Saline implants are quite problematic and don't give the best results, IMHO the modern choesive gel silicone filled implants are neatly superior.
My opinion about your situation:
-downwards displacement of implants (bottom out) due to poor adherence features of your implants (may them be smooth or microtextured?)
-as consequence of the former too long distance nipple-submammary fold
-too round shape (they were surely round, since they are saline filled)
You need an amazing though extremelly difficult procedure, consisting of:
-lower pole capsulorraphy to reattach skin to ribcage and build a new submammary fold at the proper distance from the nipple
-anatomical profile implants
-implants of high adherence to prevente the recurrence of the dislocation, macrotextured if possible and ideally polyurethane coated implants (if available), since the polyurethane shell offers the highest adherence and an unique velcro effect in the whole market
Seek a good surgeon profficient in capsulorraphies.
I don't think you need a lift. You have bottoming out. You do not have breast ptosis. Tightening the pocket to match the smaller implant will suffice. Alternatively, you can undergo deflation of your implants by needle aspiration. This will allow your skin to retract. You can then just undergo exchange of implants. Lift incisions should be avoided when possible.
Ary Krau MD FACAS
Breast Revision to Include Smaller Implants
It is certainly feasible to #downsize to smaller implants and also alter the positioning; if possible. However, decreasing is size may also require a Breast #Lift to to #tighten loose skin, better optimize the end result. Any #revision has risks of unhappy outcome or other complications. Also, the right implant for the revision is contingent on shape of body and your desired outcome.
I have 500 high profile saline implants & would like to downsize to 300cc moderate profile silicone. Would I need a lift?
Thank you for the question and pictures. No, I do not think that breast lifting will be necessary. Downsizing of the breast implants along with adjustment of the breast implant pockets (capsulorraphy, refers to internal suture “repair” of the breast implant pockets), will likely achieve your goals nicely. Make sure that your selected plastic surgeon has significant/demonstrable experience with revisionary breast surgery. You may find the attached link helpful to you as you learn more. Best wishes.
Without a doubt you will NOT need a lift. Your current implants are low in your breast tissue envelope and your nipples are very high, well above your inframammary fold. After removing your current implants, repairing the internal capsule so that a smaller and lighter implant sits in a higher position on your chest wall, your breast tissue envelope will conform very nicely and with a very similar breast shape, only improved!
Best of luck!
Is Lift Necessary After Placing Smaller Implants
You don't need a lift as there is no true droop. Your implants are positioned much too low and that requires a procedure known as a Capsulorrhaphy to reduce the pocket space and hold the implants in a higher position.
Thank you for the photos and your quesstion and based on them without an examination it does not look like you would need a lift. An implant exchange and pocket revision may be all that you would need but that is said without an examination.
It does appear that the breasts have bottomed out. I think if you downsize your implants, a lift could be done at the same time. The skin on the lower portion of the breasts has stretched out too much and a lift would tighten that skin and give your breasts substantial improvement. I would deflate the implants ahead of time to allow your stretched skin to recover prior to your nxt procedure.
Very likely would need a lift as well
From your photos it appears as if you have had some bottoming out of your implants (pseudoptosis) Whether you need a lift would really depend on the size reduction you are looking for. I would think you may also need additional tissue support to keep the implants from bottoming out again. It appears as if you are thin and the weight of the implant has stretched your skin/breast. If you were going to go down a small amount you may not need a lift, more-so support, if you were going to drop a moderate or larger amount you may also require a lift. I hope this helps. Best of luck, regards, Dr. Joseph Eby.
Great move in the right direction
Your problems are very very typical of patients who chose to go with extreme sizes. Bigger the implants the bigger the problems. All patients insisting on extreme sizes should see your photos. Anyway you are on the right course. If you simply go directly to 300 cc implants you would likely be best off by doing an uplift at the same time. Otherwise the bottoming out will persist and you will not be pleased. You could leave the implants out for 3 months and start over and possibly avoid an uplift. You will be happy with smaller implants. My Best, Dr C