58 y/o considering downsizing implants - which approach is best for minimizing downtime and invasiveness?

Hi, if you are wishing to downsize, then this can often be coupled nicely with a breast uplift procedure in order to maintain a natural and youthful breast shape. In patients that are active, I usually recommend placing implants over the muscle to minimise chronic aching and implant animation - this has the added bonus of enabling a return to exercise sooner as well. Implant exchange and uplift can be performed as a daycase procedure with no overnight stay under a short general anaesthetic. I would usually recommend getting back to light exercise once your wounds have healed at around 2-4 weeks post-op. You should wear a supportive bra when doing so to maintain your result.

Putting new implants in the same pocket would minimize downtime. This would take about 30 minutes under general anesthesia. At size 32, each 100 cc of implant corresponds to 1 cup size change. If you want to be a C then 260 cc implant would be required.

Best Wishes,

Gary Horndeski, M.D.

Dear cowslip,
in case of implant replacement, you can use the same incision. I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Usually, replacing implants has easier recovery than first time getting them.

I will reuse old scar to remove implants, small downsize (325cc +/-) best as much smaller may require internal pocket work which may prolong recovery time. Also much smaller implants (under 300cc) maycause sagging of breast tissue.

Recommend exchange to slightly smaller via same scars with short recovery, back to most activities approximately 1 or 2 weeks.

An exam and consultation with a plastic surgeon is recommended to further discuss your options and expectations.

You did not post photos, so I cannot be specific. Usually, you need 6 weeks before returning to full activities. If you have little natural breast tissue, I would suggest keeping the implants behind the muscle for better coverage of the implant. go for a consultation and discuss all your concerns and options.