I have 850cc silicone breast implant. Want to reduce to 500cc .Can a lift & reduction be done at the same time?

Dear Arleene,    Front and side view pictures would have been very helpful. In principle, it can be done at the same time - implants size reduction   with, either,  mini lift (donut, Bennely)  or full lift (key hole, anchor).  You have to realize that not all results are the same, because experience , skills and aesthetic eye are critical for good outcome. So, do your due diligence carefully and choose your surgeon wisely, to avoid bad result and need for corrective surgery.   Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery of redo breasts augmentation, to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking.                               Best of luck,                                                     Dr Widder

Breast implant downsizing from 850 cc to 500 cc can be done and a breast lift performed at the same time.  Usually there is also some capsule/pocket work that would need to be done to help the implant sit better.  A lift can then be done at the same time.There are some occasion, depending on the skin quality that a downsize can be done without having to do a lift.  A consultation with board certified plastic surgeon can help determine if you would need a lift or not after downsizing.Hope that helps.

Thank you the question. Yes, in most cases, downsizing a breast implants along with breast lift/reduction of breast tissue can be safely performed in one stage.  The recovery experience and expenses will vary based on many variables.  Keep in mind as you are thinking about your goals that sometimes adjustment of the breast implant pockets (capsule adjustments) and/or breast lifting may be necessary to achieve the outcome you are looking for.   Whether or not the adjustment of the breast implant capsules and/or breast lifting will be necessary will mainly be dependent on your physical examination; specifically, factors such as the amount of redundant skin, quality of skin elasticity,  and how much you downsize will be important. In other words, there may be other variables involved, besides just breast implant volume, that come into play when it comes to achieving the desired aesthetic outcome.
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" or "significant change" 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.