I currently have 500cc / 550cc implants and would like to downsize. Which size implant would be ideal for my body type?

Dear sweetpea212,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Judging by your photos, in addition to removing and replacing and going smaller, I would also recommend a lift to achieve a desirable aesthetic outcome. As far as how small to go, I like to review photos with my patients as well discussing in detail what they are trying to achieve, in particular in the upper pole. With going smaller, the result will also be that there is less upper pole. There are ways to counteract that, for example, I remove the lower pole breast tissue during the lift and add the volume that I am removing to the size of the implant to achieve more of an upper pole if the patient desires. Another way to size, if the patient has saline implants, we deflate them in the office (very simple) and then size our patients with Allergan/Sientra sizers.

Hope that helps.