Breast revision or removal and lift? (Photo)

Question

I got my implants in 2004. Lately I have been thinking that I would probably look better if I remove them. The reason behind this thought is mainly due to the fact that I have gained weight over the last 16 years (about 20lbs). Second, my nipples have dropped and I don't like the way they look. I have 470cc and I'm 5.5. Q: Would half of the current size be too small to where I'll be better off by removing the current implants and doing a lift? Please provide me with your sincere feedback. TY!

Stephanie Beidler Teotia, MD · Answer

Thank you for your question and submitting your photo. From what you describe, and the size of your implants, I think a Mastopexy and a breast lift may give you what you need. Unfortunately, it is hard to say without an exam. We would need to assess the amount of breast tissue you have and then base the outcome on whether or not you would also need a smaller implant. Depending on what kind of look you are trying to obtain will help us decide if a  smaller implant is recommended. I hope this helps. I wish you the best of luck.Sincerely,Stephanie Teotia, MD

Donald R. Revis Jr, MD · Answer

Good morning!I think a donut mastopexy with downsizing your implants by half would look better than a complete explant, because a complete explant is going to be a massive change to the shape and fullness of your breasts.

Kenneth Hughes, MD · Answer

The smaller the implant and the less the amount of time it has been since placement, the greater the chance the breasts will return to their preoperative state. It is very difficult to predict breast size following explant b/c breast implants and weight fluctuations over time tend to thin tissues, cause a decrease in size, and create more droop.  
Usually removing them and performing the lift at the same time makes the most sense as some patients clearly need a lift and only want to go through one surgery.  If you are borderline, it is not unreasonable to remove the implants and then observe a waiting period of six months before the determination for breast lift is made. This will give your breasts time to bounce back and your PS time to determine what type of lift, if any, or a breast fat transfer is necessary for you to reach your goals.

Andrea Marando, MD · Answer

Thank you for your question and photo. A mastopexy / breast lift would definitely improve your shape. Depending on the amount of breast tissue you currently have and the volume you wish to maintain, you might want to consider a change of implants or removal - both combined with breast reshaping / lift. Best way forward is to have an open discussion with your plastic surgeon of choice, explain your wishes and expectations and I am sure you will be guided in your choice correctly.All the bestAndrea MarandoPlastic and Cosmetic Surgeon, Manchester and London, UK

Gary M. Horndeski, MD · Answer

You would benefit from explantation and lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery.  Later, fat transfers can be performed if additional volume is desired.Best Wishes,Gary Horndeski, M.D.

Farbod Esmailian, MD · Answer

Judging by your photos you would benefit from a lift.  As far as removal vs replacing and going smaller, this is difficult to say without and exam.  We would have to assess how much breast tissue you have and determine how much smaller you would be.  The resulting size may or may not be acceptable to you without and implant.  You would however have a huge improvement with a lift alone and perhaps downsizing as the implants appear to be too big for your body.Hope that helps.

Finny George, MD · Answer

Hi, thank you for sharing your question. 
Removal of the implants with a lift, will likely leave you with significant volume loss without the projection you may desire. You are a great 
candidate for revision of your breast augmentation with a lift to reposition the nipples to their youthful position. The specific implant size and shape should be 
determined together with your plastic surgeon after a formal evaluation 
of your breast tissues. 
Consult with a board certified plastic surgeon to review your options. I hope this helps. Best of luck!

Daniel Barrett, MD · Answer

Dear rrollins,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for sharing your question.  I see your concern and agree that at a minimum a lift will be required to achieve the best aesthetic result.  Whether you wish to maintain your implants, or have them removed, will depend on what look you are most interested in - removal would lead to a loss of overall volume and upper breast fullness. Hope this helps.

Milind K. Ambe, MD · Answer

If you have enough of your own breast tissue to get you the desired bra cup size then I would recommend an explanation with a lift.  It appears to be that no implant would be needed but it is difficult to say without an in person exam.  Best of luck to you.

Breast revision or removal and lift? (Photo)

Answers (13)

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