Those are quite large for someone with your frame. There are some patients who do quite well with downsizing alone. Whether you need a lift depends on tissue elasticity and how loose your skin was prior to augmentation. Your best bet is to be seen by a plastic surgeon who can examine you and give an indivualized plan.
As a rule of thumb, it takes a reduction or an increase of 150cc to make a visual difference in the breast. A 200cc change could be just right, though better to work with photos and sizers to determine the right look for you. If you wish to avoid a lift, first reduce the size and profile until your result is "you", and make that decision later.
Thank you for your question. Your implants have been there long enough to have stretched your skin in a way that may actually limit their retraction. Depending on the type of implants you have it is possible that you could possibly deflate the implant if they are saline devices otherwise you could either have them removed, replaced with a smaller implant, or have implants removed with simultaneous transfer of fat. Whether or not you require a breast lift will determine on how responsive your skin is and I would certainly recommend a consultation with a board-certified plastic surgeon who is experienced in these matters. I hope this helps and have a wonderful day. Dr. Kayser - Detroit
I would suggest meeting with a board certified plastic surgeon and discussing all your options. After an examination, your surgeon will have a better idea if a lift is needed. You may find the smaller size is much more comfortable and fits your frame and tissue better.
Without a photo, there is little to be said about your situation. However, keep in mind that a downsizing makes the implant more narrow which could leave you with a larger gap between your breasts. Have a discussion with your surgeon about your goals and your decision to change profiles is a good one.
You should see a board certified plastic surgeon in your area to get a formal opinion through an in-person consultation.
Best of luck,
Vincent Marin, MD
San Diego Plastic Surgeon