Implant Revision and Downsize? (photo)

I had BA April 13, 2011. 350 cc, Mentor gel, mod plus, under the muscle. I am 34, 5'5, weigh 120 lbs. I need a revision and I want to downsize. My right breast is drooping and I do not know what the problem is, it was not like this in the beginning. When I flex my pec muscles it almost looks like the implant has come out? Also, I feel that these implants are much too large. Do you think I will notice a significant difference if I go down to 200cc implants?

Doctor Answers 9

#BreastAugmentation Revision

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From your photos, it is clear that you have asymmetry. However, no surgeon can tell you precisely why. I would consider looking at your pre-op photos to see if this existed from the beginning. Downsizing 150 cc will make a difference, but you run the risk of needing a lift. I would also consider differently sized implants since you also seem to have a volume difference as well.

You should see a board certified plastic surgeon in your area to get a formal opinion through and in-person consultation.

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon

San Diego Plastic Surgeon
5.0 out of 5 stars 52 reviews

Revision and downsize

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The right breast appears larger in this photo, and it looks like it has "bottomed out" in that the fold looks lower on that size. 

Your surgeon should consider:

  • reconstructing the fold on the right in it's proper position
  • Use of smaller implants after further discussion about your goals
  • Possibly using a smaller implant on the right than on the left.

All the best

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Achieving Desired Results after Revisionary Breast Surgery?

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Thank you for the question and pictures.  Certainly a 150 mL change in breast implant volume will “create” a significant change.  Of course, online consultants will not be able to provide you with recommendations as to whether this size of breast implant will necessarily accomplish your goals.

Your best course of action is to communicate your goals carefully with your plastic surgeon;  in my practice I would ask that you show me pictures of what you would like to achieve and what you consider too big or too small.

 Also, given the degree of breast asymmetry,  it is probable that you have a breast implant displacement on the side that is “lower”. Breast implant pocket adjustments ( capsulorraphy)  may be necessary to improve the breast symmetry.

Again, careful communication with your plastic surgeon will be key to the successful outcome of the revisionary breast surgery.

 Best wishes.

Implant Revision and Downsize?

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The posted photo demonstrate asymmetry to volume and appearance. Yes best to have IN PERSON evaluations to plan a revisional surgery. 

Breast Augmentation Revision

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Your inframammary fold on the dropped out side has lost attachment to the deep tissues, allowing the implant to slip downward into the lax, thin tissue below your breast.  I gauge an appropriate implant size change by percentage change.  I have found that 20 to 25 % is a modest change. 30 to 35 % is more noticeable. You are opting for a 42% reduction.  This is a large change, and will significantly change your apparent size, which might be exactly what you want. Only a thorough discussion will allow me to determine that. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Right isn't drooping but the crease is lower

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I'm sorry you're unhappy with the size but if you are then by all means decrease the volume by 100 to 150 cc on each side.  The real problem however is the creases are very assymmetric, at least from the photo I am looking at now.  The surgery would require a reduction in size of the implant as well as either raising the right crease or lowering the left.  Discuss this with your plastic surgeon before deciding to proceed. Good luck, Dr. Schuster in Boca Raton Florida

Breast augmentation revision can be complex

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Thank you for your question and for providing the photos.  In my experience the implant size must be reduced by at least 150cc for the patient to see a significant size change.  It is also helpful for me to see the patient's before photos.  It looks like the right inframammary fold may be lower than the left.  If the right fold is lower than the left, it can be raised and repaired.  Surgeons approach this differently and there is no one great way to raise a fold.  I often use Strattice but there is no guarantee when trying to raise a lowered fold.  Regarding the pec muscle, your surgeon will evaluate it and make sure it is not detached.  Another possibility is the pec is compressing the implant when you flex. Have one or two consults with board certified plastic surgeons who specialize in breast surgery and can make recommendations that will help you achieve your goals.  Great communication is essential.

Hope this helps.

Tracy Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews

Implant Revision and Downsize?

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        Usually 100 cc reduction is enough to notice a difference in size, so 150 cc difference should produce a nice reduction.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast augmentation revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Revision breast augmentation can correct asymmetry.

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You will be much happier with 200 cc implants and with raising the fold under the right breast, which has slipped down.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

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.