Reducing Implant Size and Lift?

I reduced size after my surgery in dec,580 to 480 i said i'd cope with the larger size to avoid scars from a lift, im 32 and no kids. Had them a month and i am miserable they are still big,i feel that they flop and i suppose a lift would have been needed to give a bit more of a round boost at the bottom.Im 5,3' UK10 I am conscious in all my clothes,i've lost my confidence and rippling seems very bad i never had with smaller implants. Im 6 wks along,im 32 I know will not be happy the next 15 or so years having my breasts this size,I have no children. Its consuming every minute.What issues of going down to 300cc and how soon can it be done?

Doctor Answers 4

Your surgeon will not be annoyed with you

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You need to explain to your plastic surgeon what you are going through and if it is a lift that will make you happy then discuss it with him.  In plastic surgery it is very difficult to know how you would feel with your results until you get them and if the results are good but it is not exactly you want then your should get it revised.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 63 reviews

Reducing breast implant size and lifts

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I agree with Dr. Pousti including the distress you are experiencing. 

Unfortunately there are some misconceptions about breast implants and lifts that even many surgeons play into. 

Breast implants do not "lift" the breast and larger ones do not lift it further or smaller ones (or even removal) create a need for a lift. The so-called lift of implants is an illusion created by filling out the lower pole of the breast and filling in the scallop of the upper pole of the breast. The need (and benefit) of a lift is a separate issue and a separate procedure with different benefits and tradeoffs. It has to do with where the nipple sits in relation to the inframammary crease at the base of the breast and behind it. Lift (mastopexy) procedures, properly done, move the nipple-areola and breast up on the chest. They do not provide forward projection or fill in the upper pole of the breast. 

Downsizing implants is also not something that can just be chosen. Without more complex surgery, the width (diameter) of the implant cannot be reliably reduced, only the forward projection can be reduced from the projection of an implant in place. If you have a high or medium profile implant you can reduce it to the lowest profile implant. As in placing implants the first time, it has to fit and look natural and have a known effect rather than start with the number of cc's and working backwards. Unfortunately it is not easy to advise on this issue if the plastic surgeon doesn't understand these issues. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Anxiety After Revisionary Breast Surgery?

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I'm sorry to hear about the “distress” you are experiencing. Unfortunately, despite good intentions, online consultants will not be able to provide you with precise enough advice. Your plastic surgeon will continue to be your best resource;  I can assure you that most plastic surgeons are used to dealing with similar issues that you describe. In other words, I do not think that you have to be worried about your plastic surgeon being “annoyed”;  taking care of patients, along with the “ups and downs” associated with emotionally charged operations/decisions, is part of our jobs.

 Meet with your plastic surgeon, discuss your concerns in a calm/constructive fashion;  hopefully you can mutually decide the best course of action.  I would imagine that you will have a sense of relief after doing so.

 If for some reason this course of action is not successful (or just for your own peace of mind), consider second opinion consultations with board-certified plastic surgeons in your area.

 Best wishes.

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Reducing Implant Size and Lift

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Sorry to read about this. 

It is hard to give specific advice without at least some photos, and that is nowhere near as useful as an in person exam. 100 cc is not a lot of volume in implants so large, and it is not surprising that if you felt way to big at 580, that 480 might still be too large. Sometimes looking at the implants at the office will be helpful. If they are saline, it is possible to partially deflate them just before surgery so that you can see the size with  varying amounts removed. No such opportunity with silicone.

Getting downsizing right is the hardest sizing issue for breast augmentation. Discuss at length with your surgeon. The possible need for a lift varies a lot, and depends on skin elasticity. Some women do fine with significant downsizing or even explantation. Discuss at length with your surgeon, be as sure as you can that you both understand your goals. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.