Will I need a lift with implant exchange? Can I pull it off without a lift ? (photos)

currently have 300cc silicone implants above the muscle with a capsular contracture on my right breast. should I get a breast lift when getting a capsulectomy and exchange. Should I go subglandular again or subpectoral? A plastic surgeon I consulted with advised me to go under the muscle and not to do a breast lift. Should I go with round smooth or textured? Can I go bigger without a lift ? I would like a natural full look.

Doctor Answers 12

Will I need a lift with implant exchange? Can I pull it off without a lift

Thank you for submitting your question. It appears that you have capsular contractures and your implants and capsule should be removed and replaced in a new plane (preferably submuscular).   I would recommend a breast lift to improve the aesthetic result.  Textured implants has  a desecrated risk of recurrent contracture and would be a good option.  When your ready, make an appointment with a Board Certified Plastic surgeon. Best Wishes.

Will I need a lift with implant exchange? Can I pull it off without a lift ?

Thank you for your question and photos.
You will need to have your implants exchanged and placed under the muscle to minimize a repeat CC. I do not recommend larger implants. Remember, implants are heavy and become more unstable the larger they become regardless of where they are placed. You may need a lift, but you can minimize your chances of a lift if your surgeon can deflate the implants (if saline) a few weeks before your planned implant exchange. Deflating them prior to your revision and wearing a tight sports bra can help the skin contract a bit. I hope this helps.
Best wishes and kind regards,

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.7 out of 5 stars 209 reviews

Lift

You have very thin breast tissue and you have already suffered capsular contracture.  For these reasons I would recommend a subpectoral position.  Since your areola have widened and are ptotic, I would also recommend a lift for the best result. 

Treating a capsular contracture

Thank you for your question and photos.  You appear to have significant capsular contracture on both sides, as well as stretched, thin skin.  If you were in my office, I would recommend the following:

1.  Removal of both implants and capsulectomies (removal of scar tissue around the implants)
2. Placement of new implant (saline or silicone, your choice, also size of your choice) UNDER the muscle (lower risk of recurrent contracture)
3.  Breast lift--you're going to have more loose skin than you think when those implants are removed.
4. Placement of Surgimend (acellular dermal matrix) to help reduce the risk of recurrent capsular contracture.

I've included a link to a page with a lot of my before/after photos related to breast implant revision surgery.  I think you might find it helpful.

Best wishes,
Dr. Kavali

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 39 reviews

How to fix capsular contracture

Hello and thank you for your question.  You should go to a board certified plastic surgeon with expertise in aesthetic breast surgery.  Your situation is more complex than most people are willing to admit.  You will need a capsulectomy, new implants, and they should be placed under the muscle --> you have already had a capsular contracture and you should do everything you can to minimize it from happening again by going at least partially under the muscle.  You will most likely need a lift because when your capsule is removed, this hard scar holding your breast tight will leave you with really loose skin, especially when you go under the muscle. An implant cannot give you a therapeutic lift, even when you go bigger.  Do the right thing and go to someone who will not cut corners because you need to get this done right.

Sean Kelishadi, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 22 reviews

Capsular contracture

You have a difficult problem and I am afraid you are at risk for another capsular contracture if you have the new implants placed above the muscle. Your new implants need to be below the fascia or the muscle and adding a lift adds another layer of complexity. It is best that you get advice only after a full consultation, good luck!

Mark Deutsch, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 28 reviews

Breast surgery options.

You would really benefit from an in person consultation with an experienced board certified plastic surgeon.  You have many options and choices to consider.  Much of it depends on what size and look you will be happy with.  Its great that you are doing your research ahead of time, but I really think you need to discuss the pro's and con's of each option with a surgeon.  Good luck.

Dean Fardo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 11 reviews

New implants and lift

It would be difficult in my opinion, to do a capsulectomy and move the implants to the sub muscular position and then do a lift at the same time. The blood supply would be an issue. From the photos, it would appear the lift is necessary. If you're going to change position of the implant and leave it in the subcutaneous pocket after the capsulectomy, then I would recommend a highly textured silicone gel implant like an Allergan Natrell.Ask  your chosen plastic surgeon for their advice and the reasons behind the choices. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 43 reviews

Will I need a lift with implant exchange? Can I pull it off without a lift ?

In your presented case ONLY in person evaluation would allow that determination to be made.....................

Breast lift?

I would definitely consider a "site change" to the subpectoral plane to decrease the chance of another capsular contracture. The question of doing a lift or not would depend on the size and style of implant you choose. I would likely recommend a textured implant as well.
Best of luck

Asaf Yalif, MD
Roswell Plastic Surgeon
5.0 out of 5 stars 6 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.