Should I change my 9-year-old silicone implants, get smaller implants or stay with the same size; anchor or lollipop? (Photos)

40 years, 5'6,145lbs. Augmentation with 450 silicone 9 years ago. Had twins and weight fluctuations now I want a lift. After my first surgery I was a bra size 34D, now I'm 34DDD I like to go back to 34D. Seen 3 surgeons, 2 told me to change my implants to smaller ones and have an anchor incision, 1 told me I don't need to change my implants and with a lollipop lift and some reduction of the extra skin I can go back to 34D. He said must women want bigger implants not smaller.

Doctor Answers 3

Should I change my 9-year-old silicone implants, get smaller implants or stay with the same size; anchor or lollipop?

Thank you for the question and pictures. Although breast implant size selection questions seems to be one of the most  frequently asked questions on this forum, I think that other concerns, such as careful selection of plastic surgeon and accurate diagnosis and treatment recommendations, are even more important when it comes to successful breast surgery. 


 Although definitive advice would require in-person evaluation, I think that it is likely that you will benefit from revision breast lifting surgery. Since your breast implants are 9 years old, I would recommend exchanging them.


 

Generally speaking, patients undergoing this combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with will a significantly higher risk of complications and need for additional surgery.  Again, it will be important that you educate yourself regarding the pros/cons/risks/complications associated with breast augmentation/lifting surgery.  


Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting surgery ( regarding breast implant size/profile selection) 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. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or 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 "D or DD 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. The use of computer imaging may be very helpful during this communication phase.


3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.

I hope this, and the attached link, helps. Best wishes.


San Diego Plastic Surgeon
5.0 out of 5 stars 1,460 reviews

Should I change my 9-year-old silicone implants, get smaller implants or stay with the same size; anchor or lollipop?

Thank you for your question.  Based on the last photo my guess is she will need an anchor lift to get the elevation that you want.  The choice of breast implant size should be made based on the base width of your breast.  Careful discussion with your surgeon will be necessary to choose the proper size.  My suspicion is that if you are a triple D now and you want to be a D thensmaller implants in the 300-350 cc range may be necessary.

Breast Implant Exchange & Lift

An anchor lift does appear to be necessary given the amount of breast sag I can see in your photos. In terms of replacing the implant, it depends on how much excess breast tissue can be removed and the integrity of your current implants. In some cases such as yours, the decision could be made during surgery. 

Joseph Thomas Cruise, MD
Newport Beach Plastic Surgeon
4.7 out of 5 stars 89 reviews

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.