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In general, I use drains when doing an explantation, especially when performing a capsulectomy.
I like to explain it like this -&nbsp;The implant has created a cavity that the body needs time to heal.&nbsp; The drain helps to remove any extra fluid that the body puts into this space during the healing process.
Drains cannot completely prevent a seroma, but they can decrease the chance of it&nbsp;happening.
The drains are usually present for about a week, but this time period varies by how much is draining.&nbsp;&nbsp;

I’ve read stories from women who had explant + fat transfer and suffered from seromas after surgery. They did not use drains. Will the use of drains help prevent seromas from forming after explanation?

Are drains required to prevent seroma after implant removal?

Performing a capsulectomy at the time of implant removal&nbsp;really has to be tailored for each specific patient.&nbsp; The information needed&nbsp;includes the patient's&nbsp;examination, implant status (ruptured or not), capsular contracture, pain or any other symptoms.&nbsp;&nbsp;
The general reasons that capsules are removed are due to capsular contracture or for&nbsp;ruptured silicone implants.&nbsp; They also are often removed by patient request.&nbsp;&nbsp;A total capsulectomy has a higher&nbsp;risk&nbsp;of complications than leaving a capsule in place, as it's additional surgery.&nbsp;&nbsp;Removing a portion of the capsule may be done to decrease the chance of a fluid collection after surgery.
In your situation with saline implants,&nbsp;no pain and no capsular contracture, removing your capsules likely isn't required.&nbsp;&nbsp;

I am 46 years old with saline implants under muscle. I'm a size D. Not thin. I'm removing the implants. I've been to 2 surgeons. One wants to do a capselectomy, the other said he will remove some of the capsule, not all, that it's not necessary. I have no pain, no contracture. I will be having a lift at the same time. I'm thoroughly confused if I should have this done. Can you please explain both sides? Thanks. Anna

Capsulectomy or not? Risks of having it done or keeping capsule.

Removing leaking/ruptured implants (and often the capsule that they are in)&nbsp;is usually advised.&nbsp; The decision about what to do after that is completely up to you.&nbsp; Replacing the implants with new implants is a good option if you are happy with the current appearance of your breasts.&nbsp; If you did desire a lift, they are usually well tolerated from a pain perspective.&nbsp;&nbsp;
When considering the risk of additional surgery, your overall health status is usually more important than your age.&nbsp;&nbsp;

I probably could use a lift but that is NOT my big concern, I need the old leaking implants out. I have read that they can cause some autoimmune issues and pretty much every symptom the article listed I have. Dr.Will probably suggest a lift but I don't like the way its done... it looks really painful. Its not like I am going to be a centerfold :) I am a curvy 58 yr old woman and would be fine having new non leaking implants. maybe procedure has changed so I will leave that up to Doc recommendation.

I need 20+ old and leaking implants removed. I want to have new ones but unsure due to my age (58). Does my age matter? (photos)

Your saline implants should be able to be drained and removed through your previous incisions.&nbsp; This can be done with numbing injections in an office setting.&nbsp;&nbsp;
If you have capsules that you would like removed, an incision underneath the breast is the generally accepted approach.&nbsp;&nbsp;This allows for most or all of the capsule to be removed safely.&nbsp; I recommend that you meet with a plastic surgeon in your area and discuss your options.&nbsp;

I do suffer with several symptoms of what I now know to be BII, but I don't know enough about it at this juncture to make any other decisions! My head is about to explode with all of the differing opinions and procedures that I feel I'm losing my mind! Thanks for your time!

Can my saline implants be drained and taken out through the original areas around the nipples?

Removing the capsule surrounding a breast implant is usually done if there is a problem - contracture, pain, malposition, silicone implant rupture, etc.&nbsp; That said, patients often request that the capsule be removed.&nbsp; To take the capsule out en-bloc requires a larger incision than taking the implant and capsule out separately.&nbsp; Removing the entire capsule also has a larger chance of complications such as hematoma.&nbsp;&nbsp;
The decision of what to do needs to be made as part of an in-person discussion with a plastic surgeon after a good examination.&nbsp;&nbsp;

I had my first implants in 1999. In 2003 I had my second set of round, saline Allergen implants put in place. My original doctor said that he left the capsule inside when he performed the 2nd surgery. I now want my implants taken out and wondering if the en bloc surgery is what I need? I don’t want the capsule from either the first or second surgery left inside me. What do you think?

I had my first implants in 1999. In 2003 I had my second set of round, saline Allergen implants put in place. Do I need en bloc?

Thank you for the photos.
It is difficult to know how much your breasts will change after removal of your implants without a good examination and to see your pre-surgical photos.&nbsp; Your implants haven't been in place for very long, so the chance is good that your tissues will shrink up to some degree.&nbsp; Everyone's tissue&nbsp;is different, so this is the part that is really hard to predict.&nbsp; If you're worried about being too large, the most conservative approach would be to remove the implants and wait about 6 months.&nbsp; At that point, you should have a good idea of what everything looks like and can make a decision about further surgery.&nbsp;&nbsp;

Hello I had a breast implant and breast lift 8 months ago. I have 255cc HP implants, that are too big for me, I was a 34C before I had kids, went down to 34ab. I was hoping to go back to 34C I am now 34DD. I didnot like my breast since I got the implants, I am petite 100lb and 5feet tall. I am thinking about removing the implants. I m terrified to replace them and make another mistake. What should I expect ? Would my breast would be saggy? What would you recommend?

What should I expect - will my breasts be saggy? What would you recommend? (photos)

Thank you for the photos.
Total capsulectomy with removal of your deflated&nbsp;implants is&nbsp;possible, but if the capsules are very thin, removing the entire capsule may be more difficult.
Generally capsules are removed when they are causing a problem - distortion, pain, palpability, etc.&nbsp; If you're not having symptoms like this, it may not really be indicated.&nbsp;&nbsp;

I confirmed I have ruptured saline implants in both of my breasts with an MRI. I believe I've had ruptured implants for the past 4-5 years. The photos showed a small amount of the capsule was left in each breast (barely visible). Would explanting with total capsulectomy be more difficult now that my saline implants have been deflated? Does this also mean my capsules are very thin?

Would explanting with total capsulectomy be more difficult now that my saline implants have been deflated? (photos)

If the lateral displacement of your implant doesn't bother you, there is no reason that you HAVE&nbsp;to undergo surgery.&nbsp; Sometimes patients begin to have discomfort or other problems as the implants move laterally and this would be a reason to have surgery.&nbsp;&nbsp;
Regarding the Allergan recall, the FDA&nbsp;statement specifically states "If you have no symptoms, we are not recommending the removal of these or other types of breast implants due to the low risk of developing BIA-ALCL. However, if you have any questions, talk to your health care provider."
Lateral displacement is not a symptom of BIA-ALCL and your implants can absolutely stay in place.&nbsp;&nbsp;

My only option was to get left lateral pocket closure and breast augmentation because my implants were recalled by allergen. My plastic surgeon is making me pay full price when I just paid full price 3 years ago.

3 years w/implants I have lateral displacement. Do I have to get surgery or can I let the implant stay in its new place?

Thank you for the information about the implants and the photos.&nbsp;&nbsp;
It would likely be very difficult to achieve both of your goals - explant and re-do Benelli - at the same time and get a satisfactory outcome.&nbsp; From the look of your photos, a Benelli likely would not be able to achieve your goals and&nbsp;give you a good shape&nbsp;after removing 215cc of volume.&nbsp;&nbsp;
If you're thinking about starting a family, your breasts are very likely to change during and after pregnancy.&nbsp; Any lift done at this time will change as well and may need a revision after all is said and done.&nbsp;
Another option would be to remove the implants and see how much tissue shrinkage/retraction that you get afterward.&nbsp; It wouldn't burn any bridges and you could always have a revision of your mastopexy in the future.&nbsp;
&nbsp;&nbsp;&nbsp;

Hello, I am unhappy with my size. I originally got implants 6 years ago (300cc mod plus with benelli). They looked great but too big. I went smaller to 215cc moderate 2 years ago with another benelli. I still feel like they are way too big for my frame. I am a 32DD. I want to explant and redo the benelli because of my scar. I am extremely worried about how they will look after the surgery especially any caving or inverted nipple. I do not want a vertical scar before having any children.

Explant and redo of benelli to fix scar? Advice? (photos)

As others have said, there are multiple options to treat your condition.&nbsp; These range from injectables, to lasers, to surgery.&nbsp; It would be difficult to address the deeper lines, especially under your left eye, with a non-surgical treatment.&nbsp; A lower blepharoplasty would allow your surgeon to alter the underlying structure and remove any extra skin present.&nbsp; For a number of patients, this procedure can be performed under local anesthesia in an office setting.
A consult with a surgeon who is experienced with eyelid surgery is a must.&nbsp;&nbsp;

I am open to surgical and non-surgical and also in combination with facial rejuvenation (facelift, necklift, etc). I currently get xeomin injections in the glabella and crows feet, but not under the eye.

What is the best treatment to get rid of these under eye wrinkles? (Photo)

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General Surgery, Tulane University Medical School, New Orleans, Louisiana, 2015

Plastic Surgery, Houston Methodist, Houston, Texas, 2018

BS, Cell and Molecular Biology, Tulane University, New Orleans, Louisiana, 2004

MS, Cell and Molecular Biology, Tulane University, New Orleans, Louisiana, 2005

MD, Louisiana State University School of Medicine, Shreveport, Louisiana, 2010

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