Currently a 34DD. I want to switch my 500cc saline implants, to "gummy bear" implants but I want to go smaller.

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.

Thank you for your question and photo.Since you want to avoid the vertical scar associated with the traditional techniques, I recommend a new technique called The Horndeski Method (TM). This technique reshapes the breast creating upper pole fullness without implants, improves cleavage and provides long term results. The vertical incision has been completely eliminated for improved cosmesis. Incisions are hidden around the areola (areolas can therefore be made smaller) and in the inframammary fold. I hope this helps.Kind regards,Gary Horndeski M.D.

You have very large areolas that would require a significant reduction in implant size to correct.  If you would like to revise your breasts, I suggest you undergo a Wise pattern lift with a much smaller implant size, more in the order of 300 cc.  A shaped silicone gel implant would be a good option but they do tend to be a bit harder than round silicone gel implants.  

Thanks for your photos.  I see that you have some sagging of both breasts, and your right breast has more skin than the left.  You also state that you are unhappy with your areola size. These changes are common after pregnancy and many women simply have 2 different breasts naturally.Putting in a larger implant to "lift" the breast really is not a great option. It will further stretch the skin, make your breast lower on the chest wall, and thin out your skin. I would be very concerned that doing this with an areolar reduction would also result in a  very wide scar.A true "gummy bear" implant or form stable implant is not recommended for patients with loose skin such as yourself. The best operation to get you the best results is a lift with a vertical scar with a modest sized silicone gel  implant that meets your size goals.

Hi, Dream705.  Thanks for sharing your photo.  In-person examination would be the best.  Based on your photo, it seems like you had breast augmentation in sub-glandular plane.  In order to have smaller, perkier breasts, you would need smaller implants with site change (sub-glandular to sub-muscular) along with breast lift.  I agree that your areolas are fairly large.  Your areolar size can be made smaller during breast lift.  In regards to breast lift, given the extent of your ptosis, you will most likely require vertical incision along with incision around your areola.  I understand that a lot of patients are apprehensive about vertical scar.  However, as long as the vertical scar heals well, it will look good.  Please visit with a board-certified plastic surgeon to learn about your option in-peron.  Best wishes!

Judging by your photographs you have very significant ptosis and a large areola. In my opinion it would be best to downsize your implants by at least one third and perform a Wise pattern breast lift. The wise pattern breast lift has an incision around the areola with a vertical incision between the areola and the inframammary fold. There will also be an incision in the inframammary fold. It has been my experience that the areolar incision and the vertical incision normally heal very well with a relatively inconspicuous scar. The inframammary incision scar howeverca widen to a degree but is normally concealed within the inframammary crease. Properly done this combination of procedures should result in a very significant improvement in the shape and appearance of your breasts. Good luck.

Dear dream705:Thank you for posting your photo.   You have several issues that need to be addressed.  Based on the photos alone, I see  you have significant sagging with asymmetries in your nipple position, breast shape, and possible volumes. In addition, the areola size is stretched out.  I will assume that you have loose thin skin as well.   Although a formal physical exam is really required to make any meaningful recommendations, I would likely suggestion a revisional breast augmentation and mastopexy procedure.  You will definitely need a breast lift to address the sagging, loose skin, and improve your overall breast shape.  You can definitely downsize your overall size and I would definitely concur with your decision to transition to the silicone gel "gummy bear" implants.  Please visit with a board certified plastic surgeon to learn more about your options.  Best wishes,Dr. BasuHouston, TX

I think you have asymmetrical breasts with extra skin and ptosis.  You will need a breast lift and smaller implants. You will need to have at the very least a vertical scar with the left. Please see a board certified plastic surgeon for evaluation and to discuss your options.