Would downsizing from 605cc to 450-500cc range cause significant sag? (Photo)

I would recommend removing the implants and allowing your tissues to rebound/recoil after having such stress under the excessively large implants for your frame. After 3 months, we would re-evaluate the tissues and see how much tissue excess there truly is. At this time, we could potentially then proceed with placement of new smaller implants under the muscle with or without a breast lift depending on the measurements that are taken after your tissues have recovered. This is a complex problem that was created from placing incredibly large implants. I hope that you can find the correct surgeon to help I would recommend seeing a board-certified or board-eligible plastic surgeon with aesthetic surgery training and experience to tackle this type of problem in a safe and efficient manner. Best of luck!

You are sagging now, but I would definitely go smaller. These are way to large and heavy for your frame and tissue and will just sag more.

At this time, your breasts are sagging significantly and the nipple-areola complex is pointing outward. I recommend 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.