I have decided to remove my implants after 15 years without replacement. I have opted not to have any further surgeries and know I will have smaller breasts. I have textured saline 330cc implants over the muscle with a capsular contracture on right breast. Knowing that I will need to take care of the excess skin and larger areola, what type of breast lift would you recommend in my case?
Breast Lift Type for Excess Skin and Large Areolas?
Doctor Answers (20)
Breast lift and removal of breast implants
The decision to remove your breast implants and have a breast lift is a difficult one, because you trade your implant problems for scars on your breasts. Looking at your photos it appears you will need a lift and the type depends on how much extra skin you have after implant removal. This is based on measurements before hand and during the operation, as well areolar reduction should be part of this procedure. I have a tendency not to push the verticle technique as it can leave bunching of the skin below the breast. I usually remove this excess at the time of the operation. Also discuss how your nipple will be supported, and it will depend on where your scars are. I would typically use a superior pedicle for your nipple movement. The main thing with this procedure is giving you shape to your smaller breasts and this is created with deep internal sutures in your breast tissue and moving the existing tissue around to give you projection. Safety is the main part of any procedure, so if you smoke: stop, and consider a pre-operative mammogram!
I hope this helps. Dr. Trussler
Breast Lift After Implant Removal
Removal of breast implants leaves sagging breasts with significant amounts of excess skin. Your enlarged areolas are likely the result of the implants. The surgery entails resizing the areolas to the normal size of 38-45mm. This incision is then used to access the breast pocket. The implant and capsule are removed. Once this is done the excess skin is removed from around the the areola. The scars are going to end up around the areola, then a vertical scar down to the crease then possibly a transverse scar in the crease. It's unlikely that you could undergo anything but a standard mastopexy and obtain a good result.
Breast lift for excess skin and large areolas depends
There are two types of surgical procedures:
Circumareolar lift (incision around the areola alone) -- with lifting and reshaping of the breast tissue.
Vertical scar mastopexy (lollipop incision) -- with lifting and reshaping of the breast tissue.
The Circumareolar lift can be done for those ith the sternal notch to nipple distance of less than 25cm after removal of the implants So the ability to use this procedure will be decided at the time of implant removal. The vertical scar mastopexy does not have this limitation.
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Best type of breast lift-removing implants.
Hi Breastconfused. I recommend a superior pedicle mastopexy with a lollipop scar. You might need a very short horizontal scar in the inframammary fold/crease. I also suggest some internal work on the breast mound, using sutures to lift and shape the breast itself. This will help improve the longevity of the lift. In addition, I favor using Quill sutures to produce a pretty scar, especially around the areola. Hope this helps.
Tracy M. Pfeifer, MD, MS
You need a vertical breast lift with a lollipop scar.
Removing the breast implants and doing the breast lift can all be done together.
The vertical breast lift gives you the best long term result because it shapes the breasts INTERNALLY, without relying on tightening the skin. Skin stretches, after all. And nobody needs the old fashioned "anchor" scar.
I believe you will probably do well with a vertical ift or lollipop incision. I don't think you wil need anything fancy since most of your issues will be related to volume loss not excess skin. I don't think you will have enough tissue to move around to make a significant difference and each extra manuveur adds certain risks. You don't want to make a mountain out of a mole hill. Scars are permanent and will your black skin I would want to minimize scars initially. You can always add scars later if you are dissatisfied.
Mastopexy Breast lift with implant removal
SEE VIDEO BELOW FOR MASTOPEXY WITHOUT IMPLANTS BY CLICKING "MORE":
I would recommend implant removal with a superior pedicle and transposition of redundant lower pole parenchymal tissues to the evacuated capsule using a vertical mastopexy approach or LeJour Modification.
Breast lift choices
You will need a full lift to reduce the areolas and tighten the lax skin. You will see controversy about using a lollipop incision with no crease component or using a modified anchor incision with some crease element. Personally, I have not seen results from other surgeon's versions of the lollipop that in my opinion I like better than the results I get with the freehand central pedicle lift which has some scar in the crease.
Breast lift after implant removal
Breast Lift Surgery
It’s not unusual for patients to have significant breast sag following removal of breast implants. This is especially problematic when the implants have been placed on top of the muscle and a capsular contracture is present. Under these circumstances, the absence of muscular support can result in severe breast sag. In addition, when implants are placed on top of the muscle, breast sag is often accompanied by significant thinning of the skin which can make breast lifts difficult and dangerous because of compromised blood supply.
It’s virtually impossible to know what type of breast lift will be needed without pictures and a physical examination. In some cases the decision can’t be made until the implants have been removed. In some cases, when blood supply is compromised it may be appropriate to perform breast lift surgery as a secondary procedure.
The type of procedure chosen depends on a variety of factors. In some cases a lollipop incision will be adequate. This will lift the breasts in an upward direction and reduce the size of the areola. When larger amounts of sag are present an anchor incision is usually necessary. This will not only reduce the size of the areola, but will also provide greater amounts of lift by excising additional skin in the vertical dimension.
This is potentially a complex problem and for this reason consultation with a board certified plastic surgeon with experience treating complex breast problems is appropriate. This surgeon should be able to formulate a treatment plan that’s appropriate for you.
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.