32 year old mother of 2 planning to explant. Not getting any support from loved ones and am terrified (Photo)

Question

My PS said that my pockets expanded from lifting weights and that my implant is rubbing against an exposed nerve causing me a lot of pain. I want them gone but almost everyone in my life is totally unsupportive. I'm terrified because I have ZERO breast tissue left so I'm so worried I will just be all loose skin

Christian Subbio, MD · Answer

I'm sorry to hear that your loved ones are not being supportive.  This is your decision and your decision only so if they don't like that, then to bed.  Whether or not you will be happy with the explant result really depends upon your particular case, your breast tissue, the size of the implants, etc.  It can only be determined with a long and thoughtful consultation with a plastic surgeonBest of luck!
Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Jed H. Horowitz, MD, FACS · Answer

hello ashleyfelice Sorry about what you are going through,You may not be satisfied with the appearance of your breasts. Incorrect implant size, inappropriate scar location or appearance, and misplacement of implants may interfere with a satisfactory appearance. Asymmetry (unequal breast size or shape) may occur. The implanted breast may sag or droop (ptosis) over time, much like a natural breast. The explanted breast may droop or be distorted in shape. #options #pre-op

Farbod Esmailian, MD · Answer

It is unfortunate that you are not getting the support that you are looking for.  Ultimately it really comes down to what you want and how you feel.  The friends and family will eventually come around and support you.Difficult to say how much if any loose skin you would have.  It depends on the quality of your skin, how big the implants are and how long you have had the implants for.I would recommend being evaluated by a board certified plastic surgeon that has experience in breast revision surgery.Hope that helps.

Anita Patel, MD, FACS · Answer

I'm sorry to hear you aren't getting support from loved ones, and would say just do what is best for you, since it is your body. Without seeing you in person for a consultation, and getting a complete history and exam, it is really hard to comment on the pain issue. I'm not sure what type of pain you are having, or the source of the pain, or if implant removal would relieve the pain. If you have minimal breast tissue, then yes you may be left with loose skin and minimal volume after explantation. If this is necessary to deal with the pain that is one thing. Based on the photo, your implants appear to be too narrow for your breast width, or sitting too far out to the sides from an expanded pocket, or both. Lifting weights can contribute to lateral displacement of the implants (moving out to the sides), but this can be addressed with a couple of maneuvers. First, I would make sure the implant size is appropriate for your breast diameter (not too narrow or too wide). Second, you would likely benefit from closing your breast pocket from the sides, otherwise known as a lateral capsulorraphy. This will prevent your implants from moving so far out to the sides. Whether or not keeping implants and making these adjustments would relieve your pain is unknown. I would recommend having an in person consultation to go over your options in detail and determining what is best for you. I think your fear is understandable, and hopefully learning the pros and cons of all of your options will lessen this fear.

Urmen Desai, MD, MPH, FACS · Answer

I think addressing your pain is a priority.   I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified Beverly Hills Plastic Surgeon

Daniel Barrett, MD · Answer

Dear ashleyfelice,it is hard to predict the shape and size of your breasts after breast implant removal. I would suggest you to consult a board-certified plastic surgeon. You will get the best information after a thorough examination.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Camille Cash, MD · Answer

I'm sorry that you are having issues and that you do not have support from your family and friends.  You must do what is right for you in order to address the pain you are experiencing.  You can choose to have the implants removed, see how your breasts appear after they are healed, and then decide if further action is needed.

Eric Desman, MD · Answer

I am sorry you are having trouble with the pain. Your explantation surgery should address that problem. It looks like you should do well with respect to your tissues healing after surgery and you likely won't have loose skin problems. It may take a few moths for everything to settle down though, so just be patient and keep communicating with your Board Certified Plastic Surgeon.

Lisa Cassileth, MD, FACS · Answer

You have a lot going for you if you remove your implants. The easiest removal is the “bottomed out” implant (like yours), because it stretches out the lower pole of the breast. The nipple is high, the implant low. This is means you can return that skin to the abdomen, instead of having it on the breast, ie no sag. Please PLEASE repair the muscle on explant, I am so sick of redoing bad explanations where nothing was done with the muscle or capsule and the patient has a pec muscle movement deformity and is hollowed out in the middle. Your whole inframmary crease will need to move back up to whence it came... super fun and easy. And your abdomen will get a little longer too... bonus!

Tom J. Pousti, MD · Answer

I'm sorry to hear about the problems (both physical and psychosocially) you are experiencing.
Generally speaking, 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.
 Patience is definitely indicated after removal of breast implants; it will take many months/year for the skin to “bounce back” and for you to see the final appearance of the breasts.
 
 I hope this helps. Best wishes.

32 year old mother of 2 planning to explant. Not getting any support from loved ones and am terrified (Photo)

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