Downsizing my implants

Dear Lisa8974,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient.
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.


Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Your implant should be able to be reduced and the excess skin is removed only using the incisions below your nipple areola complex. This should result in a nice breast shape without raising your nipple-areola any higher.

Unfortunately, you have not provided photographs. However, at size 36, each 200 cc of implant corresponds to 1 cup size change. To go from a DD to a C would require implant removal, which corresponds to 2 cup sizes. The implants can be removed and the skin envelope can be reduced. This can be done through a circumareola incision or a smile incision on the bottom of the breast. It depends on the type of lift you had before. I would need photographs to give you a more accurate answer.

Best Wishes,

Gary Horndeski, M.D.