Downsizing Breast Implants
Not easy to answer without examining you.
It sounds like you have three options:
Remove your implants
Remove your implants and have a breast lift
Replace your implants with smaller ones, with or without a lift, depending upon the difference in implant size and the elasticity (tone) of your skin
Do nothing; stay as you are.
The change in volume from 350cc to 250cc may result in a half- to full cup size reduction.
A breast lift often reduces about 1/2-cup as well. Even though no significant volume is removed from the breast with a breast lift (mastopexy), the lift does tighten and narrow the width of the breast, which influences the fit of the bra.
In my practice, if a patient has saline implants, I will offer to incrementally deflate the implant with a needle and syringe, in the office, with a little bit of local anesthetic. This way we can see how much smaller an implant will produce the size the patient desires.
Unfortunately, this cannot be done with silicone implants.
You will probably be a bit smaller than you were before you had the implants, or at lest, you will be smaller than you remember you were.
Without examining you, it is impossible to assess the elasticity of your skin which will make an important difference in determining whether a lift is needed.
If you remove the implants and find you are unhappy with size or shape, you can go back for a second procedure to place an implant and/or breast lift). Though not desirable to have two procedures, you haven't "burned any bridges."
Reducing implant size and performing a lift
Make sure you know exactly what the surgery entails. It is fairly easy to determine how much native breast tissue you have, and how your likely postoperative appearance would be with a lift and smaller implant. However the difference between the two sizes you mention is not huge, so do spend some time with your surgeon on this issue.
You don't want to have a surgery only to discover you are still top heavy and need further surgery.
Regrets after breast implants, and downsizing
If breast augmentation is done for the right reason, few women ever look back, and in fact think little about their implants except at time for mammograms. The decision to have an augmentation should be made for self interest alone; the size and look should be of your making. It can be difficult not to be influenced by others, friends, spouse, boyfriend, even your surgeon, yet if the look is not you and you alone, how you feel inside, it is easy to understand why you might become unhappy with the implants.
When considering reducing the size of the implant, generally, it will take a reduction in implant size of 100cc to see a difference which is appreciable, better 150cc. If you are worried about still being top heavy perhaps you should remove them altogether. The mini lift may produce more breast scars and be another source of displeasure. You may just have the implants removed, a very simple procedure, and then you can decide if the breast shape is you or not. No matter how you look, if you feel right, and the look is you, happiness cannot be far off.
Best of luck.
The one question I would ask is how long you have had the implants? If they have been present for over a year the breast tissue has accomodated to the new volume and your skin will not tighten after the implants are removed. 350 cc are large and the impact on the breast and the skin will be obvious upon removal.
Generally speaking, when implants are removed the upper pole volume of the breast is dramatically reduced. The nipple position will appear lower and the breast will appear "saggy".
Like the surgeon you saw in consultation, I would encourage decreasing the volume of the implant not removing it. The exception would be if you have ample breast volume, you are young, it is within 3 months of implant placement or the skin quality is excellent and you are accepting of a more "mature appearance" of your breasts.
If you have saline implants and are committed to a surgical procedure, your surgeon may be willing to "pop" your implants. This will give you the closest approximation to your appearance if the implants were to be removed.
I hope this was helpful.
If you think that you will look ok without implant( think about the reason that you had implnt) then have your plastic surgeon to deflate them(if they are saline) in office under local, then wait few weeks . If you are happy with the shape and size of the deflated implants,then have them removed surgiclly. If you are not happy with the deflated breast implant and want more volume ,then you can try smaller implant.
If you have silicone implants ,you can remove them surgically and wait . You can have smaller implants later on.
It is very important to communicate your size goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the press implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.
If you want to go smaller then more than likely you will need a lift. In most patients if you just remove the implants, they will look very flat.
Downsizing implants with breast lift.
Hard to say without seeing you. Having said that, often when we down size implants there is extra skin. This skin will sometimes need to be addressed with a lift. Talk with your Plastic Surgeon about your expectations. Bring in photos if you can. I also would wait at least a year before doing revisional surgery.
With removal or downsizing of breast implants, you will likely need a lift
If you have your implants removed, then your remaining breast volume will be similar to what you had prior to your breast augmentation, but you will have more sagging since your tissues have been somewhat stretched by the implants. If you would be happy with the breast volume you had previously, then you could consider removal of your implants and a mastopexy (breast lift).
Of course, a breast lift requires additional incisions on the breasts (usually around the areolar margins, perhaps up and down underneath the areolar margins, and sometimes in the crease lines of the breasts). If you downsize your implants, you may be happy with the new size. There will be some settling or sagging of your breasts with the change being somewhat uncertain.
You may need a lift or you might be happy with shape. If a lift is needed it can be done at the same time that the implants are changed out, or you might wish to consider deciding later whether a lift is needed. You might consider consulting with another plastic surgeon for a second opinion.
Don't get caught up in the details of choosing implants...
The best advice I could give you is to focus on your desired breast contour.
Forget everything else.
Close your eyes and imagine the breast size, shape, and proportion to the rest of your body that you would like to achieve.
Now communicate that appearance to your surgeon. In my opinion, the best way to do this is through photos (that whole "picture is worth a thousand words" thing has been around a long time for a reason), but the point is really to communicate what you want to LOOK LIKE- NOT what number you want on your implants or what letter you want on your bra.
After understanding your desired APPEARANCE, your surgeon should be able to make a good recommendation for achieving it for you.
For more about how to properly proceed, and how not to, please read this: