Downsize 350/325cc HP breast implants (34D) to small C for petite 31 yo Asian female 5'2" 115 lbs (very self-conscious) (Photos)

Yes, I would recommend downsizing at least 150cc.  The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

It is hard to be specific without an actual consultation and examination as others have noted. General recommendations for you if you want to be a full cup size smaller would be to decrease your implant size by at least 100 cc and tighten your pockets laterally and possibly inferiorly with a capsulorrhaphy to ensure your implants stay in the proper position rather than slide to the side again.  I don't think any type of lift would be necessary.  I hope this information helps.Thomas Taylor, MD, FACS

Dear downsizejanice,
if you aren't satisfied with the results of your previous breast augmentation then you might be a candidate for revision surgery. You wanted to know what implant size would provide you with the wanted breast size.
Determining the ideal breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient. 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.
You would need a smaller implants but your implant pockets would also need to be reduced. 
Anyway,if you are considering a revision surgery I would recommend you to visit a board certified plastic surgeon for a on-person examination and consultation.

Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery 
Member, Am. Society of Plastic Surgery

Thank you for this complex question.  Decreasing one cup size on someone with a 34D bandwidth equals approximately 200 ccs.  However, this is a very simplistic way of looking at a more complex problem.Questions that need to be answered:  how many children have you had, do you smoke, do you have medical problems of any kind.  It would be helpful to see pre-operative pictures of your breasts 1.5 years ago.  Your external scar makes me wonder if you have some degree of capsular contracture, although external and internal scarring does not always correlate.  Was your breast augmentation a moderate or high profile implant.  These and more questions need to be answered before any of your RealSelf online team of plastic surgery experts can answer your very challenging questions.Since 350 cc implants are not very large, it is possible that the side boob that concerns you may have pre existed to some extent, and therefore reducing the implant may not bring the breast tissue in from the sides.  This, of course, can be determined only with an in person examination plus the above questions answered.  If you were my patient, and if certain of my assumptions are correct, then you may need an internal capsulopexy, both inferior and lateral, to decrease the breast implant pocket.  This can best be handled through a periareolar incision (around the areola).  I would highly recommend you consider discussing this with your previous plastic surgeon which would certainly be a good starting point to help you in your decision process.  

Unfortunately, it's unpredictable whether you would need a lift after implant exchange.  If you decrease your implant side about a cup and closed the lateral pocket, the skin may contract and you would not need a lift. On the other hand, it is possible that there would be excess skin and a lift would be needed.  Based on the condition of your at an examination your surgeon should be able to give you more specific advice.

Thank you for reaching out. As much as we would all like to give exact numbers and resolutions through RealSelf, a lot of times it is best determined with an in person consultation. I would set up a few with local experienced board certified surgeons to learn about all options and what will get you the results you will be happy with and love long term. Best of luck! Dr. Kim

Thank you for reaching out and sharing photos. I would suggest you visit a few experienced board certified surgeons for in person consultations. They will be able to measure you and suggest a size that will better suit your body frame, it is really difficult to suggest an amount of cc's base on a picture. Best of luck! Dr. Kachenmeister

You will get the best answer to your question by scheduling an in person consultation with a plastic surgeon certified by the American Board of Plastic Surgery and discuss your unique situation and concerns. The surgeon would meet with you and examine you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the operative procedure(s) in person and what to realistically expect. Then you can make an informed decision on size and shape, lift or no lift with exchange of implants. Your surgeon should be able to explain to you why they are recommending the size they are according to your current breast measurements including your chest width and your desired outcome.


We have all our Breast Augmentation patients not only utilize our 3D imaging so they can get a real visual on what the implants will look like on them but also to actually try on the different size implants with a tight bra and t-shirt to see what they might expect. That way they have a good visual of what a 450cc implant will do as opposed to a 350cc implant for example. You want to make sure that you see a surgeon that will listen to you and your goals for the procedure and discuss in detail their recommendation for size and shape not only taking into consideration your desired outcome but also your breast measurements before the procedure including your chest dimensions. And then let you try the implants that they feel will give you the desired result so you are in agreement with the size.

I am sorry to hear about your concerns after breast augmentation surgery.  Yes, you should be able to undergo downsizing of breast implants.  Keep in mind as you are thinking about your goals that sometimes adjustment of the breast implant pockets (capsule adjustments) may be necessary to achieve the outcome you are looking for.   Breast lifting is not necessary.
Generally speaking, the best online advice I can give to ladies who are considering revisionary (downsizing) breast augmentation surgery is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "down a cup size” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. 
3. Once you feel you have communicated your goals clearly, allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.
I hope this, and the attached link (dedicated to revisionary,  specifically downsizing, breast augmentation surgery concerns), helps. Best wishes.

I would not change out your implants as your breasts look great; the reason is that you are a hypertrophic scarrer and you will be risking more scarring; if you go smaller then you would need a lift and I would avoid this based on the scar you are showing.