Breast Implant Exchange and Lift for C Cup Breasts?

I am 42 years old. My first breast implants (300 cc) were placed in 1993. Those ruptured and were replaced with 300 cc implants. Since I've recently had two children. I did not breast feed. My breasts seem much larger after pregnancy. I wear a DD bra size and my breasts are too large for my frame of 5'4, 114 lbs. I would like a nice C cup and have looked into an implant exchange. I'm worried about my breasts sagging. My doctor has not suggested a breast lift with my implant exchange. Do you think I will need a breast lift also?

Doctor Answers 7

Breast implant sizing

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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.

Implant removal and concurrent breast lift (mastopexy)

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It sounds as if you may need a simple removal of your implants with simultaneous breast lift. If you are a DD, removal of the implants alone will likely take you down 2 cup sizes.

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

Breast lift or not

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It is hard to tell whether you would need a breast lift with an implant exchange without examining you.  If you are dropping down in size you probably will need some sort of a lift.

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

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Downsizing DD to C cups

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It is uncommon for augmented breasts to permanently increase in volume with pregnancy. If the increase in breast volume has remained stable for more than 6 months after your pregnancy, it can be considered largely permanent.

Despite the larger breasts, I think we can assume that you would not be happy without breast implants. Removing the breast implants (without exchanging them) would NOT result in the breasts you had in 1993 but probably in smaller and more deflated sagging breasts. Therefore, if ALL you were asking for was a breast implant removal, you would absolutely require a Breast Lift (Mastopexy) if your breasts were to look attractive.

However, if you wanted to down size to smaller implants, the TYPE of Breast Lift you may need to have would depend on your current breast volume, your breast skin surface and your implants used. Rather than engage in "breast cup talk" which has NO clinical applicability, the best approach would be to either pick a smaller implant that you could live with and have your surgeon lift (if needed) the breast onto it OR to use temporary sizing implants in the operating room and pick the best appearing / fitting implant in the actual breast and THEN performing the lifting procedure called for, if any.

Pick a surgeon you trust ( and make sure you understand your options. You WILL do well.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Decreasing from DD to C

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As Drs. Baxter and Salemy have explained, we would need to see photos of you to properly answer this and to examine you to see how much of your current size is you vs implant. Either downsizing or totally removing your implants would be appropriate and I would be almost certain that you would need a lift.

Breast lift after downsizing implants

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When patients desire a smaller cup size, in particular from a DD to a C as in your particular case, the chance of needing a lift is high. We can't know for sure without examining you, but this is something that your surgeon will probably discuss with you prior to surgery. What you may want to also ask him is what kind of lift you need -- where will the incisions be? This will allow you to prepare for what things will look like after the procedure.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 155 reviews

DD to C cup without a lift?

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Of course no one can give you specific advice without examining you, so your own plastic surgeon is in the best position to advise you. However, I would say that in general to go from a DD to a C would generally be about a 300 cc reduction so in a case like yours that most often means removing the implants and doing a breast lift. But focus more on the look you want rather than the specific cup size.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 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.