I Have 1000cc`s Saline over Filled with 850 Implant Bag, How Can I Proceed To Meet My Expectations? (photo)

I have lots of experience with large implants, and going up is easy and going down is difficult. You have stretched the skin out considerably. For the best result I would recommend a staged procedure. First we remove your implants and get you to wear a tight compression bra for three months to shrink your skin envelope back down as far as it will go. Then we take your measurements again, and perform a so muscular augmentation in the size that you want with a lift. Two surgeries but a more controlled, longer lasting result.

I would say that the best approach would be to go through the nipple to get the best view of the space.  The TUBA is so limited, that the space probably needs to be revised completely.  This is a very difficult technical problem with going smaller, the sagging, and the implant malposition.

The ideal solution to your problem would be to perform a lift and reduce the size of the implants. This may need to be done in stages. You would be a good case to deflate the implants with a needle and allow the skin to retract. Then you can start from square one and get the proper operation done.

Not sure I have much to offer that hasn't already been said. Your implants are too big for your frame. You can probably achieve the upper pole volume that you want with a much smaller implant placed in the right position, but you most likely will need a mastopexy now. I also would suggest removal of the implants for about a month or more to see how much your skin retracts and then consider replacement of smaller implants in a controlled dual plane pocket and likely a vertical mastopexy. 

Thank you for posting your photos along with your question. The simple answer is you need a revision. As you already noticed, your implants are too big. Placing large implants to compensate for sagging breasts is not always a great idea. These implants are stretching your skin, weighing down on your breasts and causing them to sag. I believe placement is not under the muscle and this also need to be addressed. Plus seeing where your nipple position is now, makes me think you probably needed a lift to begin with. 
I believe you need a Breast Lift with Implant Exchange(reduction) with sub-muscular placement.
Some patients get in similar situations because the surgeon tries to please the patient by tries to avoid breast lift scars. This may limits the surgeons abilities to produce an aesthetic and long lasting result. Please understand that these extra scars are the only way to achieve your expectations. And remember, in plastic surgery scars are usually not the problem, but rather the solution to the problem. 
Best of luck,
Dr. Miguel Mota

I think you will need a lift. Regardless of what size implant you have, or get, you need a lift to give you the look you describe.Good luck,Greg Sexton, M.D.Columbia, S.C.

Hi.  I would deflate your saline implants percutaneously in the office, and let the tissue re-drape, for at least 4 weeks.Then, I would plan a breast lift, to get your nipple back to the correct position, and to remove any residual loose skin.  Finally, you could place a more proportional gel implant, behind the muscle.It's a lot of work.  And there's no good way to do it without the lift.

Sorry for what has happened to your breasts. It seems the pockets were made a bit too wide apart and the weight of the implants has stretched everything out significantly. I would definitely suggest downsizing your implants based on measurements taken of your chest to ensure the right size is chosen. You will definitely need a lift as well, I would also suggest having your saline implants ruptured 4-6 weeks before any procedure to allow the breast to settle back into a more normal shape. This will minimize the amount of lifting that needs to be done, thicken the tissues before your procedure and give you the best possible outcome. This is not something that can be tackled by your average plastic surgeon so I would suggest having an in-person consultation by a local breast implant revision expert to be properly assessed. Hope that helps! 

Thank you for your question. It appears that your implants are in a subglandular position. A large portion o my practice is dedicated to revisionary breast surgery. In your case, I would deflate your implants percutaneously ( a 2 minute procedure under local anesthesia), wait approximately 2 months, then perform a re position of ultra high profile implants into subpectoral location (under the muscle) and perform a breast lift. You should be able to have a beautiful result. Please look at my gallery under breast revision - chronic changes associated with implants on top of the muscle. Best wishes to you.

Hi! For your guidance, breast implant removal or downgrading size may be performed as a single surgical procedure or combined with additional procedures, especially when you have extra skin brought out by the previous large implant.  Initial deflation in the office may help the skin shrink. You may require a lift and placement change. Contact your surgeon or find another board-certified surgeon that has extensive experience with your concern. Best of luck!
#RealSelf100

Direct downsizing to smaller implants is only possible up to about 100 mL less and certainly would not address the issues of your current breast shape. 
My recommendation is to deflate your implants gradually in the office and allow your skin to shrink down  as much as possible. Once your implants have fully deflated, you can either have them removed, or have them removed and have a major revision done at the same time, or you can have them removed first and later have a major breast revision.  
Whichever option is chosen, this will require compression and a lot of patience from you because your breast skin will be deflated and very unattractive for several months and until you have your revision procedure. 
Without seeing you in person I can only speak in generalities, however when I do these procedures, the implants are moved to a position under the muscle, biologic matrix is used as a muscle extender for internal support, and a mastopexy is done. You will require drains.  
The process from beginning to end takes months. Revision surgery of this type is expensive and well worth it when done properly.