Downsizing twice? (Photo)

Hello, While it is a difficult question to answer without performing a physical examination, substantial downsizing often requires reduction in the size of the internal pocket as well as the skin envelope. It may be helpful to change the implant projection to a lower profile with a wider base width to minimize the need for internal pocket revision. A large implant will often cause skin stretch, and the skin envelope will need to be tightened when downsizing the implant. This is accomplished with a mastopexy. I hope this helps.

Thank you for your inquiry! Removing the implants and tightening the pocket would be an option for you. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Thank you for your question. A photo of your breasts in a bra is not helpful. However, since you've already downsized once, the breast pockets may be stretched and could be too large for the smaller implants you're considering (200-300cc), which might lead to implant malposition (shifting, sliding) or an unnatural appearance. Your surgeon may perform a capsulorrhaphy (pocket tightening) to correct this. This procedure involves suturing part of the pocket to make it smaller. You may need breast lift depending on how much skin laxity and sagging have occurred after further reducing the implant size. Your surgeon will assess the condition of your tissue and pocket size to recommend the best approach for you.

If at one time you 700 cc and are going down to 200 cc then you will need a lift. The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them 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.

Best Wishes,

Gary Horndeski, M.D.

A photo of your breasts in a bra is not helpful. Theoretically, there is nothing wrong with a second reduction. Anything in addition to replacing with smaller implants that may be indicated is based on individual anatomy, which is best determined by physical examination.