Should I Downsize or Have my Implants Taken out Completely? (photo)

I had a lift w/ implants 10ms ago w/ 240cc. If you look at my full profile you will see Ive been unhappy with the size from the start. Ive given it time and I am ready to really start thinking about doing a revision surgery. I started w/ a B cup I thought I would loose so much volume with the lift that i needed the 240cc to get me to a big B/small C. But now I am a full D! Theyre too big, cant adjust, less active, dont feel good in clothes, the list goes on. is there a better implant size for me

Doctor Answers 18

Should I Downsize or Have my Implants Taken out Completely?

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I looked at some of the other postings of yours, and it looks like all the reviewing surgeons, including me, think that this is a nice result.

It looks like on your pre-op photos you were about an A cup, and 240 cc implants should give about a 1 to 1.5 cup increase in size. There are no fixed defintions of cup size, and I have numerous patients who have B, C, and C cup bras at home that all fit. 

If you feel the implants are too large, then they are too large for you, irrespective of the the bra label. 

Since your implants are silicone, the excellent suggestions of deflating them cannot be done. Downsizing implants is the toughest decision to try to quantify. New patients can try on implants for size, and patients interested in up-sizing can do a "rice test" to get an idea of how much larger an implant will work. 

It is unlikely that you would see much change with less than a 50 cc reduction in implant size. If you compare your preop photo with now, and try to guess if, say, half way in between seems ok, using a small 120 cc implant would be a good choice. Removing the implants entirely might wind up with still another operation to redo the lift if your skin doesn't shrink down enough.

Thanks for your question, best wishes.

Seattle Plastic Surgeon

Nice result

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You have a nice result. The size difference between what you are now and what you want to be is quite subtle and there is a law of diminishing returns with multiple implant surgeries. If you feel that you really MUST go smaller then it can almost certainly be done using a lower profile implant and (probably) a revision nipple lift. But remember - the enemy of good is better. You don't want to turn an already good result into a poor one.
Good luck

240 cc Implants Too Large?

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   The average implant placed in the US is 350 cc.  So 240 cc is a small implant to begin with.  An implant much smaller than the one you have will produce little difference in volume and removing the implants may be the right thing for you.

Unhappy with breast lift and implant

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I do not consider your breasts to be too big, but they are not mine.  They are yours.  You have to live with them.  One note of caution; don't fixate on the A,B,C,D, etc.  Those measurements are all relative.  If you are unhappy looking in the mirror, or exercising, or in your clothes, then go with a smaller implant, or no implant at all.  Good luck.

Talmage Raine MD FACS

Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon

Breast lift

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I actually think you have a pretty nice result, but if you want to be made smaller, it is always possible.  If you are undecided as to whether to go without implants at all or just downsize, I have a suggestion, but it only works with saline implants. The implants can be deflated with a needle, so you will know what size you would be with the implants removed.  If you feel you are too small after the deflation, you know you need a small implant.  This only works with saline obviously and you should only do it if you are sure you want those implants removed.  Hope this helps.  Merry X mas!

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Breast implant removal and a lift may be in order

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This is my guess about your case:

You were pretty okay with your breast size but had some sagging.  You did not want the scars of a full breast lift and opted for an implant to take up some of the sag and a periareolar lift to reposition the nipple.  This got you to perky without additional scars but now you feel too busty for your frame and the things you like to do. 

I, along with several of my patients, have learned this the hard way:  Fear not the vertical scar of a vertical breast lift.  A vertical lift can make the shape of a breast so much better and even make the breast seem a little bit bigger, all without a breast implant.  I have had several patients over the years who feared the vertical scar and opted for the operation you had only to regret it (and I also regretted it).  They then went for implant removal and a full lift and that got them to where they wanted to be in the first place but only after wasting time and money on an operation that was not their best choice. 

I could write a book about this very topic.  Maybe I should!

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

Removal of a small implant after mastopexy with augmentation might require adjustment of the breast lift.

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The breast pictured shows an attractive breast after a conservative augmentation and donut mastopexy.  Removal of the volume will probably require a revision of the mastopexy.

Breast Revision

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I've read your post and the posts of the other doctors. I've have these thoughts:

1. When someone like yourself gets such an unexpected increase in cup size from a relatively small implant, there is more going on than just size that is upsetting to the patient.

2. The ideal breast for you is smaller than yours, possibly smaller than yours without implants.  The ideal breast is also flatter than yours, with less fullness and hanging tissue on the sides.  The ideal breast has smaller areola than yours.

3. Your breasts are by no means objectively large in appearance, but you do have some lateral projection beyond the sides of your chest and fullness below that hangs slightly, contributing to an appearance of fullness in the breast which is perhaps excessive in your estimation.

4. Objectively, you have what most surgeons and patients would consider a nice, natural result despite moderately thickened periareolar scaring.

5. Changing implants to a smaller and flatter implant with a capsular tightening could decrease both projection and lateral fullness, but do little for or worsen breast mound shape. If you additionally convert your circumareolar lift to a move formal lift, you will improve mound shape,  sagging, and reduce areolar size.  A formal lift will also give you the best chance of having your scars look as fine as possible due to reduced periareolar forces.

6. Conversely, you could also remove your implants entirely and replace lost volume (if needed) with your own fat.  Breast shape would certainly be less projecting, but it would not address the other issues like areolar scarring, areolar size, and sagging.

Finally, your case is not an easy one.  No one here can give you the right answer, if there is one. You should have this conversation with your surgeon and/or get a few opinions before you proceed with anything.

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

Should I Downsize or Have my Implants Taken out Completely?

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I recommend complete removal and replace via fat grafting obtain from liposuction. See recent article from Dr Del Vecchio. You are a great candidate for this type of operation. 

Breast lifts, breast implants, revisions

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I agree with the some of the other responses that you have a perfectly normal and good looking result from an augmentation/mastopexy with a properly sized and positioned implant. Also, that it is a personal choice issue within what is feasible reasonable. It seems that the problem is in a misconception of what implants and lifts do and don't do. It is just not possible to have exactly the size/shape we might like to have. 

Implants do not lift the breast and removing them does not make them sag. This is an appearance or an illusion. Breast lifts do not tighten the skin or tissues and do not provide central projection or upper pole fill.

At this point, the only realistic choice short of leaving things as is or removing the implants entirely, is to exchange the implants for ones of the same width but a lesser forward profile. If your existing implants are a middle profile, then you could change them to a lowest profile of the same width and drop about a half cup size but still fill out the breast properly. I would not recommend narrowing the width of the implants much at all or they will not predictably fit the existing capsule space. 

As regards your expectations of size before the lift with implants, a lift does not significantly reduce the size (volume) of the breast, but the breast looks bigger (not actually get bigger) if it has been positioned higher. The minimum size increase with a properly sized round implant (lowest profile) is one cup size. The combination of these two is what makes it hard to judge the size result after a lift plus an augmentation. 

Scott L. Replogle, MD
Boulder 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.