I had a BA almost 4 months ago, changing me from a 34A/B to 32C/D. I'm getting them removed for numerous reasons, but I'm concerned that the new crease created for the larger breasts is very low and won't retract upwards after removal, making my post-explant breasts appear saggy even if they're not. My doctor says my initial incisions were on my breast, but they seem really low now. Will I need surgery to heighten the crease or will it correct itself with time?
After Implant Removal, Will my Crease Rise on It's Own or Will That Need to Be Surgically Fixed? (photo)
Doctor Answers (5)
After Implant Removal, Will my Crease Rise
The crease will not change unless the surgeon repositions it at the time of the implant removal. Right before surgery, stand in front of the surgeon and show him where you want the crease and have him draw it on the skin. Then during surgery he can remove a strip of the capsule scar tissue to create a raw surface and then with internal sutures he can position the crease to your liking.
Removal of breast implants four months post-op
You had breast implants placed 4 months ago. The increase in breast size increased from a A/B to a C/D cup. The incision was probably placed in the crease initially, but it sounds as if your implants have "bottomed out" post-operatively. Saline implants tend to "bottom out" sooner than silicone, although at 4 months post-op it is unusual for this to occur with either type of implant so soon. The inframammary fold position probably has not changed but is giving the illusion that it is lower because your implants are sitting low and the nipples are too high. The reason the incision seems to be lower now is because your implants have settled too low.
You have options:
1) If you plan to explant without replacement, more than likely your skin will contract. Four months is not that long for the skin to be stretched and it looks as if you had a tight skin envelope pre-operatively. You did not mention history of stretching of the breasts in the past due to weight fluctuations or pregnancy, therefore the skin will probably retract and the incisions, more than likely, will be above the fold.
2) If you chose to have a breast revision, there is a solution to your problem. A capsulorraphy could be considered on both inframammary folds. This procedure involves placing sutures in the folds to give better support for the implants so they are not bottoming out or sitting low. You would have more of a natural look, the incision would be lower and nipples in a central position instead of sitting high.
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Appearance of Breasts after Removal of Breast Implants?
As you know, no one can accurately predict exactly how your breasts will “bounce back” after removal of the relatively recently placed breast implants. However, based only on the limited information presented here, I think that your breast will look very similar to your “natural self” breasts several months after the procedure is performed.
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Will my Crease Rise on It's Own
The crease will not likely rise on its own But assuming the insertion scar was at the fold, it is only about one cm difference, and that may just be "tenting" with an unchanged fold.
This would require an examination to make what is a subtle judgement call, but I would be inclined to leave the fold as it is. All the best.
Removal of breast implants and resulting cosmetic affect
Thanks for the pictures. It is always difficult to tell how your breast tissue and skin are going to respond to explantation. Some patients have very good skin tone and the skin and breast tissue "bounce back" so to speak. Most patients however have a little droop to the tissue because it has been stretched (and usually the inferior edge of the muscle has been cut as well). You might be better of have a revision procedure to raise the implants on both sides since it does appear that you have had a little bit of "bottoming out" of the implants.This will also serve to move the scars back to the inframammary fold. If the implants are removed, the scars will also become more visible since they will no longer sit in the shadow of the breast. I hope this helps.
Daniel A. Medalie, MD