I currently have 600cc silicone implants and I'm wanting to downsize to 475-500cc. Any suggestions? (photos)

You can easily downsize and will not need a lift.  Your breasts will look beautiful with a smaller implant.  I would split the difference and go with something in the 500cc range.

From your photos, it should not be a problem to downsize your implants.  This is a procedure that can often be done under local anesthesia as it is not difficult.

Yes it is possible to go to smaller size implant without making without external incisions in many cases.  It of course requires and exam, review or records and discussion of your goals.  There are other ways to support breast tissue that are minimally invasive as well like the REFINE system.

I am sorry to hear about your dissatisfaction after breast surgery. Your question is a very good one; however, whether or not removal/replacement alone will achieve your goals is hard to know without physical examination and a complete communication of your goals. Sometimes, additional work such as “capsule work” (capsulorraphy) is necessary to improve the outcome of surgery when patients undergo downsizing of breast implants. Please make sure that your plastic surgeon has a significant/demonstrable experience with revisionary breast surgery. Make sure that you communicate your goals carefully as well. Working together, you will come up with the best plan to achieve your goals. You may find the attached link, dedicated to revisionary breast surgery concerns, helpful to you as you consider options. Best wishes.

Thanks for your question about breast implant revision.Your photos are very helpful and do demonstrate a nice overall shape, but it does appear that your implants may be a bit large and relatively wide for your frame.  However, I think you have a very nice result and if you are not significantly bothered by being slightly large it is perfectly fine to stay where you are and delay another surgery in a short time frame. For what its worth, I think many men and women would think you have a very beautiful breast shape.  If your are very bothered by the size and weight of the implants then I think it is possible to modestly decrease the size of your breast implants and change the width of your breast base width with exchange of implants and slight modification of your breast pocket.  It seems as though this is possible without a lift, but a detailed in person consultation to review your goals and take detailed measurements and assessment of your breast tissue is very important.  I recommend that you visit with a board certified plastic surgeon with additional ASAPS credentials to ensure you are receiving the highest level of advice.Best Wishes