After Removing my 450 Cc of 4 Yrs Implant to 300cc Will I Need a Lift? (photo)

Hello.

Thank you for sharing your photos along with your concern.

Usually, a lift should be considered ONLY if it is necessary since scarring will result off of it and at the end of the day, patients seeking aesthetic improvement will want to stay as scar-free as possible.

With that perspective, your surgeon's decision must have had a reason supporting it and keeping an open line of communication with him/her is essential.

Also, it is important that you consider the fact that you stand early in the recovery timeline to be able to come up with a well founded judgement about the results of your surgery; I recommend that you be a little more patient and give mother nature the chance to do its job.

If it helps, let us imagine a lift being performed during your revision resulting in unsatisfactory results. At this point, a surgeon cannot reverse a lift easily since skin is excised during the process. I hope you understand that I am not trying to prove your surgeon right or wrong but to encourage you to give your body time to recover instead of stressing over something that may be falling into the right place once the recovery process is completed.

I hope this helps and thank you for your inquiry.

The best of luck to you.

Dr. Sajjadian 

It is certainly feasible to #downsize to smaller implants and also alter the positioning; if possible. However, decreasing is size may also require a Breast #Lift to to #tighten loose skin, better optimize the end result. Any #revision has risks of unhappy outcome or other complications. Also, the right implant for the revision is contingent on shape of body and your desired outcome.

Thank you for your question and the photo to clarify your concern. Normally, when changing implants and reducing their volume, the shape of the breast is affected as well. The degree depends on the position of the nipples and the fullness of the lower pole of the breasts. I agree with the other colleagues that an uplift/mastopexy, would have improved the shape. However it depends on what discussed with your surgeon at the time of the consultation and what agreed would have been the best course of action in your individual case.

My advice would be to arrange a follow up appointment and discuss with him your concerns and evaluate the different alternatives.

Best of luck

Andrea Marando

 

The breasts look pretty good , but if you wanted them a bit higher, then a lift would be necessary. Best to be evaluated in person.

Thank you for posting a photo.  These things are better determined in-person but by the looks of your photo, your breasts look good in terms of size and shape after your operation.  I understand that you may be wanting a bit of a lift, however, which is something you should discuss again with your plastic surgeon.  You also should not be shy about getting a second opinion from a surgeon that specializes in breast lifts and also breast revision procedures, as their is a bit more work involved when revising a breast augmentation than performing one in the first place.  Hope this helps!

If you wanted the implant in a higher position, internal sutures and a lift would have been indicated.

From the two posted photos I think I would have done a full lifting. But you would need a detail pre operative informed consent due to possible scarring. 

It is hard to tell from just one view. And as always, it is in the eyes of the beholder. 

I do see what appears to be some loose skin at the lower poles of the breast before surgery, but that looks better in the early postop photo you posted.  On the one photo, the breast position looks OK. I think your surgeon exercised reasonable judgement. That doesn't mean you would agree with it. But a lift would not result in much change in your current breast contour, and would add a lot of new skin incisions and scars. 

Thanks for your question, best wishes. DO continue to follow up with your surgeon

Thank you for the question and pictures.

 Given that you are early out of your breast implant downsizing procedure, it is too early to evaluate the end results of surgery. You may find that, over the course of the next several months, that the breasts skin/tissues will re- drape over the smaller breast implants;  you may find that you will be pleased with the results of surgery at that point.

 In the longer term, if you still feel that the breast implants are too low, you may benefit from internal suture repair of the breast implant pockets (capsulorraphy).  This procedure will serve to help keep the breast implants higher on your chest wall,  while negating the need for breast lifting ( which may be too much surgery considering the scars associated with this procedure).

In the meantime, I would suggest that you continue to follow-up with your plastic surgeon and remain patient as the healing process continues.

Best wishes.

There are a number of misconceptions here in addition to the apparent lack of understanding or communication over what procedure was to be done (and consented for and presumably paid for). 

450 cc implants do not cause "major back pain" and silicone implants would not significantly change the weight of the implant or perceived "weight" of the breast. Downsizing from 450 cc's would also not result in a significant change in weight effect on the back. Breast augmentation is a cosmetic procedure and removing or downsizing implants (or lifting breasts) is a cosmetic choice, not a functional one. 

Breast implants act like a pillow behind your breast. They do not actually "lift" the breast in the usual sense of that word (in relation to a breast lift procedure). They do not make the breast sag or descend if they are removed or downsized. True ptosis or "sag" of the breast can be determined before surgery and is based on where the nipple-areola sits in relation to the inframammary crease behind it which will not change because of an implant. The breast can appear lifted when it is filled out in the forward direction and it can appear lower if the implant is removed or downsized but this is an illusion. 

From your photo it does not appear that you need or would benefit from a lift but this should have been established before the procedure. It also appears that the peri-areolar incision was used again which, in my opinion, is not a good idea. The width of the smaller implant also looks a bit narrow. Downsizing an implant is best done by decreasing the forward volume (profile) and not downsizing the width without pocket adjustment.