Implant reduction? Lift or both? (photos)

I'm post BA (6/6/16) with 315cc teardrops and feel they're too big. I'm 5'8" and 117lbs and have always been thin and small breasted. I've been in contact with my doctor twice since and I have options. The doctor is now thinking a 234 moderate plus with a lift. My understanding for the switch in implant types is the width of it, 6mm less than current implant. I also understand there are more scars What comparison factor should I consider? What difference with the type of implants have?

Doctor Answers 6

#BreastImplantRevision - Implant reduction? Lift or both?

It's a good question, and there is not an absolute answer.  But I'd start with another option: don't do anything (for now).  While you ultimately have to be comfortable with your surgery, your overall result is very nice.  Many women would be happy to have this result, including some who have gone through multiple surgeries.  So I'd suggest waiting at least 6 months following your surgery to make sure you're unhappy enough to warrant another procedure.  Because it looks like if you're going to do anything you'll go with smaller implants (compare the two sizes - what you have now and what you'd have - to make sure that's enough of a difference for you), switching to a moderate plus (which is normally my preferred implant as I like their height to width proportions) and then maybe a lift.  Is it worth it for you to have scars (plus the attendant risks of a lift)?  It is also reasonable to consider whether or not you've had children and/or breastfed, if either of those is of interest to you.  If not, and you are planning to, then that could tip the scales toward waiting until you're done.  Each case is different, though, and that's why your discussing this with your own plastic surgeon is the appropriate thing to do.  You can also consider one or more additional opinions before you undergo more surgery.  I hope that this helps and good luck, Dr. Alan Engler, Member of #RealSelf500

New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Tradeoffs need to be figured in

Thanks for your question and the photos. You are not even 3 months out and so I personally would wait until you are a minimum of 6 months from the time of surgery. I usually like patients to be a full year out to allow everything to mature, settle, etc. The two issues are size and nipple position. A 25% reduction that has been suggested along with a profile change will result in a smaller breast that will also be a little softer. Given your height I don't feel like you have too much volume and you look very proportionate, but this is a very personal preference issue. The scars associated with the lift likely will be in a lollipop pattern. This will position the nipple up higher on the implant. Bottom line is that you have to weigh the advantages/disadvantages. If you want the most perfect breast while naked, looking in the mirror, etc. then the combination of implant exchange and mastopexy is best. I'm not sure that I would be that persuasive to suggest that, particularly at only 3 months out. Best of Luck!

M. Scott Haydon, MD
Austin Plastic Surgeon
4.8 out of 5 stars 90 reviews

Lift will help

Thanks for the great question and the photos. In my opinion, you would definitely benefit from a lift to reposition your nipple in a more aesthetically pleasing location. Right now your breast tissue is falling over the top of your implant. I typically use moderate projection implants for my augmentations with lifts. This is because there are contradictory forces you need to keep balanced. The implant is pushing out on the skin and the pressure from the lift is pushing back on the implant. The implant needs to be the correct size so as to not push out on the skin and worsen the scarring. There are more scars involved with a lift, but the tradeoff is that you'll have a great shape to your breast, especially with the implant underneath. Best of luck with everything!~Dr. Sieber

David A. Sieber, MD
Bay Area General Surgeon
5.0 out of 5 stars 34 reviews

Decreasing Breast Implant Size

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.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Implant reduction? Lift or both?

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.   Whether or not the adjustment of the breast implant capsules will be necessary will mainly be dependent on your physical examination; specifically, factors such as the amount of redundant skin and quality of skin elasticity will be important.  Based on the positioning of your nipple/aerial complexes  currently, and her plan to downsize breast implants, some type of restaurant and will likely be helpful. Exactly what type of breast lift would be beneficial will depend on exactly how  small of breast implants are utilized and physical examination characteristics such as skin elasticity…  In other words, careful physical examination and intraoperative planning will be 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.  For example, I have found that the use of words such as “natural” or "down a cup size” or "C or D cup" 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 breast surgery, specifically downsizing breast augmentation surgery concerns), helps. Best wishes.  

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Lift with replacement

The low profile implant replacement will possibly ripple and the scars of the lifts are unpredictable. Please consult with revision expert in your area 

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 42 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.