Breast Implant Removal after Breast Reconstruction with Fat Grafting?

Question

I am planning to remove my breast implants after previous mastectomy and reconstruction done in 2014. I plan to do fat grafting only and perhaps a lift. I do not want any sort of flap. My nipples healed beautifully with full feeling and I want to keep it that way. I am at my proper weight but do have enough fat for this. Can beautiful results be achieved? I am looking for a surgeon near DC that specializes in this surgery.

Alan Gonzalez, MD, FACS · Answer

Hello @whycellulite, thank you for your question. In my opinion when there is an implant removal it is always necessary to adequately remove the capsule and reconstruct the tissue. In my opinion the fat transfer or fat implant should be given in a later process with a prudent time of 2 to 3 months to ensure the fixation of this to the tissues and minimize the possibility of infection or that the fat dies. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD, FACS .

Raffy Karamanoukian, MD, FACS · Answer

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Stanley Okoro, MD · Answer

Thanks for your question. Make sure you consult with a board certified plastic surgeon in your area, as they can pinch and feel for excess subcutaneous fat to transfer. If you truly do no have the fat,  you can consider injecting Sculptra or Reunva to add volume. Good luck!

Wess Cohen, MD · Answer

Thank you for your question. Beautiful results can be achieved with fat grafting after a mastectomy and revision reconstruction. You should be aware that multiple rounds of fat graft will likely be needed. One technique that I employee in my practice is to serially downsize the implant while fat grafting. This allows a more predictable result with the implant maintaining the breast shape. Additionally, if you want to use your own tissue and do not want an implant your other options may be a DIEP flap or a PAP flap. Good luck.

Daniel Barrett, MD · Answer

Dear whycellulite,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You did not show photos, so I recommend meeting with a board certified plastic surgeon in your area and discussing your options.

Breast Implant Removal after Breast Reconstruction with Fat Grafting?

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