Getting Smaller Implants - 700cc to 500cc Feasible?

To create a natural appearance, nothing compares to the cold-subfascial technique in my opinion.  A low profile implant is used and the special subfascial plane is used to create aprojecting natural appearing tear drop shape.  Also after several surgeries you are much better off with subfascial placement for support. 

Downsizing presents some technical challenges, but in your case you are so unhappy with your current size that it is very likely to make you happy.

A lot of what can be done depends upon your skin quality and the degree of droop or ptosis that you have.  Seek out a consult with a plastic surgeon in you area.  I agree with the person you saw in that many times when you go down significantly in size you may need a lift to tighten the skin around the new implant size. All of this should be possible.
Good luck,
Dr. T

It is certainly feasible to #downsize to smaller implants and also alter the positioning; if possible. However, decreasing is size may also require a Breast #Lift to to #tighten loose skin, better optimize the end result. Any #revision has risks of unhappy outcome or other complications. Also, the right implant for the revision is contingent on shape of body and your desired outcome.

Hello,I think this is a good choice. Going to a more moderate implant size can give a much more natural appearance. I have performed this before with good results. You will have to have a lift to remove some excess skin, but incisions on the breast tend to fade fairly well over time and it will likely be worth the more comfortable fit and better shape.Best wishes,Dr. BlaggAustin, TX

Hi and great question. I think it is feasible to go down in implant size. This process just adds one more step: how to deal with the excess skin and the position of the nipple. Why? Because as we decrease the volume of the implant the sag is going to increase. This will be seen as excess skin and a lower nipple position. Overall, this will result in a less perky, less youthful, and less aesthetically pleasing breast. The way I deal with significant excess skin and/or low nipples is by a lift. Is a lift alway necessary? No, not always.If you are downsizing your implant by only about 10%, then you should not need a lift.
Any more than that and some form of a lift will be needed.

Most of the time this can be combined into 1 procedure. There are times (significant capsular contracture with above the muscle implants or Breast Fold Reconstruction Needed) that these need to be performed in 2 separate procedures. For your specific case, it is a little difficult without photos.  You previously had an anatomic shaped implant.  I think the anatomic shaped implants are really needed in very small subset of people:  extremely thin and/or significant native breast architecture distortion.  Why?  Because in those cases we are relying on the implant to form the breast.  If you were very happy with the anatomic implant previously, then I would suggest going back to it.  As for which dimension to use on the implants:  you should use the base width (12cm, 13cm, 14cm, 15cm etc) that matches your specific breast base width (and therefore your chest width); that (and that alone) will give you the most natural look to your breast regarding a natural shape to the breast.  I do not think that an around the nipple lift alone will be enough when downsizing from a 700cc to a 500cc this is almost a 30% volume decrease.  And an around the nipple only lift is going to create a "purse-string" or flattening of the nipple/areola and this should be your most projecting part of the breast...thus, creating an unnatural appearance.  I believe you would need a full lift with an implant decrease of almost 30% in volume.I hope that helps. Best of luck!

Yes, it is possible to reduce the volume by 200 cc. This however, may require a full breast lift at the same time to tighten up all of the loosened skin. Consult with several breast revision specialists.

                  When
breast augmentation patients are unhappy with breast size, the majority would
like to have larger implants. It’s unusual for patients to want smaller
implants, but never the less this occasionally does happen. This may occur for
a variety of reasons but when it happens, it represents a surgical challenge.
Although these cases are challenging, with careful attention to detail results
can still be excellent.

                  The
presence of larger implants results in stretching of the over lying soft tissue
and increased breast pocket size. When undergoing removal and replacement with
smaller implants, these issues must be dealt with to obtain an optimal result.
In some cases, patients will need a breast lift to suspend stretched soft
tissue. In other cases, the breast pocket will need to be adjusted to avoid
excessive implant displacement. This type of movement can be minimized by
utilizing implants with wider base dimensions. This will also tend to create a
more natural appearance and will hopefully address this concern as well.

                  It’s
important to discuss all of these issues with your plastic surgeon before
proceeding with this procedure. With careful attention to these details results
can be excellent. 

It is quite possible to downsize your breast implants to regain your confidence. If a breast lift or tuck is needed, it may also be performed later as a staged procedure. Our office specializes in breast implant revision and exchange. Raffy Karamanoukian MD FACS

If large breast implants are downsized, excess skin may be present.  This is similar to a person losing a good deal of weight in their abdomen and noticing that the abdominal skin is a bit looser.  The good news is that a lift can reduce the skin excess and tighten the envelope of the breast.  Breast shape can be maintained by selecting base diameters of the replacement implants to fill the width of the breast.  Lower profile implants tend to uplift the nipple less, so a lift is often beneficial.  I suggest a detailed consultation with a board certified plastic surgeon to review the particulars of your case.   Good luck!