Question

Breast implant removal - Will my breasts sag if I decide to explant?

What if you decided to explant? Will your breasts sag?


Asked by: xklorx
WI

Answers (3)

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1
July 19, 2008

Sagging breasts after explantation

Steven Wallach, MD
Steven Wallach, MD
Board Certified
Plastic Surgeon

This is a question that varies from individual to individual. There are many factors that should be considered:

  • age
  • length of time implants were in
  • size of implants compared to original breast size
  • capsular contractures
  • pregnancy
  • etc...

If the implants were small, you were young, you had reasonable sized breasts to begin with, and only recently had them placed, then I would probably say no, they wouldn't sag much.

The opposite is true for large implants, older person, no original breast tissue, etc.

2
July 17, 2008

Out But Not Down

Athleo Louis Cambre, MD
Athleo Louis Cambre, MD
Board Certified
Plastic Surgeon

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.

3
July 17, 2008

You may wish to have a breast lift after explantation

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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