Will Breasts Sag if I Decide to Explant?

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

Doctor Answers 85

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.

San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

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.

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
5.0 out of 5 stars 21 reviews

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.

Good luck!

Anita Patel, MD
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 12 reviews

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. 

Lisa L. Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 54 reviews

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.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 13 reviews

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.

Athleo Louis Cambre, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 1 review

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.

Breast sagging after explantation

The main problem with the breasts after explantation is loss of volume.  In general, if your nipples are low prior to explantation, they will still be low afterwards, although if the implants sit high on the chest wall, the nipples sometimes come up one to two centimeters with explantation.  If the nipples are below the mid arm level, a donut mastopexy or lift is used to bring them up and there is a scar around the nipple areolar complex.  A more important lift is the internal lift to decrease the base diameter as well as increase breast projection.  This is done with absorbable sutures inside the breast pocket after the capsule and implant are removed.  If there is too much tissue on the lower pole of the breast, some of the skin can be removed with an ellipse and the scar is hidden in the submammary fold.  Rarely, a vertical scar is needed to decrease the width of the breast in some cases where the nipple is very low.  There are cases where a lift should not be done at the same time as the explant but they are rare.

Susan Kolb, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 11 reviews

Sag after Breast Implant Removal

Whether you will sag after breast implant removal depends upon whether your breasts are sagging with the implants in. If your nipples are not located in the correct position, and/or are pointing downward, and/or located at the bottom of the breasts, your breasts will look saggier after breast  implant removal. If your breasts are long and saggy with the breast implants in but your nipples are located in the correct position, you may also have sag after breast implant removal. Whether you can improve the breasts with a breast lift will depend upon the volume of your existing breasts without the implants. 

Lu-Jean Feng, MD
Cleveland Plastic Surgeon
4.5 out of 5 stars 42 reviews

Will breasts sag after explanting

The amount of sagging you may expect depends upon several things.  First, how long have you had the implants?  What size are your implants?  Do you have a lot of scar tissue around the implants that must be also removed? How much tissue do you have?  How many children have you had, and how many did you breast feed?  How old are you?  These questions should be discussed during your consultation to determine what would be the best procedure for you.  Many women choose fat transfer after the removal of implants just to give some fullness and decrease the amount of sagging. I recommend discussing this with a board certified plastic surgeon who has a great deal of experience with removing breast implants.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.5 out of 5 stars 7 reviews

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.