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.

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.

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.

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.

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.

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.

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.

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!
Michael McNeel, MD

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 tmes
Was this review helpful? 3 others found this helpful

Comments (55)

Sort by

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.
  • Reply
I took at look at your review and you are looking fantastic. I am sure as time goes by the implant will settle into place even more and the swelling will subside. Sounds like there was a lot of internal work so I am sure there is still swelling even if seems like it is all gone. I remember I had a gyno appointment about 2 months after my surgery. She commented that I still looked swollen and I didn't think I did. Looking back, I definintely was, especially in the cleavage area. I need to post some new pics, as I feel they have changed even more over the past 6 months. You will be back in the gym in no time- in the small chance that you feel like you have gained weight, I am sure it's mostly water weight, as the body holds so much water after surgery. I felt much smaller at first too, but now that I am used to them, I realize they are still plenty big. In fact, I wish I had gone even smaller, but I am pleased with them. Glad my story is still helping you; I am sure yours is doing the same for many out there. Anyway you are looking great, and keep posting updates! It will only get better from here!
  • Reply
I'm so glad to have found your review. I have read so many stories about complete removal or first time argumentation but I have had a hard time finding women going for smaller replacement with a lift. Your recovery seems longer then most but really more of what my expectation is for myself. I know it's been awhile so you may not even be on this site anymore but thank you so much for sharing your experience. I can only hope my results will be as good as yours.
  • Reply
So glad my story helped! I also had trouble finding many similar experiences. I am sure your results will be fantastic. Feel free to ask any questions at all and best of luck to you. When is the surgery?
  • Reply
I am guessing August 13 now that I take a look at your user name. :)
  • Reply
My surgery is scheduled for Aug 5th. I'm so nervous.
  • Reply
Hey jcj! You look fantastic! Those scars have really faded over 6 months- I am betting they are going to disappear soon enough! I had my explant 4 months ago, and other than a scar mishap, I am very happy! Thanks for the supportive comments earlier. You were right about the anxiety- I didn't have any on surgery day, I just wanted to get it over with so I could exhale! Again, you look beautiful! Some of us just like our boobies smaller! lol :-)
  • Reply
Thank you so much! Whoa girl you look amazing!! I know you are so happy. Don't you love wearing the cute smaller type bras again and not feeling the need to hide all the time? I am very happy for you. I am much happier now too - I feel like they have grown a bit (probably just used to them) but in clothes and bras they are MUCH smaller than they were. I feel much more proportionate now and don't feel so top heavy and embarassed anymore. As for the scars fading, let me tell you. I started this stuff called bio oil the other day and I swear I saw a difference in them after just one day. The stuff is a great moisturizer, especially under lotion and I found it at the grocery store so it should be widely available. Anyway, glad to see you are doing well and that you are pleased with the results. As for the scar, it is not even noticeable and I am sure it will fill out over time. Just in your series of pics I can see the improvement!
  • Reply
Thanks, lady! Yes, I love wearing cute little bras and not needing all that support! It's funny that you feel like yours have grown, I'm pretty sure mine are still shrinking! lol. But either way, don't you feel that they look so much larger in photos? I bet you love the way you look in clothes now! When your boobs are bigger, you either have to wear something tight to show a waist, which elicits lots of staring, or you wear something looser, which drapes off your chest and makes you look heavier! I have bio oil! I bought it before surgery, but haven't used it because I wasn't sure it would make any difference, but if it's working for you I'll give it a go! Thanks for the encouragement on my scar- I really hope it does improve. On your next revision (hopefully many years into the future!), do you think you'll stick with that size or go even smaller?
  • Reply
Yes I do feel they look bigger in pictures! And you are right - either wear tight clothes to accentuate or baggier ones which just add weight. As for my next revision, I might opt to go even a bit smaller. I will definitely stick with the moderate profile - I do like the lower projection. I know they say that unless you do at least 100ccs you don't really see a difference, but I would consider going down a bit. I guess the only disadvantage with going smaller is the additional work the surgeon does with the capsule repair and possible lift, although you are proof that is not necessary when downsizing!
  • Reply
I had mods, too. HPs weren't available back in 2000, thank goodness! lol. I would think if you only downsized a bit, you wouldn't need any capsule adjustments. Did you pick your original implant size, or is that what your surgeon chose? I am droopy now, (definitely not perky like you!), but I think my 'hang' makes me look like I have more going on up there! I'd be afraid a lift might make me look completely flat-chested! What size are you now? I was measured as 32DD/ 34D, which seems ridiculous, but my breasts are much wider from the implants, so I need a D-cup. How is your sensation? Has it returned to normal yet?
  • Reply
You know, I don't even remember how I chose my original size. I think I just said I wanted to be fairly big and projecting and I chose the moderate plus. He thought I could handle a larger implant due to my height and chest width (and I agreed) so we went with the 425 filled to 500. Now I have 320s so he did quite a bit of capsule work around the lower outer sides to taper in the capsule with the lift. He also did a little lipo around the sides under the arms where the bra line is too. The sensation is kind of strange, it has mostly come back on the right but not on the left. When water hits them in the shower though, it is almost a little painful. So kind of weird that I can't feel, yet some things I feel more! As for size, I am not even sure. I haven't gone to be measured yet and I have only bought a sports bra, which I got in a 36D. All my old D bras still fit though, but they seem to fit properly now where as before I think they were a little too small. I need to go get measured. I have read with lifts alone, that they actually don't reduce the actual size much since it is just skin being removed. Most of the things I have read say that women usually keep the same cup size, it's just lifted more but I am sure some have a tiny decrease in size depending on how much skin is removed.
  • Reply
OK, it's good that you feel that you chose that size. Not that you looked too large, but a lot of women in the removal forum (myself included) had their PS choose their size and ended up larger than they wanted to be. Yes, I remember reading about your lipo. I have heard it's painful! Sorry to hear normal sensation is taking its sweet time returning. My procedure was simpler than yours (partial capsule removal and "scoring), but I still feel very 'protective' of my breasts as they are still sensitive/ sore. My left nipple was so hypersensitive it was a nightmare! Honestly, numbness was preferable! I had to stay away from the cold aisles in the market! lol. You look too slender to have a 36 band! I would bet that if you got measured, you would be told you are a lot bigger than a D. I was told that most of us wear bras that are too small in the cup and too big in the band because it's more comfortable (that's what I was doing- I thought the implants made me a DD, but I was an E!). If you are wearing a 36D, that would put you at a 34DD or more! Are you still wearing sports bras because they are more comfortable or because it was recommended for healing? Do you feel any "lighter" with 180 ccs less and are you comfortable with them bouncing when you work out now? (I feel like a huge weight was lifted!) Do any of your scars still feel thick or lumpy underneath? I have to say, your PS must be SO glad you posted this review because your results are seriously amazing (but your breasts already gave him a great starting point)! ;-)
  • Reply
You are too kind, thanks for thinking I look slender! You may not can tell in the pics, but I have quite broad shoulders and a wider rib cage. Even before any type of augmentation, I always wore a 36. Even when I was younger clothes and dresses would fit in the waist but I never could quite get them zipped up around the top due to the broadness of my chest and back. A 34 cuts in badly but maybe a professional measue would say different. I am wearing the sports bras mostly because I haven't had a need for a real bra since my old ones still fit. I work from home and really the only place I go is the gym so sports bras usually work for me 90% of the time - I sleep in them too. When I do wear an underwire, I like putting a genie bra over it - that really gives great support and smoothes out where the band sits. If I ever took the time to get properly fitted and invest in 'real' bras I may not do that anymore. I think I do feel lighter, but I almost can't even remember what the old ones felt like. They definintely are closer in on my body so don't hang on their own as freely as they did, it's more of a single unit now. I got an AMAZING bra from this site called Moving Comfort so the bouncing is kept to a minimum when working out - again, when they move it's kind of just as one single unit, they don't feel like they are hanging loose like they did. None of the scars feel thick at all, they are all almost completely flat against the skin. The inner edges of the ones in the crease have a tiny slight raise but it's very minimal. I think wearing the tape religiously for 2 months after the surgery really helped with that. I also really don't mind the loss of sensation. I was never one of those that was crazy about my breast sensation so I don't even really notice or miss it. The nipples and everything still 'work' when cold and all of that so it's all still wired up properly inside, but they just don't really feel temperature or touch from the outside. I know what you mean about feeling protective over them, I still am too and probably will be for a long time!
  • Reply
Thanks for answering all my questions, jc! I am wider on the top than the bottom, too! I have almost nothing in the way of hips, though! I got measured at Nordstrom's and the lady put me at a 30/32 band, but I thought it was way too tight! It squeezed me in and gave me rolls and bra overhang! Yuk!! You sound like a hermit when you say the only place you go is the gym! Girl, you paid a lot of money and endured some pain to get those boobs where you wanted them, and you are surely in good shape from those workouts- get out there and show off!!! :-) I understand how you forgot how the old ones felt...I already forgot how the implants felt. It's pretty amazing how quickly the brain adjusts to the 'new normal.' I also have a Moving Comfort bra that I used to wear during workouts! Too big now, obviously, but I agree it was awesome! I bought mine from herroom.com- they have a lot of sales and discount promos, so you can often catch a really good deal! I guess that's good news that you don't miss the sensation. I used to love 'boob action' before implants, but things were never the same after BA. I guess at this point boobs don't do much for me anymore, either. I'm also a little shy about that ugly scar- thankfully I'm married and my hubby doesn't mind it at all! At least your nipples still work! That would be odd if they didn't contract, or if one did and the other just sat there looking bored! lol. Don't you just long for the day when your breasts feel like every other part of your body and you stop thinking of them as fragile? :-)
  • Reply
HAHA I guess I am a bit of a hermit! I will admit I am a total home body who loves reality TV but I do still get out occasionally! I think working at home has made me a lazy bum, but I like it. :) I will check out that website for sure. And maybe your love for boob action will return now that you are a la naturale again. I just got me some Latisse so now I will be reviewing how my eyelashes turn out!
  • Reply
I work at home, too! Way too easy to stay in sweatpants! :-) Good luck with the Latisse! Keep me updated on your boobs! lol.
  • Reply
I sure will; you do the same. Thanks for all your kind words and support. You look amazing and it will only get better from here.
  • Reply
Will do! Thanks right back at you for your kind words and for answering my endless questions! I look 'decent', YOU look amazing!!
  • Reply
I do have implants under the muscle but the results are terrible if you slowed me I will send you pictures. I am looking for a doctor that can help me to fix this problem, but now I am looking very carefully. thanks for you reply very helpful
  • Reply
I am afraid to have it don since I am in the service and I need to do lots of push ups, how long ti takes the recovery?
  • Reply
Do you have implants now and you would just be changing them out, or would these be new? The first time I had the implants seems like I was back to normal after 3 weeks or so, but this time it took much longer. Not sure if it was the additional internal capsule work or what, but it was at least 2 months or more before I was back 'full blast' at the gym. Even now I am not really doing push ups anymore (but I could, just a personal choice really). Hopefully if you do it you can take at least a few weeks off from the push ups or at least modify them so you don't damage anything internally or delay healing.
  • Reply
thank you so much for you answer :)
  • Reply
hi congrats for you result I am going to the same problem, I need to downs size an lift do you have your implants paced under on voer the muscle. and respectfuly thank you so much
  • Reply
Hey there! Thank you - I have them under the muscle. I am very glad I went down in size. I would have been happy if I had gone even smaller than I did really, but I am pleased with the result.
  • Reply