I am considering downsizing from 560 to 300cc - will I need a lift along with my implant exchange? (photos)

Question

I am looking to get a breast revision to 300CC as I am currently 560CC and I feel it’s much too large. Will I need a lift if go for this change?

Gary M. Horndeski, MD · Answer

Your breasts are too low on the chest wall. You would benefit from 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.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Matthew S. Kilgo, MD · Answer

Hello. In my opinion you would need skin resection in order to reshape the breasts after downsizing implants by 260 cc. The nipple areolar complexes appear to be in good position, however the breasts have "bottomed out" with most of the implant volume sitting below the nipple areolar complexes. I would recommend removal of your current implants and repair of the capsule to reduce the size of the implant pockets on both sides. This would elevate the infra-mammary folds to a more natural position. You may also benefit from reinforcement with absorbable mesh to prevent recurrent implant malposition. The excess skin would likely need to be removed in an anchor pattern. The goal of the procedure would be to reduce the overall breast volume but improve the breast shape with the nipple areolar complex centered over the most projected portion of the implant. I hope this helps. Good luck.

Harry T. Haramis, MD, FACS · Answer

When downsizing, especially from a much larger size, usually the inside pocket needs to be reduced as well as a lift for resulting loose skin.

The implant pocket can be adjusted for better upper fullness as well.

An exam and consultation with a plastic surgeon is recommended to further discuss your best options and expectations.

Connie Hiers, MD, FACS · Answer

You do not appear to need a lift, but your inferior pockets will need to be tightened since you are bottoming out from such large heavy implants. You may need mesh for support.

Kenneth R. Francis, MD, FACS · Answer

Dear Binners,
Your current large implants appear to have "bottomed out,"  by design, or gravity.  This causes your nipples to be waaaaay above your inframammary folds (IMFs).  So rather than a breast lift when you downsize your implants, you will need some form of internal bra procedure, (with or without mesh) and possibly a reconstruction of your IMFs with internal suturing.  Good news, bad news...probably more complicated than a lift, but also less scarring.  Good luck!

Mats Hagstrom, MD (license on probation) · Answer

Your current implants are much bigger than your natural breast diameter.
Your implants have currently bottomed out.
If you exchange the implants for smaller implants, then the appearance of bottom out implants will be exaggerated.
With a smaller diameter implant all of the volume will be below your nipple.
Ab breast lift is done when the nipple position is sitting too low.
Your problem is not nipple position, but rather that your implants have bottomed out.
Correcting this deformity is a bit tricky and requires the implant pocket in the lower lower aspect guy.
This can either be done by closing the pocket using permanent sutures or permanent sutures in conjunction with mesh or cadaver dermal products like Aloderm. 
Consult with a few board-certified plastic surgeons in your community.
You should confirm that they have ample experience correcting implants that have bottomed out with consistent high-quality outcomes spread.
If the procedure is not done sufficiently the condition will recur and further revision surgery will be indicated.
You don’t need a breast lift.
Changing implants to smaller implants is a good idea, but it needs to be done in conjunction with correcting the bottomed out implant deformity.
It would’ve been wise to choose smaller implants from the beginning.
Anytime, excessively large implants are used the chance of undesirable side effects, complications and need for revision surgery will always go up.
Best,
Mats Hagstrom MD

I am considering downsizing from 560 to 300cc - will I need a lift along with my implant exchange? (photos)

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