What Would Happen if 20 Year Old Breast Implants Were Removed?

I have 20 year old silcone capsulated Breast Implants. I'm sixty years old. I'm considering having them removed and not replaced.

This will leave very flat, saggy, unattractive breasts. Suggestions? Alternatives?

Doctor Answers 16

Explantation deformity

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I usually recommend an internal lift sometimes combined with removal of excess skin around the nipple areolar complex (or on the lower pole) at the time of the explantation and total capsulectomy.  This helps to avoid deformities, decreases the base of the breast, increases the projection, and help form a fold if it is deficient.

Atlanta Plastic Surgeon
4.0 out of 5 stars 31 reviews

Removing 20 year old breast implants (explant)

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There are so many factors that will effect the ultimate outcome and appearance of your breasts following implant removal. These include:

1.Age (yes, over 40 does mean less elasticity/contractility than a 25 year old but usually more than a 60 year old)
2.Size of implant
3.Number of years implant is in place
4.Over or under the muscle placement
5.Length and duration of nursing while implants are in place
6.Natural volume of breast tissue

In summary, it is my experience that If you go with a conservative volume implant (that is a subjective and not objective term) relative to your breast tissue, it is likely that you will have some loss of upper fullness with implatnt removal but not a drastic amount of sag (ptosis).

I have prepared a video on youtube entitled Breast Augmentation Overview in which I show the consequences of two patients who have undergone implants removal:

1.Scroll to 1 min into the video and you will see a 40 year old who underwent implant removal 1 year after placement. I do not have the pre implant photos because the augmentation was performed elsewhere and the patient preferred to have me remove the implant rather than the initial surgeon

2.Scroll to 1 min 30 sec into the video and the second patient is a 42 year old who had implants in place for 20 years.

Occasionally, it is obvious that a person will need a lift and implant removal and replacement can be performed simultaneously although there are some concerns about the circulation to the nipple areolar complex. I generally prefer a two stage approach with implant removal followed b 6-9 months of observation and then decide on a lift at that point in time. If there is a question about the need for a lift, saline implants can be deflated with a needle to get a rough idea bout the degree of sagging or droop (ptosis) followed by observation for 1-2 weeks to observe the effects of immediate contraction

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Sagging breasts following implant removal

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Yes, you may need a mastopexy if the implants are removed. You can determine this preoperatively, as your surgeon should have experience with this type of procedure .

What to Expect Following Implant Removal

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                  Plastic surgeons occasionally see women who request removal of their breast implants.  In many cases these implants have been present for many years.  Patients may request removal for a variety of medical, surgical and aesthetic reasons.  In your case, distortion of your breasts from capsular contracture may be a contributing factor in your decision to have them removed. It’s not unusual for women to be concerned about the appearance of their breasts following implant removal.

                  In any particular case it’s virtually impossible to know if breast sag will develop without pictures or a physical examination.  The presence of a nipple areola complex that sits below the infra-mammary fold, poor skin tone and a high ratio of implant volume to native breast tissue volume all suggest that breast sag is likely. 

Breast sag following explantation is more likely in patients who have had multiple pregnancies, have breast fed, have had weight fluctuations and have had implants for longer periods of time.  When implants are large and placed on top of the muscle the incidence of breast sag following implant removal is higher as well.

Your history suggests that a capsulectomy will probably be required at the time of breast implant removal.  This may cause flat saggy unattractive breasts.  Under these circumstances breast lift surgery will probably be necessary to address these aesthetic concerns.

                  If you’re considering removal of your breast implants, consultation with a board certified plastic surgeon is appropriate.  This surgeon should be able to indicate the magnitude of the breast deformity caused by explantation.

What Would Happen if 20 Year Old Breast Implants Were Removed?

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The answer here depends on many factors including the quality of the breast tissue and general position of that tissue over the implants.  In general, you suggest that the implants are capsulated and capsular contracture tends to hold the scar tissue, implant and breast tissue higher on the chest wall.  With removal, there is a good chance for the breasts to look deflated and saggy.

For more information, please go to my website at:

Removal of implants after 20 years

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You have said it all.  If you implants are small, you may not have flat or saggy breasts.  There is nothing wrong with leaving them out.  Discuss this with yourself and your significant other.  The alternative is to replace them with a smaller implant but you will run the risk of encapsulation again.  This is a personal matter.

Gary H. Manchester, MD (retired)
San Diego Plastic Surgeon

Breast implant removal

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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.

Removing breast implants

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It is difficult to predict the final shape of the breast after implant removal.  If you have had them for a long time and your skin has lost elasticity they may appear saggy.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast implant removal

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The appearance of your breasts after implant removal depends very much on the size of your breasts before you had augmentation. If you were very small, then the chances are that you will return to your pre-augmentation size and shape - except aging has occurred. However, if you were larger to begin with, then once you remove the implants, you are more likely to need a breast lift to avoid significant sagging and an unsightly appearance. Sometimes the better option would be to stage the procedures - first undergo the implant removal and just see how you heal and what the final shape will be. Many times you may not need any other procedures. If you do, then you can decide along with your surgeon what procedure would ideal for you. Although that means two surgeries, the results are often better that if you perform everything all at once.

Bahram Ghaderi, MD
Chicago Plastic Surgeon

Breast Augmentation, breast lifting, fat grafting to the breasts

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Dear Petey60, The implants can be removed- ultimately the volume of the implant and possiby some of you breast tisssue will be removed- this depends on the degree of capsule formation and the implants- whether they are intact or not.

You may have a breast lift at the same time and also include micro fat grafting (your own fat used to add volume to the breasts) to achieve a nice shape and size of breast.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 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.