Would it be possible to have current implants replaced with smaller ones without a lift? (Photo)

I had my BA 5 years ago with 350cc (right) and 375cc (left) high profile round silicone smooth textured implants. I realise that I should have chosen low profile implants as I hate the size and high profile. I understand that a replacement w/ full breast lift would provide the 'best' result, however due to the fact that I'm young and have not had children yet, I would like to avoid it until after having children. Would a replacement with smaller implants & no lift still greatly improve the look?

Doctor Answers 1

Can I change to smaller size implant with no lift?

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It is impossible to accurately predict what will happen if you change to smaller implants, or simply have them removed.  If you do have the implants removed there is a chance that the breasts will simply go back to what they would have been had you not had implants, however I believe that this chance goes down with time, and with increasing size of the implant.  This is because the longer the implant is in, and the bigger the implant, the more structural change occurs in the breast and also chest wall.  Both adjust to the implant; the breast tissue and skin tends to thin, and the ribs and chest wall muscles deform due to the pressure and weight of the implant.
In your case since several years have passed since surgery there is a good chance your breast tissue is thinned by the implant.  In addition, you look quite slim, so most likely your breast volume has is made up of a higher proportion of implant compared to breast tissues.  Therefore I think it is likely that just removing the implant will cause significant droopiness (ptosis) and a lift would be required for better shape.  
If you have a smaller implant inserted, it may be ok provided you insert a lower profile implant as you suggest.  I think a lower profile implant is worth considering, but there is no guarantee that your breasts won't become droopy.  A good option is changing to a lower profile implant in a similar or slightly smaller volume.  Since you have a high profile implant, it will have a relatively narrow base width.  A lower profile implant will have a wider base width.  This will mean an improved cleavage and less projection, whilst hopefully a good "take-up" (filling) of the skin to try to avoid droopiness.  It may not quite give you the look in your "wish pics", but bear in mind they show women with smaller breast volumes (and one is in a bra so it is even harder to assess).
I think your idea of avoiding a lift prior to kids is a good one.  One option you have is to remove the implants and see how it looks.  The skin and breast tissue may retract and things look good.  If they don't then a lower profile implant could be inserted (usually several months later).  Obviously this approach requires two surgeries, so it may not appeal to you, however it does give you a chance to see what happens.  The other option is to changeover to a slightly smaller but lower profile implant - but this does have an element of risk  of droopiness.
Unfortunately this is a hard decision.  I think an in person consultation is likely to help you decide and it would be worthwhile you seeing an experienced plastic surgeon.
All the best,

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