I want to replace my large implants with considerably smaller ones. I'm hoping to avoid a lift? (photo)

I saw a Beverly Hills Dr. in 2000 and made the mistake of giving him the liberty to choose size. I'm a big girl: 5'10", 160 lbs (athletic with broad shoulders)... and he made them much larger than I wanted. (475cc and 565cc since I was asymmetrical). I met my husband shortly after and didn't change them because he loved them. I'm officially done with these monsters and ready for much smaller ones. Thanks for your help.

Doctor Answers 10

I want to replace my large implants with considerably smaller ones. I'm hoping to avoid a lift?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

My over the internet guess is you will need a lifting operation. But ON<Y IN PERSON consults allow the final determination..

Don't lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I agree with the other  doctors that an in office exam is absolutely needed to dtermine the best way to go for you, but here's my opinion based on your photos...
Your breasts are typical of a retropectoral augmentation. The breast volume is large, but most of the volume is lateral because the muscle forces the implant down and toward the outside. That's why you such lateral breasts and poor cleavage even with a very large implants. I suggest that you simply replace your implants with silicone gel implants in the 250-350 range and go above the muscle. Closing the existing capsule will correct the lateral displacement of the breast and perhaps even raise the left breast a little to match the right better. A lift will result in permanent scars at a fairly young age and not enough improvement in shape, lift and areolar appearance to be worthwhile, so I'd hold off on that for now.  

Joel Aronowitz, MD
Los Angeles Plastic Surgeon

Down sizing to smaller implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for the question.

In my opinion, I suggest a breast lift with implant replacement. A lift will be necessary specially after the skin laxity after removing the larger implants.

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 257 reviews

Revision and downsizing

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Downsizing and implant revision surgery is some of the most difficult type of cosmetic breast surgery done.  First one needs a BCPS that does this every week.  Secondly, going significantly smaller means at least by third in volume usually in my experience.  Anything less risks not seeing a significant result.  Your wishes need to be conveyed to your surgeon, with the differences stated with breast volume, it is extremely unlikely  a skin tightening procedure would not be incorporated .  An exam and detailed discussion is a must. Finally, in my experience I would recommend getting as close to the same size implant for each breast.  Symmetry will remain for a greater time as one ages, this is from doing hundreds of lifts per year. 

Peter J. Capizzi, MD
Charlotte Plastic Surgeon
4.9 out of 5 stars 93 reviews

Downsizing your implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question.  Unfortunately many women find themselves in your position.  Whether you need a lift or not really depends on the overall look you want to achieve and how much smaller you wish to go.  Some patients can get the look they want by doing an internal capsule tightening coupled with smaller implants, while others require a lift.  Therefore it is difficult to say for sure without an in office consultation.  I would seek out a Plastic Surgeon who performs a lot of breast revisions (especially lifts) for a free consultation.  Good luck to you!

Milind K. Ambe, MD
Orange County Plastic Surgeon
4.7 out of 5 stars 52 reviews

I want to replace my large implants with considerably smaller ones. I'm hoping to avoid a lift?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
     I think that your breast shape would be very much improved with a breast lift after the implants have been downsized.

For the lift, I typically start with the smallest incision and custom tailor each breast lift to the shortest scar possible.

Find a plastic surgeon who performs hundreds of breast lifts each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD

Los Angeles, CA

Downsizing breast implants and lifting the breasts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
You look to be perhaps on the fence here. There is a lot of skin in your breast's lower poles and I'd say that more likely you'll need a lift with smaller implants to tighten up that loose skin. But depending on what is seen in person, you might also try the downsizing, give the skin 6 months to shrink as well as it can and see if you are happy or if the lift is needed at that point.

Lift or not

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for the photos but a full examination is really needed to intelligently answer your question.  Find a board certified PS/ or surgeons in your area who is/are breast experts and get their opinion after a full examination.

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Downsizing breast implants without a lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is not always realistic to reduce the volume of breasts without reducing the skin envelope, but each circumstance is unique so an in-person consultation is the only way to determine whether you would need a lift or not. Sometimes a minimal lift such as a Benelli is a reasonable trade-off, perhaps supported with an internal bra of Seriscaffold or something similar.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

I want to replace my large implants with considerably smaller ones. I'm hoping to avoid a lift?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for the question and pictures. You will find that online consultants will not be able to provide you with specific enough advice to be truly helpful. Most important to your success will be careful selection of your plastic surgeon and careful communication of your goals. In other words, show your chosen surgeon what you are trying to achieve and what you consider to be too big, too small or “monstrous”. In my practice, I find the use of goal pictures very helpful during this communication process.

Once you have communicated your goals, your plastic surgeon will be able to provide you with advice about the size/profile of breast implants that will most likely achieve your goals and whether or not breast lifting will be necessary as well.  Be careful in your attempts to avoid breast lifting that you do not end up remaining too large or “saggy” afterwards.

My guess, based on your description of goals, is that you will benefit from breast lifting if you do want to go “considerably smaller”.

I hope this, and the attached link, helps.

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.