Revision for implants should I downsize or have them removed with a lift? (Photo)

Dear Dazzling7214,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

It appears that both implants override or approach the mid sternum, leading to your discomfort. Explantation does not have to be part of the remedy, but a capsular repair is necessary if implants are going to be replaced. For these midline issues, my preference is performing a neosubpectoral pocket as opposed to repairing the existing pocket. Implant selection and/or the possibility of a breast lift cannot be commented on without a thorough examination.

The technique I recommend is explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.