60 Years Old, Wanting to Replace 23 Year Old Breast Implants, Options? (photo)

Your 23 year old implants should be removed.  They appear hardened by a capsule and at this point in time are likely  to be ruptured.  After that you may choose to have a lift or not, and choose whether or not to have a new implant.  The lift will improve your shape.  You likely have more breast tissue now than you did 23 years ago so you could see how you feel without implant replacement..  If you choose to have a lift and implants the size will depend more on the biology of your tissues than on your preference.  A smaller size implant is a little safer for you.  I agree with the surgeon you saw in consultation.  An implant replacement without a lift will not look very good and is likely to look worse over time from the effects of gravity and tissue strain.

I am in agreement with your surgeon that, without a lift, the result will not be aesthetically pleasing and will look worse than if you removed the implants and went down to a B cup. The capsular contracture is severe and you will be at risk for capsules from any reoperation, although the risk is lower if the implants are under the muscle. As breast augmentation patients age and reach Medicare age, it is time to re-evaluate how to deal with implants, particularly if complications such as contracture develop.

Thank you for the question and pictures.

You will find that you have many options to consider.

1.Removal of implants/capsulectomy.

2.Removal of implants/ capsulectomy and breast lifting.

3.Removal of implants/capsulectomy/ breast lifting and breast  reaugmentation.

What you choose to do will depend on your goals.  The more surgery you have done the greater the risks  associated with the surgery and the greater potential that you will have complications.

My personal preference for patients like yourself is to remove the implants/breast implant capsules and perform breast lifting during one operation.  If the patient wishes to have implants replaced I would do so 3 to 6 months after the first operation.

I hope this helps.