Featured Experts:
Dr. Kaveh Alizadeh, a board-certified plastic surgeon in Jericho, New York
Dr. Norman Rowe, a board-certified plastic surgeon in New York City
Dr. Samuel Lin, a board-certified plastic surgeon in Boston
If you have breast implants you’re thinking about removing, you’ve likely wondered, Will I look flat after implant removal? The answer is, unfortunately, probably. Breast implant removal is on the rise, with more and more celebrities reversing their augmentation and the number of people getting the procedure increasing by 12% between 2019 and 2022, according to the newest available data.
What’s driving this trend of breast implant removal? It’s a combination of factors, according to board-certified plastic surgeon Dr. Kaveh Alizadeh, who is based in Jericho, New York. For one, there’s the matter of breast implant illness, the constellation of symptoms that’s attributed to breast implants. After all, “these are foreign-body devices, and any foreign-body device in a human body potentially spurs an immune reaction,” he says. Then there’s the matter of the physical repercussions of implants—namely, that they can be heavy and contribute to neck and back pain.
And finally, beauty standards have evolved over the years, with a greater emphasis on a more natural look. Some patients “are many years out from their implants, and they’re like, ‘You know what? I’m just not in the same mindset that I was when I was in my 20s,’” Dr. Alizadeh says.
However, removing your breast implants doesn’t mean that your breasts simply return to their original size and shape. Instead, the effects of time and gravity can have a flattening effect. With that, here’s what you should know.
What do breasts look like after implant removal?
For just about every patient, breasts will look flat, since there’s no longer any volume or lift without the implant. After all, “a breast implant gives the breast more cleavage and size,” says Dr. Norman Rowe, a board-certified plastic surgeon in New York City. “If removed, this fullness is immediately gone.”
On top of that, breast implants usually stretch the skin envelope, which can also lead to loose skin and sagging. And finally, “breast implants cause loss of native volume, so once the implants are removed, the breasts will be smaller than before they were placed,” says Dr. Rowe. Really, there’s no way around it. “Flattening happens in all patients,” he says.
The extent of it, though, can vary—so much so that your surgeon might be able to predict your level of flatness. This is based on the amount of breast tissue present, which is that “native volume” Dr. Rowe mentioned, as well as the volume of the implant. Also related is “the length of time the implant has been implanted,” says Dr. Samuel Lin, a board-certified plastic surgeon in Boston. The less time you have an implant, the smaller the effect it may have on all the other factors.
What can you do about flattening after implant removal?
If you think you look flat after breast implant removal, your best options are a breast lift, a breast fat transfer, or some combination of the two, according to Dr. Lin. “Keep in mind that differences often exist from one side to the other,” he says. Here’s what each entails.
Breast lift
For many people, the best option is a breast lift; the procedure includes lifting the breast tissue higher onto the wall of the chest, adding sutures to support the deep tissue, and removing excess skin.
In addition to the surgical breast lift, placing an internal bra, or a sling, may help future breast sagging, says Dr. Rowe. (However, “it will not replace cleavage,” he warns.) Dr. Alizadeh, for his part, has pioneered a breast lift technique called NaturaBra that creates a second layer of support via your own tissue, acting as an “internal bra” under the skin.
This is usually ideal for people who have a C- or D-cup breast after implant removal, who have enough tissue to create that internal scaffolding. In this case, “we’re removing the implant, we’re moving the tissue up, we’re controlling it and supporting it with this internal bra, and it looks really good—everything’s in place, using your own tissue,” says Dr. Alizadeh.
Fat transfer breast augmentation
Fat transfer to the breast is another way to create the illusion of lift, albeit in a more roundabout way than via a surgical breast lift. It can restore fullness to the upper pole of the breast, giving it a more rounded appearance that offsets the flatness following breast implant removal.
The upside is that “fat grafting is a lot more simple [than a breast lift],” says Dr. Alizadeh. However, it might not give you the quality, firmness, and lifting effect of the surgical option.
Breast lift and breast fat transfer
For many patients with concerns about looking flat after breast implant removal, the most realistic option is “actually combining the breast lift and the fat grafting, offering the best of both worlds,” says Dr. Alizadeh. “If you have lost a lot of that fullness and are removing the implant but have a good supply of fat in your hips, abdomen, or thighs, I can use that as the secondary source to augment or replenish the upper pole of the breast.”
That said, as good as this is, it doesn’t work for everyone. If you have a natural A-cup breast size and a lean figure with no fat, there aren’t many good options out there, since you don’t have enough tissue to support a breast lift or enough fat to augment the breasts. In this case, unless you’re experiencing possible symptoms of breast implant illness, you might need to consider simply getting a smaller implant—or just embracing the flatter appearance.
