Hi LindsaySue,
Exchanging to smaller implants does not always lead to significant sagging. It depends on the size of the original implants, the size of the new implants (ie how much volume change there will be), the quality of your skin, whether or not you had sagging pre-operatively, how long the implants were were in, and weight fluctuations or pregnancy. Thank you for posting the photo-that helps us. Looking at your photo it appears you have good skin quality and it should be able to "shrink" back to fit the new implants and knowing that you plan on reducing the volume by 75cc, which is not that much, I think you will be OK in terms of sagging. Remember that it will take the skin many months to shrink and it will probably look a little saggy in the beginning, maybe even for up to 12 months. Of course your plastic surgeon will examine you and discuss this issue with you in person. In my experience the most important factor is whether or not you had sagging preoperatively; if no pre-op sagging good chance you will be OK. My only concern is that 75cc is not that much of a volume difference for a patient who feels she is too big. Be sure you have a very complete discussion with your plastic surgeon regarding your size expectations. I find that when patients want to be smaller, we usually have to reduce the volume by 100-150cc at least. Of course this varies depending on your preferences and body type. Hope this helps.
Tracy M. Pfeifer, MD, MS