Want to remove 9 year old Perthese implants and replace with fat transfer for B cup - Options? (photos)

Good morning,
I would complete the capsulectomy/explant first, place a drain on each side for five days, and have you wear a nice tight compression bra for 12 weeks- do any necessary reconstruction after pregnancy and breastfeeding because there are likely to be changes during this period of time.

Thank you for your question and photos! We regularly remove breast implants with en bloc capsulectomy, transfer fat and lift breasts at the same time as well as individually. Your expectations and health will dictate the best procedure(s) for you. I suggest a consultation with a board certified plastic surgeon to examine the areas you would like addressed and go over the options that best fit your goals.
Best of luck!

Dhaval Patel MD
Double Board Certified Plastic Surgeon

Chicago
South Barrington
Oakbrook
Orland Park

Hello,
And thank you for the question and the photos.
Following removal of breast implants without replacement, a patient may choose one of two options: do nothing and see how much the skin retracts and then decide about fat grafting or breast lift at a later point, or undergo a breast lift and fat grafting at the same time.
Since you had small cup size breasts prior to undergoing breast augmentation, the breast volume and size will be similar after removing the breast implants.
Sometimes al mastopexy (breast lift) is needed which will put your nipples into the correct position, make the areola smaller and allow excess skin to be taken away, giving you a more youthful and lifted breast appearance. But it's difficult to tell without in person examination. Some people are a little apprehensive to the full breast lift due to the scars (lollipop or anchor), but typically they do very well and scars fade over time. Fat grafting can also add additional volume to the breasts, sometimes more than one session is necessary.
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast surgeries to further discussyour options, concerns and expectations. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.
I hope this helps.
Best, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

The technique I recommend is explantation and mini lift. Using a circumareola incision, the implants are removed, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

The breast implant removal and breast fat grafting can be completed during the same surgery. Some of the success will depend upon existing tissue available for receiving the fat. The fat grafting will likely take several sessions to produce a similar result. I usually perform the explant first. The fat grafting I typically perform about 3 months later. This gives the patient and the PS time to assess the chance of the breast returning to the preoperative state.

Dear Gb210704,
it is hard to tell for sure without an examination. It is probably better to wait until you are done with pregnancies and then get a surgery to correct your breasts. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You need an examination to see how much actual breast tissue is present. If you have very little, then a fat transfer may not work. You could consider exchanging your implants to a better cohesive gel implant and going smaller.

I encourage you to visit with a board certified plastic surgeon for a consultation. Your photos indicate you may have capsular contracture. In that case removing the capsule as well as the implant is indicated. If you do not have much natural breast tissue you will likely need a lift. You can have the implants removed now and either wait on the lift or move forward with it now depending on when you are intending to have children.