Lift After Downsizing?

When downsizing (switching implants for smaller) does the surgeon do work to muscle (if the current implants are under the muscle) to make it adjust to the new implants? Also if a lift is required, can that be done a couple of months after you change out implants? I am young and curious to see if my breasts bounce back with a smaller implant, however my surgeon suggested that I need a lift.... Would it be more expensive to spread out the surgeries?

Doctor Answers 9

Breast lifting after downsizing may not be needed

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In 2002  at the height of the Silicon scare, I removed hundreds of implants and replaced  quite a few with smaller saline implants. I was amazed at the breast's ability to bounce back after you reduce the weight load! If will probably cost a bit more if you eventually do need or want a lift but it may well be worth it. Obviously, if you had posted photos more concrete answers would be possible from all the surgeons.

Naples Plastic Surgeon

Lift After Downsizing?

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Without photos, and an idea of how much of a size change is anticipated, it is hard to give specific advice. 

Each case is different. Often the pocket will be made narrower if there is a large size change. 

Unless a patient already needs a lift with the current size implants, I prefer to wait 4-6 months to see how much recovery there will be. It may cost a bit more to do the procedures separately if the lift winds up being needed at all. But that must be balanced with the fact that fewer patients will need a lift, and that the complication risk is lower when the procedures are separate. Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Lifts after downsizing is not mandatory

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and if you have saline implants, the easiest way to find out is to intentionally deflate your implants and allow your breast to shrink to its natural state.  But if you have gels are unsure, you can always defer the lift to another time.

Lift After Downsizing?

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   The breast lift and the revision augmentation can be separated in time.  This is not unreasonable, particularly if you have a borderline anatomy with regard to needing a lift.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast implant revisions and breast lifts 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

Implant removal and a lift

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Staging the two procedures is reasonable but probably more expensive since you will have to pay for two facility fees and perhaps two surgical fees.

Breast Enlargement, Board Certified, Fat Transfer Breast, Nipntuck Breast Enlargement, Silicone Gel implants, Saline Implants

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The perfect course in my opinion is to replace or remove your implants, allow healing to take place for 6 months and then and only then decide for yourself if you want more surgery.  Implant removal or downsizing will lead to changes in your breast shape as you suspect.  Only time will tell whether you will choose a breast lift.  It is rare in my practice for patients to choose a breast lift after implant change or removal.

Ralph W. Bashioum, MD
Minneapolis Plastic Surgeon


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It depends on your current implant size and profile, and desired size. In general a lift will be required in addition to a pocket revision. Be careful not to end up with an implant too narrow. You need to pick an implant based on dimensions not volume.

LIft after breast implant downsizing

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It depends on how much smaller the implants will be that will determine a lift or not.  As far as the muscle is concerned the surgeon may use the same pocket and tighten it or place the smaller implant in a new smaller pocket.  These maneuvers will not lift the breast though and skin excision would be needed for that.  There is no problem in staging the treatment but generally will cost more for two facility and anesthesia charges.  Donald R. Nunn MD  Atlanta Plastic Surgeon


Concerns about Downsizing of Breast Implants? Breast lifting?

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You ask very good questions (the answers for)  most patients who are undergoing “downsizing” of breast implants may benefit from  reading.

1. Sometimes, depending on the specific patient's situation and factors such as the current position of the breast implant pockets and the “amount” of downsizing that is planned, it is necessary to work on the breast implant pocket. For example, decreasing the breast implant pocket space using internal sutures (capsulorrhaphy) may be necessary;  doing so will help keep the smaller breasts implants in good position.

2.  Every patient who undergoes downsizing or  explantation wonders what her breasts will look like after removal of the breast implants. Generally speaking what breasts look like after explantation  depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back),  the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation).

Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will  potentially influence the factors discussed above. If you take these factors into consideration and apply them  to your specific circumstances you may get a good idea of what to expect after the implants are removed.

3. Depending on many factors ( some listed above), sometimes breast lifting is indicated after removal of breast implants. Some patients do benefit from a staged approach;  the breast implants are removed initially and several months are allowed to pass to allow the skin and tissues to “bounce back” as much as possible. Then, if desired, breast lift and can be performed during the second stage.  Again, generally speaking,  that two-stage procedure is usually more costly given the additional expenses of surgery center facility ( twice) is an anesthesiology fees (twice).  However, there are also patients who benefit from a two-stage procedure when it comes to concerns such as blood flow, wound healing, and overall complication rates

 I hope this ( and the attached link) helps.  For (possible) more  specific advice, consider posting pictures as well.

 Best wishes.


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.