Breast Implant Revision: Can I Go Smaller Without a Lift? (photo)

I had 475cc silicone gel breast implants placed under the muscle two years ago. I have felt they are "too big" for awhile but have tried to accept them since I spent a lot of money on the surgery. My surgeon did exactly as I asked and gave me the "big" look. But now I am very uncomfortable with how big they are. I am unsure the amount of cc I would desire, but I am looking for a 25-30% reduction in size overall. is it possible to exchange my implants for smaller ones without a lift?

Doctor Answers 10

Breast Revision to Include Smaller Implants

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
5.0 out of 5 stars 96 reviews

Will I Need A Lift With A Smaller Breast Implant

I guess this depends on how perky you wish to look afterwards as there is likely some sagging which increases the more your implant size decreases. It is very difficult to determine the exact size and shape implant you will require or whether a lift is needed to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions and elasticity of your skin it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 100 cc implant reduction size to make her go from a “C” cup to a “B” cup size does not mean that you will have the same result with the same size implant.  Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below: 

Smaller implants with simultaneous lift will maintain comparable projection

You are an excellent candidate for a new technique called Implant Exchange with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to exchange your implants for smaller ones, reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.  Aligning the areola, breast tissue and implant over the bony prominence of the chest wall gives maximum anterior projection with a minimal size implant.  Smaller implants are more stable long term, feel and look more natural, less likely to ripple or have complications that need revision.  Your 475 cc implants can be replaced by 200 cc’s and maintain comparable projection.    

 

Best Wishes,

 

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.7 out of 5 stars 210 reviews

Breast Implant Revision: Can I Go Smaller Without a Lift?

Thank you for the question and pictures.  Although precise advise cannot be provided online, I think it will be possible for you to downsize breast implants to a moderate degree, without  the need for breast lifting. It will be important for you to communicate your goals clearly with your plastic surgeon; for example, 25 to 30% reduction in size for example made mean different things to different people. In my practice, I find the use of goal pictures very helpful during this communication process.

Sometimes, during this type of surgery, it is necessary to “downsize” the breast implant pocket size as well; this is especially true if your current breast implants displace  in any direction.  This procedure involves  the use of internal sutures (capsulorraphy).

 I hope this, and attached link demonstrating similar “cases”, helps.

You Will Need A Lift

Thank you for your photograph. Unfortunately in my opinion it is not possible to downsize your implant 30% and not have excess skin that will require a lift. You must be willing to accept that a lift is a very real possibility.

Good luck.

Dr. ES

Breast Implant Revision: Can I Go Smaller Without a Lift?

I might refuse to mess with such a very very good result if I were you! Best to re consider this idea. 

Downsizing implants

You should be alright if you reduce the size of your breast implants by 100 to 150 ccs and not need a breast lift.  There will be less upper pole fullness and a slight increase in the degree of sagging of the breasts.  This sagging should not be excessive and most likely would not require a lift.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

Probably can go smaller without a lift.

Your breasts look good at this stage and I think you probably will would be okay with a reduction in size without a lift. If your breasts are soft and natural I think carefully before proceeding. You put that part of the result at risk.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

No need for a lift

You can go smaller without a lift. Your breasts may look deflated and the skin may be loose, however, these should improve with time after surgery. 

Armin Moshyedi, MD
Bethesda Plastic Surgeon
4.6 out of 5 stars 19 reviews

Breast Implant Revision: Can I Go Smaller Without a Lift

It is really hard to tell without an examination to evaluate the skin tone. Depending on how much size reduction you decide upon, it may well be possible to avoid a lift. 

An acceptable choice in most patients is to just do the size change, and wait 3 to 6 months to see if enough recovery occurs to avoid the lift,. If not, it can be done later. All the best. 

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.