How Much Smaller an Implant Can I Get with an Implant Exchange Without Requiring a Lift? (photo)

Question

I would like to remove my 375cc (over-inflated to 425) saline implants, placed 12 years ago, with 250-325cc silicone implants. My implants are above the muscle and incisions are peri-areolar. I am hoping to avoid a lift. I have been told by 2 plastic surgeons that my nipples lie at the correct level by examination. Both surgeons recommend that I just do an implant exchange or that I undergo an explant with lift, followed by a second procedure with implant replacement.

Brian C. Reuben, MD · Answer

This is a great question and a tough one to answer.  From the photo you have included, the nipple position appears to be good.  With such large implants place above the muscle, you have stretched the skin out and down sizing the implants will leave extra skin.  The smaller the implant, the more the excess skin you will have.  Having a detailed discussion with your plastic surgeon about your ideal look and size can help guide what can be done.  One option is to down size and then perform a lift at another operation if needed.  Another option is to perform a periareolar mastopexy (incision around the nipples) at the time of surgery if there is some excess skin and nipple descent that would create an unappealing look.  Your surgeon can help guide you in a direction that fits your budget and timeline.  

	Good luck!

Gregory T. Lynam, MD · Answer

You have the typical look of subglandular implants in a thin person where you see the outline of the implant and no feathering of the edges as is seen with submuscular implants. If you like this look then going down 100cc may be OK It is hard to predict how well your skin will shrink. Good Luck!

Steven Wallach, MD · Answer

Just based upon your photos, it looks like you will need implant exchange if you want to downsize. It does not look like you have alot of native tissue. An exam in person would be appropriate.

Norman Bakshandeh Day, MD, FACS · Answer

Downsizing your implants by 50-100 cc. should not cause much ptosis and will actually soften your appearance to a more natural look. I would exchange these to silicone plus profile mentor implants

Mytien Goldberg, MD, FACS · Answer

From your pics and the way the implants appear on your chest, you have a grade II capsular contracture (mild to moderate). The capsular contracture causes visibility of the implant edge. You can have an implant exchange to 100cc smaller silicone implants as well as addressing the capsules. By performing either the capsulectomy or capsulotomy, the implants will sit lower on the chest and give a more natural shape to the breast. Your skin should redrape over the implant without need for a lift. I do not think that you need a 2 stage procedure. Good luck.

How Much Smaller an Implant Can I Get with an Implant Exchange Without Requiring a Lift? (photo)

Answers (9)