Is it possible to remove my large implant, remove excess skin and place a smaller implant to have higher sitting breasts?

Question

4 years ago I had a breast lift and I had implants placed. I had lost 50lbs prior to surgery so I had loose skin/tissue/ boobs. My doctor filled my breast tissue with “the biggest implant” they had. Fast forward 4 years. My boobs are extremely large maybe F size and sit very low! Is it possible to get a reduction, remove all my excess skin and place small perky implants that sit higher than the massive ones I have now?

Finny George, MD · Answer

Hi, thank you for your question.Downsizing your current implants may be possible but a thorough examination of your skin laxity, nipple position and medical history would be needed before determining if it would be safe and possible in one surgery or would require two. Consult with a board certified plastic surgeon to go over your goals and discuss your options. I hope this helps. Best of luck!

Kenneth Hughes, MD · Answer

This is all possible with a board certified plastic surgeon who has the credentials needed to determine if a breast implant pocket adjustment may be required as well as a breast lift. Having lost 50 pounds prior to having your beast lift and implants placed, you may want to consider other procedures to have the rest of your anatomy match your smaller size implants.

Nelson Castillo, MD · Answer

Thank you for sharing your question.  It may be possible to pursue your desired treatment but this would depend on your current breast appearance, and key breast measurements.  Seek out a series of consultations to get the best treatment advice.

Mahyar Amjadi, FRACS (Plast) (license conditions) · Answer

Hi!
In short, yes it is possible to do all of that, it is not a simple procedure, and you may need more than one go to get everything you want. The pockets and the capsule that you have for your old implants needs to be addressed, as well as the excess skin, and the breast tissue.
Best to contact your local surgeon and go through the issues. All the best!

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs.  The technique I recommend is explantation and lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery.  Later, fat transfers can be performed if additional volume is desired.  Implants are not lifetime devices.  8% fail within the first year and 30% fail within six years.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Crism101,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Garrett A. Wirth, MD, MS, FACS · Answer

Without a picture and certainly without a physical exam it will be more difficult to answer your question.  Based on your description, it sounds as though you would benefit from implant removal and lift, or possible implant exchange for a smaller implant and a breast lift procedure. Best wishes. WirthPlasticSurgery.com

Tracy Kayan, MD · Answer

It is hard to tell without a photo, but from your very detailed description, it would definitely be a very good option to downsize your implant, open the breast pocket a bit higher so the implant can sit there, and perform a lift to remove excess skin. This procedure would give you a smaller overall size and allow the breast tissue and implant to sit higher on your chest.

Jeanette Padgett, MD, FACS · Answer

It is possible to remove your current implants and replace them with smaller ones and have a breast lift at the same time.  The condition of your skin/elasticity and blood supply to the nipples must be taken into account.  Do to your large implants, you may need some revision of the pocket to accommodate smaller implants.  Consult with your plastic surgeon to discuss your surgical options.  Best wishes.

Daniel Zeichner, MD · Answer

Hi and welcome to our forum!Replacing larger breast implants with smaller implants usually requires a lift. The condition of the overlying skin is extremely important. If you have developed stretch marks as the result of placement of the large implants, it indicates that the dermal elastic fibers have ruptured, making the skin inelastic. It will tend to stretch with added weight. In this situation, we recommend the use of smaller sized implants to prevent more overstretching. A breast lift will conify the shape of the breasts and place the nipple areolar complex back into their anatomic positions.Visit a board certified plastic surgeon for in-person evaluation and discussion.Best wishes...

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