Would I be a good candidate for a donut lift? downsizing from 525cc to 400cc

Based on your pictures, if you were to exchange a 525cc implant with a 400cc implant; I do not believe that you would need a donut lift.
To determine if a patient really needs a lift procedure, we compare the position of your nipple areola complex to the inferior mammary fold, which is the crease below your breast along your chest wall. If your nipple is above that crease, then you do not need a lift. In the side profile pictures, your nipple is well above that crease.
If your current concern regarding your nipple position is that your nipple appears lower in your breast; then this might actually be corrected by a smaller implant. A smaller implant will have less cleavage, thus your breast itself will not look as long and your nipple may be in the middle of the implant, which is ideal.

Thanks for your question. The donut lift has the advantage of a scar that might be less apparent, since it is hidden around the border of the areola, However, unless a permanent suture is used around the border of the areolae, they can enlarge over time. These permanent sutures can occasionally lead to problems. Also, the donut lift typically does not result in as much skin removal as other types of breast lift operations, so the degree of tightening and nipple lifting might not be as great. These comments are just generalizations, because a proper assessment is required to determine your skin tone, sternal notch-to-nipple distance, etc, then discuss your expectations. This will help them advise you on the most appropriate type of mastopexy procedure.

It’s completely understandable to want to downsize your implants—especially if you're feeling top-heavy despite being fit and active. Reducing from 525cc to 400cc is a noticeable change, and whether a lift is needed will depend on your current breast tissue, skin elasticity, and overall shape.
A periareolar mastopexy (a lift performed around the edge of the areola) is often preferred by patients who wish to minimize visible scarring. This technique can be effective in cases of mild ptosis, particularly when only a subtle repositioning of the nipple-areola complex is needed.
However, it’s important to note that periareolar lifts have limited lifting capacity. If your skin has stretched over time due to the size and weight of your implants, or if there’s moderate sagging, a more comprehensive lift technique may be required to achieve a naturally youthful shape after downsizing.
Your desire to avoid additional scarring is valid, and many surgeons will first assess whether a periareolar approach can provide sufficient improvement while respecting your aesthetic priorities.
I hope this gives you a clearer idea of what to expect. A consultation with a board-certified plastic surgeon experienced in implant revision and lift techniques will be the best next step to tailor the plan to your goals.
— Güray Yeşiladalı, MD

Thank you for your question. Significant size increases, from 325cc to 525cc, will have stretched your skin. Downsizing to 400cc is reasonable, but whether it will cause sagging and need a lift depends on two key factors: nipple position relative to your inframammary fold and tissue laxity and implant footprint. If your nipples are at or above the fold and your skin has maintained decent elasticity, you may not need a lift. If your nipples sit below the fold, a donut lift likely won’t be sufficient. In that case, a more extensive lift (vertical or anchor) may be required to restore a youthful breast shape. It's best to have an in-person consultation with a board-certified plastic surgeon who can assess nipple position, skin tone, and breast volume in detail.

According to your pictures, I can say that your request is achievable. If you’re skin quality is good, seem like the donut lift will do the job. But please don’t forget that for exact decision we should examine you in person. Better be prepared for a slight change of vertical scar.

Thanks for your question and pictures. Based on your photos, you may not require any type of lift when decreasing implant size by 125 cc. Going down in size may actually fit your chest better and be more centered on your nipples. Make sure you meet with a board certified plastic surgeon for an in person exam.

Thanks for your question! I'm not the biggest fan of a donut lift because it can distort the areola. Your breasts aren't droopy now, so my advice would be to replace the implant and take a wait and see approach with the lift. You may not need one if you are okay with your nipples being a little bit lower on the breast mound. Good luck!

The breasts you currently have look pretty good - very close to perfect. No scars visible. The downside of a circumareolar lift is the high tension involved that can cause widening of the scar and areola. The results may be much less appealing than your current situation. Frequent changes in size with regard to breast implants increases the scar burden in your breasts, and elevates the possibility of wound issues, capsular contracture, and suboptimal result. Best wishes in your health journey.

Hello,

And thank you for the question.

Based your pictures, when downsizing your breast implants, you may require a donut mastopexy. This will allow to put your nipples into the correct position and allow excess skin to be taken away, giving you a firmer and more lifted breast appearance.

Some people are a little apprehensive about the scars, but the scars typically fade well over time.

I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast surgeries to further discuss your options, specific techniques, concerns and expectations. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.

I hope this helps.
Good luck!

Dr. Irena Karanetz
Breast Fellowship-Trained
Board Certified Plastic Surgeon

You absolutely look to be a great candidate for a “donut lift” or benelli lift as I call it, where the incision is only around the areola. Decreasing your implant size by 125cc will leave you needing minimal benelli lift so it would be a quick procedure with less pain and recovery time as your enlargement augmentations. We would love to see you here at Smith Plastic Surgery to hep you reach your aesthetic goals.