Normal Looking Breasts After Explant Surgery?

I have had saline breast implants for 8 years and am scared of the aesthetic outcome should I have them removed. I am 29 years old, I have very little breast tissue and stretch marks on my breasts from having a baby. I have constant aches and pains in my left breast. I have considered get revision surgery, but what I really want is them to be taken out. I have been researching this for a year now and would really like some advice (especially when it comes to finding the right surgeon to remove them).

Doctor Answers (26)

Do I need a lift after removing implants

+11

It is not uncommon for plastic surgeons to stage or separate these operations.

No one can predict for sure, how your breasts will look after downsizing.

It may depend on the size of your implant. Removing a 200cc implant is very different than removing a 600cc implant.

Let me offer an analogy which may help to explain:

If you look closely at your friends or women after the health club, you will see a variety of different looking stomachs following pregnancy. I have seen women who have had 3 children have an absolutely flat stomach that is more attractive than many 20 year olds. And I have seen women with one pregnancy who have had stretch marks extend over their entire stomach after one child. Do you think you could predict this before having their first child?

After you "deliver" the currentl implant from your breast, it will be difficult to predict the contraction of your breast skin.

Therefore you can pre-emptively perform a breast lift or wait and see what will be required at a later date. Obviously, I understand the inconvenience of a two stage operation but if you want to do all you can to minimize scarring this may be your best result. I have been impressed, in my personal experience, that after removing implants that have been in place for over 20-30 years, the skin will contract better than I would have predicted. Of course, it may look as if they had some loss of upper fullness but they appear age appropriate for a 50-60 year old. This is just one surgeon's opinion so take it for what it is worth. This is an artistic as well as a medical judgement.

I hope this helps.


Chicago Plastic Surgeon
5.0 out of 5 stars 41 reviews

Approach to breast implant removal

+8

If your implants are removed, you are probably concerned about the sagginess of the breast tissue that may remain afterward. This is a legitimate concern.  There is a way to potentially minimize your need for a lift or the type of lift you may require. One way is to have your implants deflated (with a needle/syringe) by your plastic surgeon in the office. This will allow the soft tissue and skin to contract, which will give you a good idea of how much actual breast tissue you have.  Then, 6-9 months later, you can have your implants removed and since the skin/tissue will have had a chance to shrink,you may not need a lift or at least, the type of lift you need may be minimized.  Either way, you can accomplish removing your implants and/or lifting your breasts with one trip to the operating room, instead of two.

Consult with a board certified plastic surgeon prior to your implant removal.

Best wishes,

Dr.Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 136 reviews

Removing your implants

+3

What your breasts will look like after explantation  depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back),  the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation). 
Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will  potentially influence the factors discussed above. If you take these factors into consideration and apply them  to your specific circumstances you may get a good idea of what to expect after the implants are removed.
 
Occasionally, I see patients who just want the implants removed because they don't want the implants "to be a part of them" anymore.  Make sure you think about this and that this is the right thing for you.  It's difficult to say if you need a lift after removal -- no one will know exactly what your breasts will look like after the implants are removed until it is done.  Talk to a well-trained and experienced board-certified plastic surgeon and get good advice.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 682 reviews

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Explantation May Not Alleviate Symptoms

+3

All your concerns need to be addresed; this would be best done in face-to-face consultation with your plastic surgeon:

  • It is important to evaluate the cause of your pain; explantation may not necessarily alleviate your pain.
  • Stretch marks my not change in appearance after explantation.
  • In addition to loss of fullness, you may have drooping,  after explantation

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 7 reviews

Explanting implants

+3

It is very difficult to give you a correct answer. Women that have alot of native breast tissue with implants can have reasonable looking breasts provided that the original implants were not too large, and they have good skin quality. ON the other hand, I have taken implants out on some very small breasted women who maintained reasonable shape after emoving the implant. Worse scenario, you have implants replaced at a later time.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

Implant removal

+2

Many women have the same concern about having implants removed that you do.  They are worried what the breasts will look like.  In my experience, they usually look like they did before the implants were placed, and not at all like the disaster you picture I your mind.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 7 reviews

Normal Looking Breasts After Removal Of Breast Implants

+2

I'm sorry to hear that you are having pains in your left breast. I hear your concern - it's very common for women with breast implants to be concerned about the aesthetic outcome of implant removal.

Firstly it's important to realise that no one can promise that removing your implants will eliminate the pain you are having. It may, but sometimes the pain persists after implant removal.

It's difficult for me to predict what the aethetic outcome of surgery will be. Certainly your breasts will be smaller. If you had very large implants inserted you may require a breast lift, as the skin of your breasts can be irreversibly stretched by very large implants, in which case explantation will likely result in breast sag or ptosis. If your breast implants were relatively small then your explantation outcome may be similar to your appearance before breast implants. An experienced plastic surgeon will be able to advise you in more detail after examining your breasts and knowing the size of your implants.

If you felt comfortable with your original surgeon I would advise returning to him/her for a check-up. Alternatively your GP (primary care physician) may be able to recommend a plastic surgeon, or if you have friends who have had breast surgery they may be able to recommend someone.

I hope this helps!

Jill Tomlinson, MBBS, FRACS
Melbourne Plastic Surgeon

Normal Looking Breasts After Explanation (Removal of Implants)

+2

Hi Jai,

Yikes.  It's not necessarily such a simple procedure to remove breast implants and be left with (1) a desirable aesthetic result and (2) alleviation of your symptoms.  Neither is automatically guaranteed, and even less so for both to happen.  Let's look at them individually.

1)  Aesthetic result - it is unlikely that you can simply remove implants that you've had for 8 years, particularly since you have stretch marks (which are an indication of loss of elasticity of the skin) and very little of your own breast tissue, and think or hope that they will just go back the way the were, or even shrink down acceptably.  They may, but you can't count on that and, more likely, there will either be excess skin, or some deformity from the way they do shrink, or both.  A better course aesthetically would be to replace them with some sort of implants, even if a little smaller, in which case you might need a lift.  However, this could be even more of an issue based on the second concern.

2)  Pain - It's hard to know what is causing the pain, and even harder to know how to correct it.  Do you have capsules?  Distortion?  Any other obvious things that someone else can see on you?  In general, you might benefit from having any scar tissue (the capsule) removed at the time that you remove the implants, whether or not you put in new ones.  However, you may be left with extremely thin skin and actually need additional tissue placed (acellular dermal matrix, such as Alloderm or Strattice).  This is not common, but it's more likely if you have very little tissue coverage of the implants, which appears to be the case.

Putting the two together, I suspect that you'll be happiest aesthetically if you replace the implants, and, if the scar tissue (if applicable) is removed you may have many fewer symptoms.  But, depending on what the cause of the pain is, you could actually go through all of this surgery...and still have pain.

You should, of course, speak with several plastic surgeons who can examine you before you make any decisions.  This is a good forum, but it's not a replacement for the traditional physician/patient relationship.

I hope that this helps, and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 148 reviews

It is possible to have normal-looking breasts after implant removal

+2

You don't have to commit to having any other procedure done from the start. If you want your implants removed, that's a pretty straight-forward procedure to have done.  Then just wait and see how your breasts change after that surgery. Give it at least 4-6 months.  You may find you're happy with your new breasts, or you may decide to have new implants placed for more volume or that you need a lift due to pregnancy changes.

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 17 reviews

Most patients with implant explantation look very much as before the augmentation.

+2

Women who no longer want breast implants (which is very uncommon) can have them easily removed with local anesthesia in about 10 minutes.  Usually the breasts will look very similar to their pre-augmentation appearance.

If the implants were quite large, their prescence might cause some excess skin and a deflated appearance.

In your case, it sounds like there was a pregnancy that, by itself, can change breast anatomy.  If your implants are removed and they appear droopy, I would think the pregnancy was more of a culprit than the presence of implants.

Vincent N. Zubowicz, MD
Atlanta 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.