I would like to downsize after BA. How small can I go? (photos)

Your augmented breasts do not appear to be too big for your chest. As you have not been used to having much breast tissue up to now, it will take some time for you to get used to your newly augmented look! You are bound to have some tissue swelling too at the moment and you will have a better idea of true volume about 3 - 6 months down the line. I suspect that you will be pleased with the end outcome in the end. 

Hi squid123,
Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. 

The two main types of implants are silicone and saline. The shell of the implants can be either textured (which reduces capsular contracture) or smooth. A textured implant sometimes requires a larger incision. The shape of the implant can be either round or tear drop shaped (gummy bear). Both have their advantages and disadvantages.

The different types of implant offer different pros and cons. For instance, the pros of silicone implants are that they look and feel more natural and ripple less.

On the other hand, the pros of saline implants are that they do not require as large of an incision as silicone, less expensive, they have less incidence of capsular contracture (scarring around the implant), one can tell immediately if there is a rupture, the size can be slightly adjusted, and they can be used for women less than 22 years of age.

When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.

Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.

Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.

You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

From your uploaded photos, you appear to have achieved a natural-looking result that fits your anatomy.  Give yourself those six months to become accustomed to your implants. You will probably be happy with the overall balance and symmetry.

You are still early in the healing process and what you are seeing are not your final results yet. At 2 months post op, you may still be experiencing swelling which temporarily adds weight on the breasts and make them appear bigger than the final results.  Revision surgeries are also not recommended as early as 2 months, because your body should be given enough time to heal. The best course of action would be to wait for at least 3-4 months before consulting with your surgeon regarding revision surgery.

Wait and give your  body time to heal. You may very well be pleased with your breast size as the muscles relax and the swelling  subsides. I do not believe your augmented size is out of proportion to your frame.

Thank you for the question.  
 What type/size/profile of breast implant should be utilized will depend mainly on what you are trying to achieve (in other words, what your goals are).
 Sometimes adjustment of the breast implant pockets (capsule adjustments) may be necessary to achieve the outcome you are looking for.  Much will be dependent on your physical examination;  specifically, factors such as the amount of redundant skin, quality of skin elasticity will be important,  and how much you wish to downsize.
 
Generally speaking, the best online advice I can give to ladies who are considering revisionary (downsizing) breast augmentation surgery 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. 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.
I hope this helps. Best wishes. 

Thank you for your question and pictures. Since you are 5 weeks post op is to early to see your final result. I suggest that you wait for the full 6 months. You are still swollen and your implants have not dropped or have settled in. Speak with your PS to discuss your thoughts and form a plan for the future.