I Want to Replace my Implants from 700cc to 500cc. Is This Possible Without a Breast Lift? (photo)

I'm 5'7 and 130 lbs. My implants were put in when I was 27 and I wanted the BIG sexy look. Now, I'm 40 and want smaller more perky ones. My back is in constant pain and the implants make me look fat now. When I first received them I was 12 lbs lighter. I exercise a lot now and running or doing any cardio is becoming more difficult with these big boobs. I chose to go under the muscle and through the areola. My concern is the stretching over the years and having the saggy look.

Doctor Answers 14

Removal of large and longstanding implants.

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Thank you for your question.

You're not alone.  I have seen many women who had implants 15 or 20 years ago who are at a different stage in their lives and want to have the implants downsized or removed.  The key depends upon a few factors.  Do you want them removed completely, do you want them downsized, and how were they placed in the first place.

From your photographs it seems that you already have a significant degree of drooping of the breast.  If you go a little bit smaller volumes will be decreased but you'll gain a little bit of additional laxity.  If that is acceptable to you then it is reasonable.

If you go considerably smaller you may wish to consider a lift or tightening of the breast.  If you chose this route you would have to be comfortable with the scars associated with breast lift surgery.

It is important if you go this route that you and your surgeon are all aware of where your implants were placed originally.  If you're implants were placed to below the muscle then is likely that most of the blood supply to the breast itself is intact which makes a full breast lift safer.

If this large implant was placed above the muscle and that tissues have been attenuated over time this will be a more risky lift with a higher chance of healing problems.

Most women that I see with your starting situation are removing the existing implants and going smaller way to a lift, or just doing a lift alone if they have enough natural breast tissue.  Your plastic surgeon can give you a sense of whether he or she feels you have enough natural breast tissue to remove the implants entirely.


Best wishes.




Smaller perkier breasts won't come without a lift

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Yes you can have an exchange for a smaller implant but you can't expect that to give you any lift.  If you want smaller breasts, great.  If you want smaller and perkier breasts, then you do need a lift.

You are correct about the stretching.  Over the years the extra weight has stretched out your breasts and to give you a more youthful, shapelier, and perkier breasts a lift is required.  Otherwise you will end up with a rock-in-a-sock look of overstretched breast tissue filled with a smaller implant.  A full lift (not a small lift around the areola) is likely required.  If you are very concerned about scars and want to keep the scars limited to the areola (and want to avoid the vertical scar) there are some newer innovations that can help.


Martin Jugenburg, MD, FRCSC

Toronto Cosmetic Surgery Institute


Replacing your Implants

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If you do not want a lift because of the additional scarring, have the implant exchange first and then wait and see for about four months if the appearance  improves enough for you with out the lift. If there is not enough improvement, then have the lift.  A lift at the same time of the implant exchange can be a difficult operation for a less than expereinced surgeon.

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Breast Augmentation Revision

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Even without changing your implants, you would benefit from a full mastopexy. You have the classic 'ball in sock' appearance, with irregular, stretched out skin, over stretched skin, asymmetry of position of your nipple areolar complexes, and significant sagging.  Although you say your implants were placed under the muscle, they are assuredly no longer there, as they have descended below the lower edge of the pectoralis muscle.

If you really want to make a change in the size and appearance of your breasts, you will need implants much smaller than 500 cc.  You should see a few surgeons that are expert and have great reputations in complex revision breast surgery.  Although this is a complex surgery that many doctors would do in stages, you could have an amazing and beautiful transformation of your breasts!

Best of luck!


Breast Lift Necessary if Downsizing Breast Implants?

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Thank you for the question and pictures.

Unfortunately,  it is not possible to give you precise advice without direct examination and a full communication of your goals. However, based on the picture and your description, it is very likely that breast lifting will be necessary if you choose to downsize breast implants.  Of course, the downside with breast lifting surgery is the necessity to remove skin and the presence of postoperative scars.

Most patients undergoing this procedure will accept scarring as long as their overall goals in regards to size, shape, contour and symmetry are met.   

Best wishes.

Breast Implant replacement vs Breast Lift

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Dear Tigerlady, Thank you for sharing the photo. It is very likely that you will need a breast lift by decreasing your implant size from 700 to 500 given the current size based on the photo. However, some patients with saline breast implant may not need a lift depending on their situation. If you have saline implant, you may want to consider preoperative implant deflation to allow your breast tissue and skin to retract. My article on Percutaneous Preoperatative Implant Deflation (PPID) may apply to your condition. For additional information, perform an internet search of Percutaneous Preoperatative Implant Deflation or PPID.  The best way to know is to visit a Plastic Surgeon certified by the American Board of Plastic Surgeon.

Implant reduction and lift?

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More than likely you will need some sort of lift when going into a smaller implants. Your breasts appear to be sagging now.  Good luck.  A vertical lift may be the righrt solution.

I Want to Replace my Implants from 700cc to 500cc. Is This Possible Without a Breast Lift?

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Thanks for the posted photo. Yes try the replacement. If after 3 months unhappy than have a l-shaped lift. 

Lift with Implant Reduction?

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It really isn't possible to tell without an exam, but your photo indicates a significant amount of implant and breast skin below the fold. Most of the time that means a lift is needed for the most aesthetic results. However, if you are comfortable with the lower look, which might look fine when supported in a bra, then you won't want a lift. The best approach is to remove the implants, replace them with the new smaller implants and a capsulorrhaphy to get internal support. Then wait at least 3 months before deciding if you feel a lift would benefit you.

Smaller implants and lift

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Thank you for the pictures. The need for a lift will be a personal decision based on the way you want to look. The breasts will be higher on the chest and the nipples moved up with a lift but the drawback is the scars, and other risks and comlications associated with a breast lift. Perhaps just go with the smaller implants and stay with them for 3 months before deciding on a lift.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.