Downsize Breast Implants Without Breast Lift?

I had a breast augmentation 7 months ago. I got high profile saline 690 cc. I'm 5'3", and I didn't want to go that big, but unfortunately, my doctor got me these huge implants. Now, I want to downsize them. So, I want to get smaller implants, but I don't want to get a breast lift, I'm hoping I won't need it. How do I know if I will need a breast lift? My nipples are in good position, but what can I expect if not lift is done? I want to downsize between 400 cc to 500 cc.

Doctor Answers 18

I've got a better idea

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One way to tell if you'll need a lift after downsizing to 400cc or so is to ask your plastic surgeon to deflate your implants. Deflating the implants will give you a good immediate indication of how much excess skin you will have. You can also then allow the implants to continue to deflate over time, thus allowing your skin to slowly contract even further. Good luck!

There are a number of factors which determine whether you will need a lift

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This is a difficult question to answer because there are several questions which need to be answered:

  • how large are your current implants?
  • how much smaller do you want to go?
  • how lax is your breast skin?
  • how perky do you want to be after this downsizing?

That being said, one technique that I have begun doing is to intentionally deflate a patient's saline implants in the office about 4-6 weeks before downsizing. When that happens, I commonly see shrinkage of both the capsule around those implants as well as the surrounding skin. The result is that I can sometimes perform less of a lift or potentially get away without doing a lift at all.

I hope that helps.

Do I need mastopexy if I get smaller implants?

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If you needed a breast lift prior to the augmentation, you will need one when you change to smaller implants. If you did not need one, you will probably be OK without one because the implants have not been in that long and your skin is probably not stretched out too much and will be able to shrink back. I am not sure if you are saying you want your implants to be 400cc or if you want the volume reduced by 400cc. For your height, I think your implants should be much smaller, like 300-400cc. When changing to the smaller implants, since your nipples are in good position and the implants have not been in that long, you probably will not need a lift. You can expect your skin to be a little "loose" for several months and it should gradually tighten over 6-9 months. Hope this helps.

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews

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A consultation is necessary.

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A personal consultation is necessary to decide weather or not you need a breast lift.  Your surgeon will be able to advise you of this.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Downsizing implants

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Even after a physical exam, it is diffiult to determine how the soft tissues will respond with downsizing. Many times you need a lift.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Downsizing breast implants without breast lift

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This is a difficult problem. One reason is that the very large implants that have been placed cause "stretching-out" of your entire breast skin envelope over time. Thus, if you do wish to "down-size" your implants and exchange them for smaller ones, it is important that you do so sooner than later, particularly if you want to avoid a breast lift. Another important factor is whether or not your original implants were placed over the muscle or under the muscle. Large implants placed over the muscle typically cause even more stretching-out of the breast skin envelope and increase the likelihood that you may need a breastlift.

It is difficult to determine whether or not you would require a breast lift without photos and a physical exam. The fact that your nipples are in good position is a good sign. However, your nipple position will likely change once smaller implants are placed. If your nipples were at the level of your inframammary crease (this is called Grade I Ptosis), then you would certainly require a breast lift if you went smaller. You do have significantly large-sized implants for your height and exchanging them for smaller ones sound like a good idea. Just keep in mind that you don't want to compromise good breast shape for lack of scars.

A plastic surgeon who specializes in breast surgery will be able to tell during your exam whether or not you will require a breast lift and which type of lift you may require (ie circumareolar vs vertical or lollipop vs inverted-T or anchor type). Be sure to see a plastic surgeon who specializes in complex breast surgery and revisions to ensure that you get the very best outcome that you desire.

Suzanne M. Quardt, MD
Palm Springs Plastic Surgeon

Downsizing breast implant size can create a loose skin envelop

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Downsizing from 690 cc to 500 cc may work if you did not have a lot of extra skin ahead of time. If the size was picked just to avoid the scars of a lift, then you will need a lift after downsizing. Many patients would rather have a smaller implant and live with the loose skin, rather than have the scars of a lift, so many times I recommend just downsizing and evaluating the skin after 3 months. If you are happy with just the smaller size you are done, and if you are not, you can then go ahead with the mastopexy.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 35 reviews

Downsizing your current saline implants

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Those are definitely very large implants. Whether you will need a lift at the time of downsizing will depend on several factors. First, did you have any sagging before your augmentation? Did you have excess skin on the breasts before. Now, if you are going down to a 400ish implant, you may not require a lift at the time of downsizing. But quite frankly, your surgeon will assess this at the time of your physical exam to assess your breast shape, skin quality, and nipple position.

Downsize breast implant size without doing a breast lift?

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A 690 cc implant is a huge implant in any woman, but particularly in a petite one. I am so sorry to hear you went this big.

Some doctors try to avoid doing a breast lift by adding volume. If you "needed" this amount of volume to correct your initial droopiness, then you always needed a lift.

Get your implant out ASAP. A large implant like this has a weight, and will thin your skin and cause you to droop further.

There are many questions we don't know the answers to: how old are you? skin tone? have you had kids? breastfed? Were you droopy to begin with? do you pass the pencil test?

I see many women like you. They tend to be younger women who drooped, and the doctor didn't want to put the scars of a lift on the young woman. Being a female plastic surgeon who also likes to jog,etc, I don't think bigger is better. You may have always needed a lift if you would have done a "normal" sized implant. Where are you located? With saline implants preoperatively I can help you see what you would look like with smaller volumes, so you can preview volume vs. droop as you go smaller. I was taught this technique by my mentor in Nashville.

It is easy to make you better. You may need a lift. Find someone who does the smaller scar vertical breast lift- -no scar under the breast.

Lauren Greenberg, MD
Palo Alto Plastic Surgeon

Downsizing breast implants

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It really depends on what you started with. If you needed a lift prior to your surgery, then you will likely need one if you down size and I would say that may be a reason why your surgeon put in such larger implants in such a small frame.

If you did not need a lift prior to your surgery you will probably not need one now unless you were borderline. Down sizing will cause the nipple to come down a bit but you may be ok depending on what you started with. I would really have to see you to determine this.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.