I would like to downsize from 750/800cc to 550/600cc, will my implant reduction require a lift? (Photo)

Usually the downsizing leaves the patient with extra skin that does not fully contract. This leads to an appearance of breast tissue hanging off the implant so usually the surgeon will recommend a lift to remove the skin excess.

I do recommend going smaller before those heavy implants cause even more sagging. An internal lift can be done, but you still may have some excess skin. An examination would be needed to determine if a periareolar lift could be done. You could also consider minimally invasive skin tightening procedure with radiofrequency like ThermiTight to help tighten the external tissue.

Once implants are removed, there will likely be flattening and drooping that can be corrected in large part with a breast lift. As far as the volume that is attained, that is a bit difficult to predict given the period of time that you have had the implants thinning the remaining tissue. No one can truly predict this as each soft tissue envelope will respond differently, but you may do well with just removal. If there is any doubt, explant using the original incision, followed by a period of several months of observation. After 6 months or so a decision for a breast lift with or without fat transfer can be made.