26 Yr Old Implants & Mastoplexy?

Want very much to have a long over due rpl. decrease in size & lift. Is it more complicated a surgery? Higher fee? Could I expect a pleasing result given what I have to work with? Menopause, osteoporosis and fmr smoker (4 mths at surgery is goal) effect risk & outcome? Most importantly, how does one go about finding a qualified, experienced surgeon who also clearly understands pitfalls & risks to be avoided w/ someone like myself? Thanks so much for any feedback! (Sarasota, Fl)

Doctor Answers 8

Breast implant replacement and lift after 26 years requires an expert plastic surgeon

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question. Photographs would have helped. The most important factor I believe is that you see consultations with more than one plastic surgeons who are certified by the American Board of Plastic Surgery, very experienced in cosmetic breast surgery and who have an excellent reputation in your community. Plastic surgeons who are members of the ASAPS typically have more experience in cosmetic surgery as well.

You should be able to achieve a good result with the best surgeon.

Be sure that blood nicotine tests are done prior to your surgery and are negative.

26 Yr Old Implants & Mastoplexy

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question. A photo would help sort through some of the possibilities and would offer better responses on this site.

Of the medical issues you raise, active smoking adds risk, the others not really. Four months off smoking should eliminate the extra risks involved.

If your implants are silicone and have leaked, your procedure is somewhat more complex, in that removing the capsule would probably be needed. Depending upon the position of the implants, you might do well to have a position change (as to below the muscle). 

Choice of implant and technique of breast lift are items to review at an in person consultation

When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S.


Thank you for your question, best wishes.. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Decreasing implant size, breast lifting, and keeping it safe.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Caution is warranted when a patient with larger implants placed many decades previous wishes to decrease their implant size and possibly add a lift. Obviously the amount of caution depends upon the current implant size, desired size after surgery, amount of lift necessary, and patient medical and social comorbidities. The safest approach is usually a staged approach where the implants are downsized in the first stage. The breasts are allowed to "adjust" to the new implant size. Once the breasts have healed, the degree of lift can then be ascertained. This staging is helpful to improve the risks of vascular compromise that can occur in a lift with implant exchange, as well as improving the predictability of the end result. Smoking is a very serious concern as it diminishes the oxygen and blood supply to the tissues. All efforts to stop smoking at least 4-6 weeks prior to surgery should be employed. In the end, planning is the most important factor in a successful outcome.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Breast implant replacement and mastopexy

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

 your smoking history certainly adds to the risks of the surgery. There is always a higher rate of problems with healing in patients who smoke.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

Lift plus aug

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I think the most important thing is to find a surgeon with a lot of experince in this type of surgery.also it is essential that you give up smokinmg and also not be around second hand smoke.This is important.I think experince is the key here.Also I would go with silicone as well.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

Breast aug revision

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You can have this surgery successfully performed.  Quitting smoking is essential for a minimum of 2 weeks prior and after the procedure.  It will be more expensive since you need to cover the cost of new implants and a mastopexy.  Find a board certified surgeon.  

Replacing implants and mastopexy

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
A lift with implant replacement is a more complex procedure than an augment but it can produce excellent results. I see many patients who have had implants for many years and are now requesting this operation. It is good to stay away from cigarettes (congratulations on quitting). Menopause is par for the course and osteoporosis of your bones should not complicate the situation. To find a qualified plastic surgeon, try the website of the American Society of Plastic Surgeons; anyone who is board certified will be well versed in the risks and nuances of the procedure.

You will be very delighted with the removal of your old implants and a breast lift, mastopexy.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You should be very pleased with the surgery, removal of your old larger implants, replacement with smaller newer silicone gel implant and a breast lift, mastopexy. Unfortunately there will be higher fees since you will be having a lot more surgery but it should be very rewarding to have the change. If your only medical conditions ore menopause and osteoporosis (which isn't too severe) then you should be a good candidate. The fact you were a smoker but quite over 4 months ago should not be a problem. Seek out a board certified plastic surgeon who has experience with this combined procedure. Ask to see photos of before and afters and ask to talk with other patients of your surgeon who have had the procedure. Some plastic surgeon will not do a beast lift and a breast augmentation at the same time. I find that in the right hands you should be able to have great result with few if any complications. That is why you need to seek out the plastic surgeon with experience and ask them the tough question. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 17 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.