Replace Implants to Smaller Size? (photo)

Unfortunately, your photograph is not optimal but it appears that your breasts are too low and too large.  At size 32 A each 100 cc’s of implant corresponds to 1 cup size change.  If you want to be a C you would only require approximately 200 cc implants.  I recommend a new technique called Implant Exchange with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.  Through the same incision, your implants can be exchanged with smaller ones.  Aligning the areola, breast tissue and implant over the bony prominence of the chest wall gives maximum anterior projection with a minimal size implant.  Small silicone gel implants placed retro-pectoral look and feel more natural, are more stable long term, less likely to ripple or have complications needing revision.  Saline implants undergo spontaneous leakage and require replacement.  The advantage of this new technique is a smaller implant will give you the desired projection, will resolve the heaviness of your breasts and provide mechanical support to your existing breast tissue.

Best Wishes,

Gary Horndeski, M.D.

Thank you for the question.

Although you describe your history and current situation nicely, no one ( including your own plastic surgeon) will be able to predict with certainty exactly what cup size you will wear after revisionary breast surgery.  As you know, cup sizes can be quite arbitrary and vary from one bra manufacturer to another.
 

Furthermore, terms such as “natural"  can mean different things to different people and, like discussing cup sizes, can be a source of miscommunication.

Therefore, best not  to communicate  your goals  or gauge the success of the breast surgery on achieving a specific cup size.  Also, best not to use terms that can be misinterpreted.
 Instead, I would suggest that you communicate your goals in front of a full-length mirror and/or with the help of goal pictures. Show your plastic surgeon what you would like your breasts to look like and what you consider too small and too big.
 

This careful communication will be one of the keys to successful  outcome of the planned procedure.

You and your plastic surgeon should also discuss the size of the breast implant space (capsule)  and whether capsulorraphy will also be necessary  at the time of downsizing of breast implants. Furthermore, the quality and position of the overlying breast skin should also be taken into consideration to determine whether breast lifting will be necessary at the same time.

 I hope this, and the attached link, helps.

Most likely you will be a good candidate for a reduction of your implant size to 300  cc.  It is not a bad idea to deflate your current implants to allow the breast to contract a little and the existing capsule to shrink down.  This can be done under local anesthesia. In most cases like this I would the replace the smaller implant in about  6 weeks. 

Of course you can go with a smaller implant, if that is what you are looking for. The pocket has been stretched to support the implant you now have, so the surgeon would need to tighten the pocket to fit/support the smaller implant, this is called a capsulorraphy. Keep in mind, each patient is different and depending on what size you are, if they are “sagging” etc, a lift may be needed. You should look for a Plastic Surgeon who is skilled in reconstruction of the breast pocket and consistently gets a good aesthetic result. The best plan would be to do some research in your area and consult with a Plastic Surgeon to have an examination of your particular options.

Dr. Milind K Ambe's Office

You can tolerate new implants at 300 cc's without a problem. The capsule will shrink around the new implant. I would choose silicone as these will be lighter and somewhat softer.

Decreasing the size of breast implants and achieving a good aesthetic and functional results is most often not just a matter of removing and replacing the implants. Deflating the implants will allow your tissues to contract a bit (variable from patient to patient due to the health of your breast tissue) and can help with selecting new implants. In my experience when a woman decides she wants to be smaller because of avid running, etc. it often involves a skin-tightening procedure and even a site change if your original implants are above the muscle. I would discuss what your realistic expectations are from this procedure and have your board-certified plastic surgeon review images of photos of patients that are similar to your situation. I wish you well.

Dr. Edwards