Explant Before & After

Question

I have 525 cc silicone implants under the muscle. I am ready to have them removed and have gotten several consults. Every doctor I meet with says I will “not be happy with the results.” This is very discouraging for me because I’m not interested in aesthetics. I ask for pictures, drawings, or before/afters but they don’t have anything to show leaving me more confused. Does anyone have before/afters for someone who had 525 cc implants removed and went back to an A/B cup?

Alan Gonzalez, MD, FACS · Answer

Hi @Julieskis1310, thanks for your question. My opinion is that breast implant removal should be combined with immediate breast reconstruction to reposition the breast tissue and improve the projection of the upper pole and medial areas, in my case, using my BRALAN Technique (Breast Reconstruction Anatomical Lift Augmentation) as the results will be aesthetically adequate and have minimal scarring in the shape of an L. If you are considering breast explantation, consultation with a plastic surgeon experienced in this procedure is essential to ensure optimal results. best of luck! Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation of Adipose Therapeutics and Science (IFATS), Member of the Colombian Society of Plastic Surgery (SCCP).

Chet Mays, MD · Answer

Thank you for your inquiry!    Depending on how much breast tissue you started with and have remaining is the important to know.  Unfortunately, majority of patients that are having an explantation typically do not want to share their before and after photos.  But we would love to sit down with you and review your options.  Schedule a consultation with a Board-Certified Plastic Surgeon to discuss your goals.

David Rankin, MD · Answer

Results will depend on size of implants (which we know), how much breast tissue you have, current position of your nipple/areolas, and skin quality. Having a consultation with a board certified plastic surgeon who does a lot of explanting would be the best step. You can check my instagram at DavidRankinMD for some before and afters and I'm also happy to consult with you and give you my opinion.

Shaher W. Khan, MD · Answer

Hello, thank you for your question. It sounds like you are in a tough spot with your consults. It's understandable to feel discouraged, especially when you're seeking clarity and support. Please view the video that I have attached that explains your question in detail.

Gary M. Horndeski, MD · Answer

525 cc implants are very large and removing them will result in excess hanging skin. This will result in the breasts looking like raisins with corrugations. You are better off doing explantation and lift at the same time instead of explant and waiting to get a lift. The technique I recommend is 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.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

M. Mark Mofid, MD, FACS · Answer

Thank you for your question. I am curious if the other surgeons you have consulted with are suggesting that you won't be happy with your results because of volume loss or because they would not be including a Mastopexy (Breast Lift) with the explant. I almost always recommend performing a Mastopexy when I remove breast implants in order to tighten up the excess skin left behind and reposition the nipples. The size implants that you have will most definitely require a breast lift to get you to a nicely shaped A/B cup that you desire.

Connie Hiers, MD, FACS · Answer

Do remember three things. First, these large implants have stretched and thinned your own breast tissue. Once removed, you will be smaller. Second, these large implants have stretched your skin and once removed, you will sag. Third, you were not happy with your breasts prior to surgery and may not be happy once removed. I would suggest going down to a more reasonable size and have your pockets internally tightened. You may find you are very happy with your breasts. You can always just have them removed and go back to implants if later desire. You might also be a candidate for minimally invasive plasma energy skin tightening, Renuvion, when the implants are removed. You may or may not be able to have a lift. If your own breast tissue is thin near your nipples, then it will not be safe to have a standard lift.

Camille Cash, MD · Answer

There are some factors that will influence how your breasts will appear after implant removal including how long the implants were in place and your skin elasticity.  The skin will retract to some degree after explant but it's difficult to say to what degree without more information.  Due to the implant size you will likely have loose hanging skin.  You can certainly elect to have the implants removed and allow the breasts to heal.  If after six months you are unhappy you can return for a lift.

Mats Hagstrom, MD (license on probation) · Answer

If you have a or B cup breasts with 525 mL implants, then the great majority of breast volume is implant.
The aesthetic appearance after implant removal on the number of variables.
Part of this is how long you’ve had the implants.
Having implants for a long period of time, especially if the implants were large Indentation of the ribs.
It’s not uncommon for patient to not follow up after explantation because they’re basically done with the process.
For that reason, we often don’t get before and after pictures.
There are so many variables that affect what the aesthetic outcome can look like, including your current breast shape, the shape of your rib cage, if you have breast toes, any development of capsular, contraction, etc., et etIt’s pretty important for patients who have any degree of significant capsular contraction to have the capsules removed with the implants.
If the capsules are very soft and thin, then it’s unlikely that leaving the capsules is going to cause distortion of the breast after explantation.
The one thing you don’t want to do is change your mind after explantation then go back and want to re-augmentation.
This is why plastic surgeons really want patients to know what they are signing up for when they ask for their implants to be removed.
I searched on this website and found 4200 before and after pictures i’ve breast implant explantation.
Some of these pictures are meant to promote the practice so they probably don’t include examples of many patients who were left with poor Aesthetic outcomes.
Some of these pictures also include a breast lift with the implant removal.
Still, some of the pictures may be representative to what you currently look like to give you some idea of what you could expect.
You should not expect your breast to look like they did before augmentation.
Having implants tends to stretch tissues, and the aging process can also have some impact.
Best,
Mats Hagstrom MD

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