38, 125lbs, 5'4, how can I downsize my 500cc implants & avoid excess skin? (Photos)

Question

I would like to downsize my 500 cc high profile implants sometime soon. I would like them to be more perky and a tad smaller. What would that involve? How will the excess skin be treated from going from large to smaller? That is my main concern. How many ccs do you recommend? I'm thinking 375cc HP. I am 38 years old, 125 pounds and 5'4. Thanks in advance for your answers!

Gianfranco Frojo, MD · Answer

This is a complex issue. Sometimes when patients are young and/or have excellent quality skin/tissue...simply downsizing is adequate because the skin and tissues will retract. Regardless, these are all my own opinions based on the photos provided. I would recommend seeing a plastic surgeon who has great training and experience in aesthetic breast surgery.

Jonathan Heistein, MD · Answer

Hi.  I think you will look very nice with smaller implants.  Your breasts may not feel as tight, but I don't think you will have enough loose skin to make it worth getting a breast lift.  Talk to your surgeon about the expectations.  Best of luck!

Gary M. Horndeski, MD · Answer

As you can see in your front view, your breasts are wider than your chest wall. You will need smaller implants. The technique I recommend is explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear kris03,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Douglas Taranow, DO, FACOS · Answer

Your breasts are beautiful now, and should be so after reducing the size of your implants.  Going down 125cc's will be a noticeable difference and the projection will decrease dramatically.  I feel your breasts should still look very nice with the smaller implants.
Best wishes.
Dr. Taranow

Kenneth R. Francis, MD, FACS · Answer

Dear kris03,
Your skin looks like it should have enough elasticity to downsize your breast implants from 500cc to 375cc.  This would be confirmed with an in person examination.  Don't expect to be "perkier" however.  Good luck!

David Plank, MD · Answer

A board-certified plastic surgeon is qualified to address your issues. Board-certified plastic surgeons have spent years of training and have the top level of experience and skill. Seek out a board-certified plastic surgeon for your cosmetic needs.

Connie Hiers, MD, FACS · Answer

Yes, I agree with going smaller since this size is too large and heavy for your frame. In going smaller, the lateral pocket can be tightened internally and minimally invasive skin tightening like Renuvion or Thermitight can be used to help tighten the breast skin. Otherwise, you may need a lift.

Richard P. Rand, MD, FACS (retired) · Answer

Lifts are needed when the nipples are at or below the crease under the breast and when the skin elasticity is poor. Your skin looks good and the nipples are not low enough to need a lift and they won't go lower by downsizing. If you just want a "tad" smaller, go down about 100 as you are thinking. Hard to know what "perky" means but you will lose upper pole fullness downsizing. You might keep some of it by tightening the lateral pockets. Of course, all depends on an in person exam.

38, 125lbs, 5'4, how can I downsize my 500cc implants & avoid excess skin? (Photos)

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