Breast reduction after breast augmentation surgery, is it possible?

Question

I got my breast augmentation surgery in August 2015, I went from a B to a DD. They are now too heavy and I don't feel comfortable. I want to go down to a small to full C. Is it possible or will my breast look weird with extra skin?

Jose Perez-Gurri, MD, FACS · Answer

Hi. the procedure that is indicated would be a breast lift (to remove the extra skin) and a change of implants to smaller ones. Without the benefit of a physical exam it is impossible to give a better assessment.Always seek out the opinion of a surgeon certified by the American Board of Plastic Surgery with years of experience in cosmetic breast surgery. Furthermore request to see before and after photos of previous patients by that doctor....not a clinic or surgery center. Do your homework......research and verify the doctor's credentials. Have they had problems with the Board of Medicine, disciplinary or otherwise. Any law suits? 
How about the center, clinic or facility? Are they accredited by a national organization or do they just have State approval. Understand that at the current time, there are three nationally recognized organizations responsible for the highest levels of patient safety, AAAASF, AAACH and JCHO. You owe it to yourself to position yourself for the best possible results but under the most stringent safety regulations, If you have kids, even more so.
How about anesthesia? Will you have a medical doctor certified by the American Board of Anesthesiology or a certified nurse anesthetist (CRNA)? Understand that there is no substitute for research. Cosmetic surgery, no matter how simple it may be to the patients, are invasive procedures and as such carry certain risks and complications.
In our office we use TouchMD which is a web based program in which patients have the ability to load their picture unto the program. I then evaluate them and can actually draw on the picture to show a potential patient where the incisions would be located and how the procedure is to be realized. It's all done to comply with HIPPA which is the federal law that protects the patient's medical information. Look them up.
I wish you well on your journey. Good luck Dr. PG

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided
photographs or told us your bra size.  It
is possible to have your implants reduced or remove your implants with a breast
lift and fat transfers.  I recommend
explantation using The Bellesoma Method. 
This technique 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.  At the same time or later, fat transfers can
be performed if additional volume is desired.Best Wishes,Gary Horndeski, M.D.

Andrew P. Amunategui, MD · Answer

Hi Regi19 and thanks for posting.  Yes, it is possible to reduce size after augmentation. Sometimes smaller implants alone will suffice.   You may, however, need some kind of 'tightening" or lift of the skin, especially if larger implants were used to try to avoid surgical lift/scars.   In person consultation with your local BCPS is crucial in determining what will be best for you.  Please see attached web reference.  Good luck

Thomas Trevisani, MD · Answer

Yes, it's possible, however without posted photos and benefit of physical exam- difficult to tell if you'd need a lift or not.

Dana Towle, MD · Answer

Yes it is possible to go to a smaller size. Depending on your skin and the amount of reduction in your implants it may be necessary to adjust to pockets that the implants are in and or the skin with a lift . A consultation with a board certified Plastic Surgeon will be the best way to get answers as to exactly what will be needed.

John J. O'Brien, MD · Answer

Hello, and thank you for your question. Yes it is quite possible to have a breast reduction procedure following an overly large breast augmentation. In many instances the patient's feel heaviness that they did not appreciate prior to the procedure. You may need to have your implants removed and/or downsized and you may also need to consider a mastopexy and or minor reduction depending upon your circumstances. I would recommend you seek out a qualified board certified plastic surgeon in your area to discuss this with an in person consultation.

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast augmentation surgery.  
 Although definitive advice would require in-person evaluation or (at least) viewing  photographs, some general thoughts may be helpful to you.  Sometimes, during breast augmentation downsizing surgery,  adjustment of the breast implant pockets (capsule adjustments) and/or breast lifting may be necessary to achieve the outcome you are looking for.   Whether or not the adjustment of the breast implant capsules or breast lifting (and what type of breast lifting) will be necessary will mainly be dependent on your physical examination; specifically, factors such as the amount of redundant skin, quality of skin elasticity,  and how much you downsize will be important.   I often make final determinations of the breast implant size/profile and the type of breast lifting ( if necessary) during surgery, after utilizing temporary sizers and a technique called "tailor tacking".
 
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” or "downsize 1 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.

Breast reduction after breast augmentation surgery, is it possible?

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