
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Thank you so much. Looking at the pics I can see the bruising going down and am feeling better every day. As scared as I am to really 'touch' them yet, I can already tell the silicone is so much softer feeling, it is really unbelievable the difference in the feeling. I guess I kept thinking I wouldn't really notice it or remember how they felt before but I really can. Can't wait to see your results!
My Dr suggested I research the "gummy bear" implants also because she is now doing them. After reading as much as I could stand I decided against them. Most of the Drs reviews say they are firmer than regular silicone. I think anything will be better than the ginormous saline I carried around for so long but I don't want too firm

So it's now 24 days post op. I feel like I am...

So it's now 24 days post op. I feel like I am having more pain than I would have expected at this point, and I consider myself a 'tough' person and fast healer. The pain is not unbearable but I am still not driving (mostly I am afraid of dealing with stick shift). I am taking extra strength Tylenol just about every 6-8 hours, not sure if it's really helping a lot. I can't pin point exactly where the pain is coming from; on the right side it almost feels like it's the inner part of the crease incision rather than the actual muscle, but then occasionally when I am reaching or pushing or if I flex the pec for some reason, I do feel some twangs in my muscle that is letting me know things are still tender in there. I am still kind of hunched over when I walk but that may just be me feeling like something will bust open if I stand up too straight, but it does feel like there is some tension there in the front. I guess that makes sense since I just had tissue cut out and there is not as much 'slack' to stretch there! I am still wearing the 3M micorpore paper tape and changing about every 5 days. I took it off today in the shower and it seems that it's starting to get gummy around the incisions and it's a little chapped around the inner crease part. Continuing to put on tape on top of the remnants that don't wash off seem to just be building and building and I hope they aren't going to cause more problems than good. The sticky stuff won't wash off and it will just have to wear off, but it can't really go anywhere constantly putting more tape on. I am going to leave the tape off until I go to bed tonight and let it air out. I will keep an eye out it and see what happens. My doctor said some surgeons recommend the silicone sheeting, steri strips, etc., but in his (and the nurses opinions) they said this tape is the best for scar healing. It seems like the nurse said to wear it for 6 months if I can tolerate it (she may have said 3-4 months though, but it was a long time). The doctor did trim a couple of stitches that were poking out. A loop had come out at the very end of each incision on my sides. He said that 3 weeks is usually the time they start to pop out if they are going to at all. These dissolving sutures should be absorbed at about 4 months. I have had some paranoid moments thinking what if I am one of those people who doesn't absorb the sutures and I asked him what happens if my body doesn't absorb the deep internal sutures from the capsulorrhaphy, to which he replied 'it will'. :) I can't seem to find a bra that I am happy with, I am alternating between a Genie bra and several different cuts of sports bras. It seems that the more snug the bra, the better they feel, although the tighter bras tend to cut into the incisions. I have these tendersorb pad things I got from my pharmacy and I cut them in half and place them between the bra band and the incision sometimes. That gives a little extra padding and seems to ease the tension.

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Sorry this same comment is down in my 'comments'...

Sorry this same comment is down in my 'comments' section too, but I couldn't figure out how to delete it and I wanted it up in this section of the review!

Post op day 26 - I emailed the doc office today and asked about what to do for the tape adhesive that is sticking on my skin. I had been reading that some doctors recommend oils (even vegetable oil!) for pulling tape off easily and getting the residue off the skin. They are going to mail me some adhesive remover to help with the sticky stuff. Hopefully this will get the skin nice and clean before applying the new tape every 5 days. I have another post op visit on Halloween, at which point we are going to start the massages. At this point I can't imagine massaging them...they still feel WAY too tender, I am almost afraid to even touch them and I wash them so gently in the shower. All the years of my previous implants I was religious about remembering my massages a couple of times a day, even if I did it really fast or just while I was walking through the house or sitting on the couch. Oh yeah - I meant to mention that before I had this revision surgery, the doctor had me get a mammogram first. I am only 34 but they said it was best to do it now and make sure nothing was wrong rather than doing this revision and then finding something on the operating table or later down the road. I think I was more scared of the mammogram than I was of the surgery, but it was a CINCH. I had a great nurse who I made very clear to her of my fear of getting squeezed and she assured me she had been doing it 20 years and would be gentle. It helps to make sure the place you get the mammo does a lot of people with implants (which most places probably deal with this frequently). I think they took something like 4 or 8 pics on each breast, once with the implant being squeezed with the breast tissue, and once with the implant 'displaced' (basically just pushed back and the breast tissue kind of pulled and pinched in front of the implant). Imagine kind of hunching your back and slooping your shoulders forward to make the implant go really close to your chest and then grabbing up your own existing tissue off the front of it. Anyway, I thought this would hurt SO bad because my breast tissue seems dense and there was a good bit of it, but it was fine and didn't take any time at all.

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Hi Gemma! First off thanks for taking the time to comment and check out the pics. It feels so good to know that my story might be helping others in a similar situation because I know more people are out there going bigger, and there are not nearly as many stories of people going down in size. You know, as far as how many cc's to get, I am not sure. Everything I have read keeps saying not to focus so much on the cc you want and rather print out some pics of your ideal 'look' and make sure your doctor really understands it. I had sent my doctor like 10 pics but they evidently only printed him out 2 of them. He didn't actually look at them until the morning of surgery but he asked me, 'what do you like about these?' I found that what I liked was the fact that they didn't have so much forward projection, they seemed to be a little fuller in the bottom part (not so much of the 'upper pole fullness') and he was really able to get an idea of what I was looking for based on what the pics had in common with each other. Of course you have to keep in mind your general physique - for example if you are narrow chested, you want to pick photos that are somewhat similar to your build. If you have a broader rib cage and your breasts kind of fill out to the sides and extend beyond your width, you should pic those type pics. I am sure you know all this! If you are 5'5 and curvy though and 700 has you at an FF, I would think that if you want to get to a C, you would need quite a significant drop in cc. Of course the width and projection of the implant should be taken into consideration too, but I have read that it takes at least 100cc to make a noticeable difference in size, and at least 150-200 to drop in cup size. So I went down 180cc (seemed like a lot when I found out) but in actuality, I feel like they are still quite a good size and they definitely still have the width. I went from a moderate plus projection to a moderate projection, so that also probably helped to determine the cc. Actually I never really even discussed the cc much with the doctor before surgery, I just made it clear I wanted to go smaller, more athletic and natural, and that I didn't want them sticking out so far. I said I wanted to get back into spaghetti strap tops without looking crazy and I wanted to be able to wear workout tops that had the shelf bra in them again. Maybe a 320-350 would be good for you too. It is so hard to tell though, I have seen 320 on some people and they make them a F cup, and then it seems like on others that a 320 barely makes them a B. It also depends how much existing tissue you have. After the surgery I kept thinking 'wow 320 seems so small' and 'is this even any bigger than when I first got them years ago?' And I kept reminding myself that it was 320cc more than what I started with, you know? So my professional recommendation would be in the 300-350 range, but to mostly just make sure you are clear with the doctor on the look you want. Determining the final cc should ultimately be his call. Hope this helps! Do keep me posted. Are you getting a lift along with it?
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I forgot to say your pictures look fab!
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Thank you for positing your photos and experience on here I'm just about to go through the same thing and was really worried until I read your post. I had my first ba 2 years ago and had 700cc under the muscle I'm a 36f/ff and I hate them, they are too big I wanted a dd. I'm now having them replaced with smaller implants and I'd like to be a full c cup but I'm unsure what size cc to go for any suggestion would be appreciated. I.m 5ft5 and quite curvy. I want to be sure on size and don't want to have to go through this again. Having big boobs is not what it's cracked up to be I have trouble find pretty bras its horrible. Before my surgery I was a b cup so I've gone from one end of the scale to the other. Any feedback would be great Thankyou
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Just added some 29 day post op pics. Things are...

Just added some 29 day post op pics. Things are healing well. There is a teeny spot on the top of the left nipple that was open just a hair when I pulled the tape off. Also when I pulled it off from the crease a stitch was stuck to it right in the spot where the vertical incision meets the crease (right at the T intersection). I am still having a little pain, especially when I take the bra and tape off for a while, but they may be because I over did things a little. Things are definitely getting better day by day, I can actually get out of the bed now and push myself out a little bit rather than just relying on my ab and leg muscles to lift me out. I am doing light things with my arms like sweeping, moving laundry from washer to dryer, washed a few dishes, scooping cat litter, etc. At the last visit the doctor said I could start doing some light exercise to get my heart rate up a little if I wanted (nothing with arms though of course). I may try and start back at the gym this week just walking or doing something simple like that. Said the risk of bleeding has passed and that is the main concern with keeping the heart rate and activity low for the first few weeks. Taking Tylenol still about every 8-10 hours or so. You may notice it kind of looks like the bottom of the left breast is kind of dented in where the vertical incision is. I am thinking this will round out a bit more after the implant settles in a little more.

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Hi jc! I was wondering if you have lost any sensation through the procedures? I lost some through my original BA, and am actually considering removing mine, but your scenario is my second option. I am just terrified of having completely numb breasts afterwards, though. You look really fabulous, by the way. Your surgeon did a terrific job, and you look much sportier!
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Hi Girlie! Thank you so much! I understand the concern around numbness. With my first BA, he went in the crease and I never really had any numbness except right on the scars themselves, which I never noticed much. Today is 29 days since the revision and a lot of the area is still numb, but I think that is normal at this point. I just took my tapes off and did an 'ice test' to see where I had feeling. It seems that the nipples themselves and the vertical area around the scars and surrounding area are still completely numb. There is definitely a specific area on each side where the feeling starts and ends. It may be a 2 inch wide section surrounding the incision. I didn't feel the ice at all in those spots. But when my clothes are on it, I feel like I can sense the material going over them. I will also tell you that the nipples are still working. For example when I get a chill, they are definitely still reacting like they should, which I think is a good sign. I can also tell when they are reacting, so it's like the 'internal' feeling of them is there if that makes sense!. At first, they weren't doing this right after the surgery. Everything I have read says it takes many months for the sensation to return but of course there is that possibility it won't in some areas. Where did your doctor go in (incision wise) for the first surgery?
I had mine through the belly button, having mine out through the crease. My left breast is intact, but the underside of my right breast and lower areola are completely numb. I wonder if that's because my doctor decided to stuff me about as full as he could and gave me a very wide implant for my frame. :( It must feel so nice to have less weight on your chest!

Today is 45 days post op. I am feeling pretty...

Today is 45 days post op. I am feeling pretty good. I had a post op last week and the doctor said everything is looking good. Still said no vigorous exercise and nothing with too much over head arm movements. We agreed that I can get back into the gym and if it's uncomfortable, don't do it. I have done some treadmill, bike, and stairmill. They feel like they are bouncing a little too much on the treadmill so I like to walk slower and at a higher incline. Pulling myself up onto the stairmill was a bit of a strain. Pushing out of bed or coming from a sitting position on the floor or something like that is still a challenge; I can tell that my chest is not ready for the strain of full body weight. The incisions are healing great though, no issues there at all. The vertical scars especially are clearing up nicely. Some areas around the nipple are a little pink but I think it looks pretty good. My nipples never really had a defined edge (they were very light and I also like to tan) so the scars kind of make parts of the edges of them very apparent. I am still wearing tapes and changing them out every 5 days. I go back for my next follow up appointment in 10 weeks. This will put me at about the 4 month mark. I do feel like part of the cleavage is still a little raised and swollen feeling and I pointed this out to the doctor, but he seemed to think it was nothing to worry about and said that the 'tissue integrity' was good so nothing to be concerned about. I have gone to the tanning bed but was very careful to keep everything covered up. I had tapes on, then put the tendersorb pads over all the scars, then a sports bra, then I layed a shirt over them and tucked it around the edges, then laid my pair of jeans and a jacket over them. I basically just piled all my clothes over my chest! It seemed to do the trick. I feel like they are getting bigger though. At first they seemed so small and now it feels like they have grown back! I am happy with the size though and know they are smaller when I compare them to what they were before. I actually believe these implants, although less cc and projection, are each actually each about .5 cm wider than my last ones.

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Hello. Thank you for the post. Two days ago I had a Capsullhaphory for both sides replacing my same implants. I am wearing this amazing compression sports bra that I brought with me which keeps everything in spot and it can't move. What a difference from my original surgery which was July 2011 (1 year 7 months ago). I love your new look and hope mine turns out the same. I'm new on here and dont have any pictures yet. One question I have is can you shake hands? I am in sales and worried someone will hurt me next week. I may buy a sling and pretend I hurt my arm.
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Hi Beachie! Congrats on the surgery and hope your recovery continues to go well! You know, now I am back to 100%, as it has now been about 5 months since the surgery. You don't realize how much you use the pec muscles until you aren't able to or are limited to your movement! So I can imagine that you are still SUPER tender after 2 days and shaking hands seems like a daunting task. I don't think I had to shake any hands early on but I would say just judging from other tasks that I did, it would have probably taken me 3-4 weeks before I could give what I consider a decent handshake. I don't know if that was more due to the capsulorrhapy piece of it or the lift and implant change part. All I know is that it seemed to take a lot more time for me to get back to normal than it did with the first surgery. Of course you know everyone heals differently and all that (I like to think I am one of the tough ones though!) but I would guess it will be a couple of weeks before you can give a decent firm handshake. You might have to give a weaker handshake for a couple of weeks and focus it more in the front part of your hand. Do you have anyone around you could do a practice shake with to kind of gauge what you can handle? The sling may not be a bad idea if it's too uncomfortable, or maybe say you have had a cold and don't want to spread it. Best of luck to you!
beautiful
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Let me tell you. I got some of this stuff called...

Let me tell you. I got some of this stuff called bio oil (got it at the local grocery store, so should be widely available) and I have only put it on my scars for 2 days and I swear I can see a difference. The scars were already fairly flat (thanks to wearing tape for 2 months straight!) and the ones around the nipple are white, where as the vertical ones were more pink. Those especially have faded over the last couple of days. Maybe it's due to the moisturizing but so far I am pleased with the stuff!

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Thank you for sharing your story. I recently went for a BA and got 325cc and 350cc HP Natrelle 20 implants. I was feeling like they were small and was considering upsizing. Now, after reading your review, I can see that larger implants might not be a good for an active lifestyle. You look great with the new size!
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Thank you! You are looking fantastic as well! I think that just after the surgery, it is normal to think that you wish you had gone larger. As they settle in they will fill out a little more and you will get used to the size and realize they are probably just the right size for you. I think right after my surgery I was thinking I wish I had gone larger, but as time went by, i thought I could have stood to go a little smaller! Overall though I am pleased with the size and don't feel so uncomfortable with those gigantic breasts. I have been able to get back into better shape too, I lost about 25 lbs and got back to my fighting weight. I don't know if the smaller chest had anything to do with that, but I feel like I workout harder now (like I did pre implants) and I feel more confident in the gym. I made some other changes too but I feel like the more proportionate chest had at least something to do with that.
Keep coming back and reading your review. Yours is the only story similar to mine. I'm praying my nipples don't stay pointing down. You had such a great result!! Thank you again for sharing.
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Atlanta Plastic Surgeon

I chose this provider from a recommendation from a friend who also had a breast augmentation done by him. She has also since had a breast augmentation revision and tummy tuck. He did a great job on my original BA, so I chose him again for the revision to smaller implants and the breast lift.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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