Downsizing from 400cc HP to 300cc moderate profile? (Photo)

Question

it's my 3 months post op and they're still not even.Im so worried about this. I talk to my PS she said she might do revision to correct the pocket. Is it possible to downsized for a smaller implants without lift? I choose the wrong size for me. I can't run fast with my implants. I'm athletic and love outdoor activities and decided to get smaller implants and to correct the assymeytry of my breast. Hope you guys can help me. I am do depressed. Thank you.

Jed H. Horowitz, MD, FACS · Answer

hello gagamba   It’s important to know what size bra you currently wear. Is it a 32, 
34, 36 bra, and, of course, the cup size? The strap size is important to
 know because that affects the diameter of the cup and subsequently the 
diameter of the breast implant that we choose. We also need to know your
 height, your weight, and it’s helpful to know your dress size as well.
In addition, it would be very helpful if you include photos of 
yourself. A front view, a side view, and a three-quarter view are most 
helpful. This will let us see if there are any breast asymmetries, if 
the breasts are narrow, if the breasts are wide, what your chest wall 
looks.
Breast Implant Sizing (generalization for most patients)
32A to 32C needs about 250-275cc34A to 34C needs about 300-350cc36A to 36C needs about 350-400cc

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. My first piece of advice is to be patient and not do anything right now. At only three months from surgery, there is still some healing and settling to take place. It is possible that with time you will adjust to the size and be happier with the result. Even if you are not, I would not advise revision surgery until at least 6 months. At that point, you can discuss revision options with your surgeon.Good luck!

Urmen Desai, MD, MPH, FACS · Answer

Yes, the left implant needs to be lowered. If you want to be smaller, then I think it is a good option, especially if you like to work-out. The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity. I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with. Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Sepehr Egrari, MD, FACS · Answer

It is very clear that your right implant has bottomed out. This will require internal capsule tightening. I fully agree with you that going to a moderate profile will give a better look. High profile implants look "full". The left implant appears to be in an excellent position. You do not need a lift. Good Luck.

Gerald Minniti, MD, FACS · Answer

Hello,You have dropout of your lower breast. Your higher breast may be fine though, depending on the results of an examination. You will need a revision surgery to improve your result. you will not need a breast lift, but will need other procedures that are just as complex and difficult to perform. If your doctor isn't an ABPS certified/ASAPS member surgeon who specialize in revision breast surgery, you should visit a few who are. Best of luck!

Shlomo Widder, MD · Answer

Dear Gagamba,    Thanks for posting your pictures and sorry for your problems. From observing your pictures you have got significant asymmetry as follows:  1. Left breast smaller. You will need different size implants when downsizing.  2. Right breast bottoming out. You will need inferior capsulorrhaphy (internal bra), to raise the crease to more natural and attractive level.  3. Left breast has capsule contracture and the crease is too high. You will need, at least,  inferior capsultomy (scar release) to lower the crease and create a more perky look and more  leveled nipples.  As far as implants size, most of my runner and athletic patients like the full B  size. Since you appear to be C cup size, you should go down  1/2 size. If you are currently 34 C cup, you will need 325 cc on the right side and 350 cc on the left side.   It will be in your best interest to have an experienced board certified performed the above mentioned surgical  maneuvers. If your current surgeon is not experienced enough, consider consulting with other experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures of redo breasts augmentation in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking.                Best of luck,                                  Dr Widder

Daniel Barrett, MD · Answer

Dear Gagamba,dropping of implants is part of the healing process and this occurs after the tissues surrounding the implants slowly relax, allowing the implants to settle into their final position. It can take about four to six months for the implant to drop down to their final position.I understand that you are worried about your implants are not dropping as expected and the asymmetry. However, you are still in the early phase of the recovery period. Please do allow some time for the healing process to occur. If after six months, you are not satisfied with the appearance of your breast, you can visit your plastic surgeon and discuss your concerns. Based on your photos, it it likely that you will need pocket revision in order to achieve the best results. Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast augmentation surgery. I agree with your plastic surgeon that "adjustment" of the  breast implant pockets (capsulorraphy on the side where the breast implant is sitting too low) will be necessary to improve your breast symmetry.  Overall downsizing should not be a problem.The best online general advice I can give to ladies who are considering revisionary (downsizing) breast augmentation surgery (regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful.  For example, I have found that the use of words such as “natural” or "down a cup size” or "C or D cup" etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. 
3. Once you feel you have communicated your goals clearly, allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.  Again, using as many "visual aids" as possible will help eliminate miscommunication.  Best wishes.

Ronald V. DeMars, MD (Retired) · Answer

I'm sorry you aren't happy with the results of the surgery and yes, you can do a revision. You need to decide which side you like best and have the opposite side altered to match. But if you are downsizing I would suggest you keep the one that has the higher fold if you want best results. This is the reason we constantly counsel patients on this site that they should not be the one choosing the implants as they have no experience. You are paying the surgeon for their expertise and they should be willing to make the decision based on goal photos chosen by the patient. I hope you pass this on to your friends that are considering surgery. If the surgeon is not willing to accept the responsibility (and instead pass it off onto their patients) you should consider looking further for your surgeon.

Downsizing from 400cc HP to 300cc moderate profile? (Photo)

Answers (9)

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