Will implant exchange fix sagging saline implants? is "tacking" an alternative to a lift? What is causing sagging? (Photo)

Good morning!
I think you do need a full anchor type lift, along with smaller implants, and in going smaller I would perform the Original Internal Bra, my strong permanent internal suturing technique that you are referring to as tacking. It basically makes the pockets smaller to match your new implant size, and it also moves them higher up your chest wall so your breasts don't appear so low and long. However, the Original Internal bra only adjusts the pocket size and placement, it cannot take up the excess skin or correct your nipple position, which is why the lift is also a necessity.

Dear monster6,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery