What can I do to improve shape and decrease size from 36DD to 36C in order to get an overall better aesthetic outcome? (photos)

Question

The size of my current (2006) implants are 500 cc Mentor Mod Plus. They are just too large and heavy and cause back, neck and shoulder pain as I age. I am now 58 years old and would like smaller, perky breasts. What type of breast lift might be needed and size implant in order to downsize from 36 DD to a C cup? What type of silicone gel implant would you recommend? Can I expect to get an improvement in my creases and overall breast aesthetics?

Gary M. Horndeski, MD · Answer

At
size 36, each 200 cc of implant corresponds to 1 cup size change.  Removing 500 cc implants will solve your size
problem and I recommend explantation using 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 and the ability to breast
feed are maintained, if not injured during your previous surgery.  Best Wishes,Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Lori1446,Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gerald Minniti, MD, FACS · Answer

Hello,There is no correlation between implant volume and bra cup sizes, so no one can tell you what implant you'll need to get to a C cup without being a total guess. Instead focus on change in size of implant in terms of percentage reduction.  20% being small, 50% being a large reduction. You may not need a revision lift, but a full examination is necessary to confirm that. Go visit a few ABPS certified/ASAPS member surgeons who specialize in revision breast surgery. Best of luck!

Connie Hiers, MD, FACS · Answer

The implants you have are large and heavy implants. You might consider going down to 250-300 cc's. You will need an internal lift and may need some skin tightening as well. I would suggest meeting with a board certified plastic surgeon and discussing all your concerns and options.

Robert E. Zaworski, MD (retired) · Answer

Based on your photos, you make excellent scars.  I would have a breast lift with implant replacement.  Depending on the size of the breast pocket, strattice may be needed for reinforcement when replacing with a smaller implant.  This should give you a very nice result.

What can I do to improve shape and decrease size from 36DD to 36C in order to get an overall better aesthetic outcome? (photos)

Answers (5)

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