Breast Implant Revision/Reduction after 10 years? (Photos)

I've had my submuscular saline mentor implants for 10 years. I've never been satisfied with my breast implants. They are asymmetrical and too big. Additionally I hate my side/profile because they are bulgy up top and one side is higher than the other. I would like to replace with smaller (full b cup size) implants and I'm not sure if I'll need a lift too.My underarm scars never lightened up Are there more natural shaped implants vs round implants? It's time I have the breast I always envisioned.

Doctor Answers 8

Possible Lift

Thank you for reaching out and sharing photos. It is really hard to say without an in person consultation, after having implants in for 10 years it is a high possibility that you will need a lift with downsizing the size of your implants. An in person consultation is the best way to learn about all of your options! Be sure to visit experienced board certified surgeons. Best of luck! Dr. Kim


Orange County Plastic Surgeon
4.6 out of 5 stars 15 reviews

Possible Lift

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Thank you for reaching out and sharing photos. It is really hard to say without an in person consultation, after having implants in for 10 years it is a high possibility that you will need a lift with downsizing the size of your implants. An in person consultation is the best way to learn about all of your options! Be sure to visit experienced board certified surgeons. Best of luck! Dr. Kim


Orange County Plastic Surgeon
4.6 out of 5 stars 15 reviews

You really need to be seeing in person

and allowed to expound on your goals and expectations and allow your surgeon to examined the tissue and anatomy.  Downsizing, if significant, will benefit from having a lift at the same time but that brings with it costs, risks, and scarring.  Much simpler to just re-augment with smaller implants but your goals on how perky you must be will dictate whether a lift is needed or not.  And if not sure, its always recommended that you simply have the augment first if your nipples are at or above the fold when you put a fuller under your breast in your fold.  You can always have a lift later and if a small lift, that can be done in the office.

You really need to be seeing in person

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and allowed to expound on your goals and expectations and allow your surgeon to examined the tissue and anatomy.  Downsizing, if significant, will benefit from having a lift at the same time but that brings with it costs, risks, and scarring.  Much simpler to just re-augment with smaller implants but your goals on how perky you must be will dictate whether a lift is needed or not.  And if not sure, its always recommended that you simply have the augment first if your nipples are at or above the fold when you put a fuller under your breast in your fold.  You can always have a lift later and if a small lift, that can be done in the office.

Implant replacement for downsizing: Issues to consider

There are several trade-offs to consider:

  • Rule out capsular contracture - you would need a capsulectomy (removal of the scar capsule) and implant replacement.
  • Revisions through the existing axillary incision may be very difficult to perform accurately.
  • Downsizing will probably require a lift, which means scars on the breast. Since your axillary scars are an issue, hopefully the lift can be limited to the periareolar technique (Benelli) so that the pigmentation is around the areola which is already darker.
  • Anatomic implants can help, but a capsulectomy might be needed in order to get them to stick in place and not rotate.

Implant replacement for downsizing: Issues to consider

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There are several trade-offs to consider:

  • Rule out capsular contracture - you would need a capsulectomy (removal of the scar capsule) and implant replacement.
  • Revisions through the existing axillary incision may be very difficult to perform accurately.
  • Downsizing will probably require a lift, which means scars on the breast. Since your axillary scars are an issue, hopefully the lift can be limited to the periareolar technique (Benelli) so that the pigmentation is around the areola which is already darker.
  • Anatomic implants can help, but a capsulectomy might be needed in order to get them to stick in place and not rotate.

Breast Implant Revision/Reduction after 10 years?

Thank you for photographs and inquiry. The two main causes of poor shaping such as your pictures demonstrate are either mild to modest capsule contracture pushing the implants upward or too large an implant that never settled and positioned itself properly. The latter may be the case if your nipples were low to begin with but after 10 years the potential for a nice improvement is definitely present. You may well have the option of changing to a somewhat smaller implant producing less fullness in your upper chest. This may be combined with a periareolar mastopexy to raise your nipple position and narrow your areolar diameters if desired. If encapsulation is present to a mild degree removal of the lower capsule will allow the implants to drop and your new smaller implants will look significantly better possibly not even requiring an uplift.


I'd recommend that you meet with one or more ABPS board-certified plastic surgeons for an examination and consultation in a face-to-face setting. Once you're satisfied with the options and are comfortable with your doctor and choices, I think you can proceed with high expectations. Best wishes and good luck to you,

Jon A Perlman M.D., FACS

Certified, American Board of Plastic Surgery

ABC-TV/Extreme Makeover Plastic Surgeon

Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Breast Implant Revision/Reduction after 10 years?

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Thank you for photographs and inquiry. The two main causes of poor shaping such as your pictures demonstrate are either mild to modest capsule contracture pushing the implants upward or too large an implant that never settled and positioned itself properly. The latter may be the case if your nipples were low to begin with but after 10 years the potential for a nice improvement is definitely present. You may well have the option of changing to a somewhat smaller implant producing less fullness in your upper chest. This may be combined with a periareolar mastopexy to raise your nipple position and narrow your areolar diameters if desired. If encapsulation is present to a mild degree removal of the lower capsule will allow the implants to drop and your new smaller implants will look significantly better possibly not even requiring an uplift.


I'd recommend that you meet with one or more ABPS board-certified plastic surgeons for an examination and consultation in a face-to-face setting. Once you're satisfied with the options and are comfortable with your doctor and choices, I think you can proceed with high expectations. Best wishes and good luck to you,

Jon A Perlman M.D., FACS

Certified, American Board of Plastic Surgery

ABC-TV/Extreme Makeover Plastic Surgeon

Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Breast Implant Revision/Reduction after 10 years? (Photos)

Without examining you it's difficult to be very specific but based on the photos it looks like you would definitely benefit from a lift, even if you kept your existing size. To go smaller you would definitely need a lift to avoid a waterfall deformity. Anatomic implants would certainly be an option but you'd really need to book a consultation with a board certified plastic surgeon near you to be examined in person and see what your options are. Best of luck! 

Breast Implant Revision/Reduction after 10 years? (Photos)

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Without examining you it's difficult to be very specific but based on the photos it looks like you would definitely benefit from a lift, even if you kept your existing size. To go smaller you would definitely need a lift to avoid a waterfall deformity. Anatomic implants would certainly be an option but you'd really need to book a consultation with a board certified plastic surgeon near you to be examined in person and see what your options are. Best of luck! 

Breast Implant Revision/Reduction after 10 years?

I am sorry to hear about your concerns after breast augmentation surgery.  Despite good intentions, online consultants will not be able to help you when it comes to specific advice.  Some general thoughts maybe helpful to you:


Anatomical breast implants were designed to better simulate the natural breast shape; the problem with these implants is that if they shift or rotate, the entire breast will change shape as well. This change in breast shape may require further surgery to correct. Round implants, under the hand, can shift or rotate without changing the shape of the breasts. Overall, I find that beautiful outcomes can be achieved with the use of round saline or silicone gel breast implants for the vast majority of patients.


  As you are considering breast implant downsizing,  it may be helpful for you to know that adjustment of the breast implant pockets (capsule adjustments) and/or breast lifting may be necessary to achieve the outcome you are looking for.   Whether or not the adjustment of the breast implant capsules or breast lifting (and what type of breast lifting) will be necessary will mainly be dependent on your physical examination; specifically, factors such as the amount of redundant skin, quality of skin elasticity,  and how much you downsize will be important.   I often make final determinations of the breast implant size/profile and the type of breast lifting during surgery, after utilizing temporary sizers and a technique called "tailor tacking".

 

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. 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 "B 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 revisionary breast surgery, specifically downsizing breast augmentation surgery concerns), helps. Best wishes.  

Breast Implant Revision/Reduction after 10 years?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I am sorry to hear about your concerns after breast augmentation surgery.  Despite good intentions, online consultants will not be able to help you when it comes to specific advice.  Some general thoughts maybe helpful to you:


Anatomical breast implants were designed to better simulate the natural breast shape; the problem with these implants is that if they shift or rotate, the entire breast will change shape as well. This change in breast shape may require further surgery to correct. Round implants, under the hand, can shift or rotate without changing the shape of the breasts. Overall, I find that beautiful outcomes can be achieved with the use of round saline or silicone gel breast implants for the vast majority of patients.


  As you are considering breast implant downsizing,  it may be helpful for you to know that adjustment of the breast implant pockets (capsule adjustments) and/or breast lifting may be necessary to achieve the outcome you are looking for.   Whether or not the adjustment of the breast implant capsules or breast lifting (and what type of breast lifting) will be necessary will mainly be dependent on your physical examination; specifically, factors such as the amount of redundant skin, quality of skin elasticity,  and how much you downsize will be important.   I often make final determinations of the breast implant size/profile and the type of breast lifting during surgery, after utilizing temporary sizers and a technique called "tailor tacking".

 

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. 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 "B 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 revisionary breast surgery, specifically downsizing breast augmentation surgery concerns), helps. Best wishes.  

Breast lifts after replacing breast implants

For most patients, removing implants or replacing them with smaller prostheses will lead to some sagging of the breasts. The extent of sagging is directly related the the reduction in volume. Based on your photos it appears that a reduction to a full B cup will require a substantial reduction in implant volume. This suggests that you may want to consider a lift at that time. More definitive recommendations would require a thorough physical examination. It would also be helpful to know your current bra size and the size of your implants. 

Breast lifts after replacing breast implants

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For most patients, removing implants or replacing them with smaller prostheses will lead to some sagging of the breasts. The extent of sagging is directly related the the reduction in volume. Based on your photos it appears that a reduction to a full B cup will require a substantial reduction in implant volume. This suggests that you may want to consider a lift at that time. More definitive recommendations would require a thorough physical examination. It would also be helpful to know your current bra size and the size of your implants. 

Removal

I would suggest meeting with a board certified plastic surgeon and discussing all your concerns and options. Your implants could be exchanged for smaller implants, and there are shaped implants and round.

Removal

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I would suggest meeting with a board certified plastic surgeon and discussing all your concerns and options. Your implants could be exchanged for smaller implants, and there are shaped implants and round.

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.