What if you decided to explant? Will your breasts sag?
Will Breasts Sag if I Decide to Explant?
Doctor Answers (79)
Breast implant removal
Many women are afraid to have implants removed because they fear their breasts will sag afterwards. In my experience, most women who have their implants removed notice their breasts look pretty much like they did before receiving the implants. If it has been many years since receiving the implants, or if there has been significant weight gain, there may be sagging of the breasts after implant removal.Otherwise, the removal of the implants usually does not result in much sagging.
Breast implant sagging after explant of implant
The answer is usually a simple one depending on the location of your nipple relative to the location of your infra mammary fold. If your nipple is located level or above the fold, you will not sag.
The answer to your question depends on the amount of...
The answer to your question depends on the amount of native breast tissue you have relative to the volume of your breast implants. The present position of your nipple will likely change. Obviously, the volume of your breast will change after implant removal.
They key to managing the inevitible 'sagginess' after explantation is an evaluation by a plastic surgeon for a breast lift (mastopexy). The procedure will reposition your nipple, redistribute some breast volume into an optimal position and tighten the skin envelope. You would be trading a lollipop shaped scar around your nipple and down the center of your breast for improvement in the sagginess that occurs after explantation.
It's perfectly safe to explant and not do the mastopexy, but you may be displeased with your breast shape and nipple position.
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Sagging after implant removal
The extent of sagging will depend on how much breast tissue you have, how big the implants are, how much time has passed, if your weight has changed and if you have had children. If you went from a B to a C three months ago and have changed your mind, you will likely look pretty similar to your preoperative state. If you went from an A to a D fifteen years ago and have nursed 4 children, you should expect some significant sagging.
Avoiding breast droop after implant removal
Typically if the augmented breast does not have any significant droop, them removing the implant will not create a droopy breast. The technique that I perform for this involves selective removal of scar tissue, and some quilting sutures to fix the breast in higher position.
Will breasts sag after implant removal?
Implants can, to some extent, camaflouge existing sagging of the breast. When the impant is removed, this sagging of the native breast is "unmasked". Removing the impant does not create sagging, it "deflates" the breast volume. You have to be prepared psychologically for this loss of volume.
The next question is, does the breast need to be modified after removal of the implant? It would need to be modified if is has significant, pre-existing sagging or excess skin. So the important thing to determine is whether or not you have sagging now, with the implant in place, of both the nipple and the breast tissue itself.
Also if your breast skin is significantly stretched out, you may need this removed by a lift procedure. If you have some sagging now with the implants in place, you may need a lift at the time of implant removal.
It depends on the position of the nipple and how much breast tissue you have and how this tissue is distributed. Implants do elevate the nipple position, but only a little bit. So if you take out the implant, the nipple will sit a little bit lower. So if your nipple position is good (a ittle low is OK) and your breast tissue is evenly distributed you probably don't need a lift.
Howevery, if your nipple is very low, you would benefit from a lift. If your nipple is good but all your breast tissue is in the lower half of your breast, then you would benefit from a lift. If skin is very stretched, would benefit from a "lift" to remove this. Good luck.
Out But Not Down
Women may choose to explant or remove breast implants for a variety of reasons. They may be experiencing problems related to the implants, such as leakage or deflation, capsular contracture or excessive firmness of the breasts, the implants may cause the breasts to appear asymmetric, or the implants may not be in the proper position relative to the breast tissue. In some cases, the breasts may have enlarged as a result of pregnancy and breast feeding, or through aging and weight gain, and the extra volume of the breast implants is no longer necessary or desirable.
Whatever the reason for explantation, the end result does not necessarily mean that the breasts will sag. If the implants were placed relatively recently, the breast envelope will have stretched very little, and the breasts should return to "normal" relatively soon after the implants are removed, if the skin elasticity of the breasts is good.
If, on the other hand, the implants were placed many years earlier, and if the breasts have been stretched as a result of age, gravity, weight gain, pregnancy, as well as the implants, explantation may result in a breast that appears "deflated". In these cases, the nipple/areola falls below the fold beneath the breast, the breast lacks projection, and the upper portion of the breast above the areola appears flat against the chest wall.
In cases where explantation makes the breast appear deflated, patients will require a Mastopexy or Breast Lift. This procedure is designed to correct the disproportion between the volume of the remaining breast tissue (now without the implant), and the excessive skin envelope which makes the breast appear droopy and deflated. The excess skin is removed, along with lifting the nipple/areola, allowing the breast to be re-packaged into a tighter skin bra. This lifts the breast and restores the projection of the nipple and upper breast, placing the breast in the proper and more youthful position on the chest wall.
So, although a woman chooses to have the implants out, this does not mean she must live with the breasts "down" or sagging.
A Mastopexy or Breast Lift, in conjunction with Explantation, can insure that you will not feel "Down and Out" about your breasts without implants.
Breasts Sagging after Explant
Whether your breasts "sag" after explantation depends on many factors: the size of the implants, how long they've been in place, whether you've gain or lost weight, etc. Any breast augmentation will cause some stretching of the breast skin. When you remove this volume, the skin will contract to certain degree. For smaller implants in younger patients, this may very well lead to breasts that are similar to pre-augmentation. The larger the implant (for a given breast size), the more skin stretching, and thus the more sagginess to the breast after explantation. The simple equation is too much skin for to little breast volume. A consultation with your plastic surgeon should clarify for you what you can expect after explantation.
Breast appearance after implant removal
Breast implants add volume and a little bit of lift, so taking them out means your breasts will be smaller (or "deflated" appearing) and sit slightly lower, but if you have a good amount of remaining breast tissue, no sagging now or before your implants, and excellent skin quality, it may not result in sagging to a degree that you want a breast lift. Important factors include:
1. Did your breasts sag before your implants were placed?
2. Do your breasts sag right now with the implants in place?
3. How large are your implants? If the implants are small and you have a lot of your own breast tissue, you may not notice much droop. If the implants are large, it is more likely your skin is stretched out, and you would have a more noticeable droop.
4. What is your breast skin quality? Young, elastic, healthy, or stretched out, thin, stretch marks, etc.
5. How much breast tissue do you have? Are the breasts "all implant", or do you have a lot of your own breast tissue? (This can change over time, simply due to aging or post-pregnancy, or thinning out of tissue around heavy implants...)
6. Where does your nipple sit in relation to your own breast tissue?
Basically without seeing you in person, it is difficult to say how much sagging your breasts will have, if any. A breast lift typically raises the position of the nipple, and tailors the skin to fit the amount of breast tissue you have in a more youthful and lifted position. The length of the scars depends on how much extra skin you have.
I would recommend consulting with a board certified plastic surgeon in person to answer this question for your case in particular. There are definitely women who have had their implants removed, did not get a lift after, and are perfectly happy. There are others who benefit from a significant breast lift. It all depends on the patient.
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.