I had a silent breast implant rupture (no encapsulation). My breasts are both soft and jiggly. The implants are 10 years old, mushy, and soft, and I have at least a B cup of my own tissue (sub-dermal implants). They are not droopy. Will I be deformed after having my breast implants removed? I'm very scared, my aesthetic result is important to me. What will I look like after explantation? What should I expect? Will I need a breast lift? Will all my own tissue be removed, leaving me with concave "puppy dog ears"?
Aesthetic Result After Breast Implant Removal?
Doctor Answers (18)
What to expect after breast implant removal
If you do not want another implant inserted after your implant removal, the final result depends on the amount of breast tissue you have and the size of the implant. Since you have a natural "B" this is favorable compared to having no natural breast tissue. If your implant is very large this will potentially create more sagging. The safest was to deal with this situation is to remove the implants and then 6-9 months later, if needed, perform a breast lift. The reason to wait is to allow the tissues to shrink and contract- and you may be able to avoid a breast lift and additional scars. If you attempt to remove the implant and do the lift at the same time, the breast tissue can change and your final result may look different than the result you had on the operating room table.
Consult with a board certified plastic surgeon who is experienced in this type of breast surgery.
Aesthetic results after breast implant removal
Aesthetic results can be unpredictable after breast implant removal.
Over time, the breast skin envelope stretches, and the longer the implants are in, the more likely the skin will be stretched.
Also, larger implants will produce more skin stretching than smaller implants. Your age and skin tone also factor into the equation: the older individual with less elastic skin will probably have a less favorable result.
Stretching of the breast skin is correctable with breast lift procedures. You may choose to have a lift done at the same time as implant removal, or you can wait .
After the skin has had a chance to shrink (which may take a few months), you can still decide to do the lift if the breasts are sagging.
Obviously your breasts will be smaller with or without the lift, and unfortunately you will notice a lack of fullness at the upper portion of your breasts with or without the lift.
The breast lift procedure, however, can tighten the skin and correct any drooping of the breast and/or nipple.
Explantation of ruptured silicone gel implants
Sorry to read about your plight, Bria. The MRI with a dedicated breast coil is the most definitive diagnostic technique for silicone breast implant rupture. I missed whether your implant rupture was intracapsular and/or extracapsular (i.e. contained by the naturally occuring scar tissue, which forms around all implants). You specified that pre-op you had a natural "B" cup, that your implants were placed on top of the muscle and are currently "jiggly". Assuming that your nipple position isn't below the inframammary fold (the junction of the breast with the chest wall) and that your surgeon takes just the silicone material, capsule and none or very little of the native breast tissue, you should be able to avoid a lift. Discuss your concerns with your Consultant, follow his/her instructions implicitly and look forward to a maintenance free future. Good luck.
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Optimizing results after breast implant removal
Removal of breast implants should not lead to any breast distortion, provided that the patient is assessed properly preoperative so that an ideal technique is used during surgery. For majority of patients removing the implants would not require breast lift. Make sure your surgeon has lots of experience with implant removal without replacement, as there are a few technical steps need to be taken to avoid complications.
It is difficult to predict what your breasts will look like after implant removal. Those that have more native breast tissue with smaller implants usually do better.
Breast itmplant removal aesthetic outcome
There are so many factors that will effect the ultimate outcome and appearance of your breasts following implant removal. These include:
1.Age (yes, over 40 does mean less elasticity/contractility than a 25 year old but usually more than a 60 year old)
2.Size of implant
3.Number of years implant is in place
4.Over or under the muscle placement
5.Length and duration of nursing while implants are in place
6.Natural volume of breast tissue
In summary, it is my experience that If you go with a conservative volume implant (that is a subjective and not objective term) relative to your breast tissue, it is likely that you will have some loss of upper fullness with implatnt removal but not a drastic amount of sag (ptosis).
I have prepared a video on youtube entitled Breast Augmentation Overview in which I show the consequences of two patients who have undergone implants removal:
1.Scroll to 1 min into the video and you will see a 40 year old who underwent implant removal 1 year after placement. I do not have the pre implant photos because the augmentation was performed elsewhere and the patient preferred to have me remove the implant rather than the initial surgeon
2.Scroll to 1 min 30 sec into the video and the second patient is a 42 year old who had implants in place for 20 years.
Occasionally, it is obvious that a person will need a lift and implant removal and replacement can be performed simultaneously although there are some concerns about the circulation to the nipple areolar complex. I generally prefer a two stage approach with implant removal followed b 6-9 months of observation and then decide on a lift at that point in time. If there is a question about the need for a lift, saline implants can be deflated with a needle to get a rough idea bout the degree of sagging or droop (ptosis) followed by observation for 1-2 weeks to observe the effects of immediate contraction
Results after breast implant removal
It really depends on the proportion between you breast tissue and implant volume. If there is more breast tissue than implant and the implant is not very large you should have a good result after implant removal. If the implant is very big in proportion to the original breast size, a mastopexy might be necessary. You can also replace with another implant.
This varies unfortunately.
Removal without replacement of breast implants provides variable results. Some women have enough tissue that things can look pretty good afterward while others don't or have large differences between their breasts.
John Di Saia MD
Breast Implant Removal After Silent Rupture
"Silent rupture", means that the effect of the broken implant is not visible to the naked eye or noticeable to touch. This is generally the case with silicone gel implants. Rarely, a saline implant may have a very slow, pinhole leak that is essentially silent. Most often, a silent rupture is picked up on screening MRI. The current recommendation is that such an implant be removed. The reason for this recommendation is because, while we know that silicone implants themselves do not cause disease, we don't have a good understanding of the long term results of free silicone in the breast.
I am assuming that you have silicone implants. While the effect of removal is not entirely predicable, it is important for your surgeon to know the size and location of the current implants. The more volume your implant takes up relative to your overall breast size, the more likely its removal will have an effect on breast shape.The MRI is helpful in evaluating this. Also, your skin tone and breast density will effect your final result.
Options include removal only, removal and replacement with new implants, and removal and breast lift. Only minimal amounts of your own tissue should be removed. Please make sure that your physician is a board certified plastic surgeon with experience in this area. Careful evaluation, review of your expectations, and planning are critical keys to success.
Replacement of old breast implants is easy
You seem to have done well with your old implants. With a rupture (and how do you know that it has ruptured?) a replacement should be done at your convenience. This is not an emergency. Repeat, this is not an emergency.
If you want no implants, you will be sacrificing volume with the removal of the old implants. If there is a mismatch between your skin surface are and the volume of the remaining breasts, the breasts may appear deflated. A breast lift would solve these aesthetic problems at the expense of incisions much longer than a breast augmentation scar.
My advice-replace the old implants.
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.