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

I got 450cc implants at the age of 19. now being 22 my large implants were causing me major back pain. I decided to go smaller and get silicone. the doctor first told me he will change the implant and do a lift by removing the nipple and taking the extra skin off..the day of the surgery he told me he will see if i need the lift..which he did not do..the results, my boobs are lower than before and i do not like them. he said they are fine. but i feel like he did not do a good job..what do u think?

Doctor Answers 11

About Downsizing Breast Implant Size

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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.

Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Lift after implant exchange

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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.

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

Breast Implant Replacement and Lift

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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!

Norman M. Rowe, MD
New York Plastic Surgeon
4.9 out of 5 stars 62 reviews

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The most important thing is what YOU think about your results

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

Implant downsizing and lifts

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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. 


Scott L. Replogle, MD
Boulder Plastic Surgeon

Looks GOOD!

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From the photograph it appears as if your breasts are fairly symmetric, well shaped and in good position given their large size.  It's unfortunate that you didn't have a better understanding with your surgeon before your last surgery as to the EXACT procedure you wanted.  If you're not satisfied it may be worthwhile to eventually do a Binelli (Circumareolar) Breast Lift to tighten your breast envelope around the smaller implants.  You should wait at least six months to fully assess your situation and to make any further decisions.

Anyway, you shouldn't be stressed because your breasts look good!

Eric Sadeh, MD
Manhattan Plastic Surgeon

Implant Replacement: from larger to smaller

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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


Andrea Marando, MD
Manchester Plastic Surgeon
5.0 out of 5 stars 128 reviews

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

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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. 

Too Early To Assess Your Final Results

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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 

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Will I Need a Lift?

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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

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.