Originally 34C now 36DD, options to making smaller? (photos)

Question

I currently have 275 mentor gel implants. Originally I was a size 34C however over time with a little weight gain and menopause they are now a DD and they come out the sides of my bra and under my armpits. I wear sports bra’s all the time to smoosh them down. Remove implants and do a lift which would make them alot smaller and less full, switch out for smaller implants and revise pockets, or keep current implants and remove some breast tissue especially laterally and correct pocket.

Luke J. Curtsinger, MD · Answer

You state that you would like to have smaller breasts. I would suggest that you have simple implant removal and allow the breast envelope to snap back as much as it will snap back. I have been pleasantly surprised to see how much recovery the breast envelope achieves when given the chance. I believe that invasive pocket maneuvering and use of ADM's is overrated. If you have patience, you will be able to see if you need a lift or small implant and much of the invasive, expensive, unpredictable pocket work and aggressive skin resection can be avoided.

Gregory T. Lynam, MD · Answer

I think simple removal of your current implants and waiting 3-4 months is what I would do. There are so many options that an exam and consultation is really needed. Good Luck!

Larry S. Nichter, MD, MS, FACS · Answer

Both options are viable and you seem to understand your options well. See the below link and video explaining both options. If you have smaller implants then the pocket will also be reduced ( #capsulorraphy).

Milind K. Ambe, MD · Answer

Your situation is very common, as I see it often in my office.  More and more women are choosing to have their implants removed all together once they hit menopause and their breasts naturally get bigger.  I would recommend an explantation, pocket tightening (capsulorraphy) and a lift to reshape the breast and get rid of excess skin that would cause sagging.  Seek a consultation with a Board Certified Plastic Surgeon who performs a lot of explantation surgeries.  Best of luck to you!

Steven Wallach, MD · Answer

With an implant exchange to smaller, you may or may not need a lift. These can be a bit tricky.  You can always go smaller and stage a lift if one might be needed.

Darryl J. Blinski, MD · Answer

The posted photos demonstrate a nice lifted implanted breasts. I would first recommend weight loss of 20 pounds to see the effect upon the appearance of your breasts. Than a re lift with 150 cc implants...

Steven M. Camp, MD · Answer

Thanks for sharing your question about breast implant surgery and revisions.An exam would be necessary to determine how much may need to be performed to adjust the position of your implants and to what degree they tend to move lateral toward your armpits.  In general it appears that you had nice results and now the implants have started to drift toward the sides.  If you currently have smooth implants in then it may be reasonable to switch your implants to a slightly smaller size with a texture to help the implants stay more centered.  This would likely involve removing your current implants, tightening the pocket where the implants are placed, and then placing new textured implants, and likely re-tightening your breast lift.Visit with your board certified plastic surgeon to discuss your concerns and discuss reasonable options.Best Wishes

Ciro Adamo, PhD, MD · Answer

I would say that I would not recommend keeping the implants and reducing the breasts as a downsizing option. Other than that, both complete removal and uplift or replacement with smaller implants and uplift would work well, depending on your goals. From your post, you seem to be at a point where implants are a burden for your quality of life rather than an improvement, and that would make me suggest a complete removal with uplift.

Tom J. Pousti, MD · Answer

Thank you for the question.  Based on your question, I think you may already have a very good understanding of what might be involved with downsizing of breast implants. As you mentioned, adjustment of the breast implant pockets (capsulorrhaphy) will likely be necessary to achieve the outcome you are looking for.  Depending on your physical examination, additional "maneuvers" such as breast lifting may be necessary.

Generally speaking, the best online advice I can give to ladies who are considering revisionary (downsizing) breast augmentation surgery is:

1. Concentrate on choosing your plastic surgeon carefully.  I think that this will be the most important decision you make. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “down a cup size” or "C cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.

3. Once you feel you have communicated your goals clearly, allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.

I hope this, and the attached link (dedicated to downsizing breast implants surgery concerns), helps. Best wishes.

Morad Tavallali, MD, FACS (retired) · Answer

Your breasts look like they have a nice shape though they may become a little droopy if you were to take the implants out totally. A 275 cc implant is about 1.5 cup sizes and its removal would take you to about a C+; if that is a good size for you, have the implants removed first, and possibly plan for a lift in the future- should you need it. If you want to stay larger, try a smaller implant exchange and then wait. would not rush into a lift in your case without seeing what your skin elasticity and nipple measurements are.

Originally 34C now 36DD, options to making smaller? (photos)

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