Unhappy with 305cc breast implants and want to remove / downsize to smaller implants. Will I be left with sagging? (Photo)

Thank you for the question. In the end, exactly what operation you should undergo and what type/size/profile of breast implant should be utilized will depend mainly on what you are trying to achieve (in other words, what your goals are).  In other words, there are no "general recommendations": every patient's  situation is unique and care needs to be individualized.


 Downsizing of breast implant surgery (sometimes) adjustment of the breast implant pockets (capsule adjustments) may be necessary to achieve the outcome you are looking for. Breast lifting may or may not necessary.  Much will be dependent on your physical examination;  specifically, factors such as the amount of redundant skin, quality of skin elasticity will be important,  and how much you wish to downsize.


Generally speaking, the best online advice I can give to ladies who are considering revisionary (downsizing) breast augmentation surgery is:


1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.


2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural look” or "down a cup size” or "C or D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. 


3. Once you feel you have communicated your goals clearly, allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.
I hope this helps. Best wishes.

Based on the photo, you may not need a breast lift even after downsizing. The internal pockets may be readjusted to fit the smaller implants and should still give you great results after recovery. Your best resource of information would be your board certified plastic surgeon as he/she knows your condition best.