Downsizing my implants

Downsizing your implants is certainly possible. Understanding how the breast will change with the procedure requires discussion and images to help you understand. Depending on how much smaller you go a lift may not be necessary. If maintaining upper pole fullness is important fat grafting to this area can be done at the time of surgery. I recommend seeking consultation from other board-certified plastic surgeons to help you with your decision. All the best.

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.

Hogwash. I spend my days performing revision breast surgery and there is not a single person who can't have smaller breasts that are also pretty. How that is achieved is very patient specific. A woman's breasts with implants can have a variable composition of implant and natural breast tissue volume, e.g. more implant than tissue or vice versa. I think that this surgeon was only thinking implant exchange and not revision lift/reduction, or was thrown off by nipple position and felt that a revision lift reduction could not be performed, which was erroneous.

Downsizing implants as patients age is not uncommon. Without seeing photos is difficult to comment specifically on your case, however a breast list generally has several goals includes changing the position of the nipple, but also re-draping the breast skin and tightening this skin envelop. What is ultimately possible depends on the current implant position, nipple position, and skin laxity/excess that needs to be addressed.
Sean Fisher Aesthetic Plastic Surgeon

Photos would be very helpful. If your current implant is 370 cc's, that is about 2 cups of volume. If it is removed, you should go down 2 cups. An examination is needed to see if a lift can be done safely at the same time. However, if you are a DD, removing 2 cups should take you to a C and you should have enough tissue for the lift. I suggest meeting with another surgeon. If your implants are behind the muscle, you will lose some upper breast fullness by removing the implant.

Maybe looking at other women who have breast ptosis who are your age and didn’t have implants would give you an idea of what breast look like without implants.
Breast implants due to things.
They drastically changed the shape of the breast and they make the breast look bigger.
More than anything else implants create projection.
Implants don’t actually make breasts larger.
What implants do is push to pectoralis muscle forward, making the breast look larger.
Because the majority of your breast projection comes from your implants, removing the implants will remove most of the volume and the upper half of your breast.
The breast lift does not do a very good job at restoring volume in the upper half of the breast.
A breast lift puts the nipple in a higher position, but doesn’t do very much for the upper half of the breast.
if you want projection, you need to keep implants.
It may be possible to swap for a smaller implant and do a reduction of your breast tissue if you want to be smaller and still maintain a good breast shape.
Without pictures or context, we can’t really begin to make an assessment or give you quality recommendations.
Consider consulting with a few other plastic surgeons to see what they have to say.
From what you describe what your surgeon said seems quite consistent and accurate.
That doesn’t mean there aren’t surgical options that May be advantageous.
Without pictures, we can’t really know.
It is important to have a clear understanding of what each breast surgical procedure can and cannot accomplish.
It’s definitely possible to have a breast reduction and maintain implants, which may be an option for you.
Best,
Mats Hagstrom MD