I want to downsize my 7 yr old 650 cc saline implants. Do you think I will need a lift or will internal bra be enough? (Photo)

I went from completely flat chested little to no breast tissue to 650 cc saline implants through my armpit under the muscle after 7 years they are just too big for my liking . I want to go down to a size that will still fill my chest but just be easier to run and workout with . What do you suggest I do ? One seems to have dropped lower over the years and they are a bit uneven that doesn't really bother me as much as the size ...

Doctor Answers 10

Size? Shape?

Your photo shows that you have two different breasts. When you downsize, (650-700 cc implants are large implants for an average sized woman), you may need to have two different size implants, and two different breast lifts or just a left side lift. Very complicated plastic surgery case. Search out a competent surgeon..  

Atlanta Plastic Surgeon
4.9 out of 5 stars 55 reviews

Breast Revision to Include Smaller Implants

It is definitely possible 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.  #BreastAugmentation without a #BreastLift is usually a mistake looked back on by many patients. Most breasts will look larger and more droopy.They will sag more and sooner because of the excess weight altering the longevity of the results. The shape will usually not be satisfactory and sometimes results with “Snoopy” breast or double bubble. .A #mastopexy or breast lift operation is designed to improve the shape and position of the breasts without reducing their size. It is the most suitable for #breasts which sag or droop (ptosis) as a result of development, aging, pregnancy, breast-feeding and weight loss . Some patients will experience better results to restore superior fullness if an #implant is used at the time of mastopexy; better known as #AugmentationMastopexy.
With both implant types there are choices when it comes to size, shape, and profile. The criteria best to suit you will be discussed in full detail at your breast augmentation consultation. Also, the right implant for the revision is contingent on shape of body and your desired outcome.
Altogether, the surgery will create an elevated, more youthful breast contour. Also, the nipple and areolae of the desired size and correct heightmay also be addressed. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.The best method and #technique for your #procedures will be discussed in greater length during your one-on-one consultation with a board-certified plastic surgeon. 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

My comments

I strongly advice against smooth saline implants, and agains axillary incisions, reasons are multiple but essentially other options perform neatly superior; also would recommend anatical profile-shaped implants.

I notice your implants are eccentric from the nipples, this means the nipples are not (as they should) the almost perfect center of the implants' mound peak, this needs correction.

Find a really good revision surgery professional, to carry a rebuild with areolar approach (if unfeasible then submammary fold incision), redesign of implants' pockets and placement, and downsizing as much as you wish. Strongly recommend anatomical shape, cohesive gel filled macrotextured implants, if you don't wish another bottom out opt for polyurethane coated implants.

About the internal bra... I've been doing this work for 20 yrs... and I still don't know what is that... all the bras I've seen in my life are external...

I would not do a breast lift in your case.

Alejandro Nogueira, MD
Spain Plastic Surgeon
5.0 out of 5 stars 31 reviews

I want to downsize my 7 yr old 650 cc saline implants. Do you think I will need a lift or will internal bra be enough?

I am sorry to hear about your dissatisfaction after breast surgery. Your question is a very good one; whether or not breast lifting will be necessary in addition to “capsule work” (capsulorraphy) will depend on how much you downsize and the quality of the overlying skin/tissue elasticity. Please make sure that your plastic surgeon has a significant/demonstrable experience with revisionary breast surgery. Make sure that you communicate your goals carefully as well. Working together, you will come up with the best plan to achieve your goals. You may find the attached link, dedicated to revisionary breast surgery concerns, helpful to you as you consider options. Best wishes.

Breast downsizing

Thanks for an inquiry and picture.  If you plan to reduce the size of your breast dramatically-you will need a lift to address the skin.  Please seek the opinion an experienced plastic surgeon.  Good Luck

Implant downsizing

Downsizing is always a bit difficult in terms of figuring out what a patient specifically wants in terms of volume. This is a discussion that takes place in person.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Downsizing implants

Thank you for your question. Your photo does show significant asymmetry or implant malposition and this will most likely need to be corrected when you downsize your implants. I have had success using seri scaffold to create an internal bra correcting the malposition. The need for a lift will depend on the size and shape of your new  implants. At this point you should schedule a consult with a board certified plastic surgery to discuss your goals and options.

Breast augmentation revision

Thank you for your picture. Y have a significant asymmetry. I would recommend during your downsizing that you have a breast lift and internal support via the use of Seri or STRATTICE .


Your picture did not post so I really have no idea what your situation is like.  Still, the larger the implant, the more your tissue has to stretch and thin in order to cover it.  When you go smaller, this will result in excess loose skin that may need to be tightened with some form of breast lift procedure.  I would suggest that you schedule a consultation with a board-certified plastic surgeon who can examine you in person and review your options.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 23 reviews

Downsizing breast implants

Thanks for your question

I believe you have several options and without an exam or photos it is hard to give you much advice.  I suggest that you visit with a board certified plastic surgeon in your area to discuss what options may work best for you.

Best Wishes

Steven M. Camp, MD
Fort Worth Plastic Surgeon
4.9 out of 5 stars 86 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.