Breast Implant Removal and Lift at the Same Time?

Question

Hello, I want to remove my breast implants, which I have had for 15 years. I know for sure that I do not want to replace them. I also want to get a full capsulectomy, and will more than likely need a lift as well. Is it safe to do all these procedures at once, or is it better to do two operations? I have read conflicting opinions about this, so I am just trying to figure out what is the best way. I am currently a 32G and before surgery was about a 32C. Thank you so much in advance!

Gary M. Horndeski, MD · Answer

If you were a 32 C before surgery and now a 32 G, the implants are approximately 400 cc, which is quite large.  You have not described whether the implants are in front or behind the muscle and this is significant.  I routinely remove implants and do a lift at the same time through a circumareola incision.  I never use the lollipop or boat anchor incisions.  You state that you want full capsulectomy but I do not know why.  It is not necessary to remove the capsule, unless you are having problems with the capsule.  Removing the capsule will remove volume and can lead to bleeding and complications.  You are a candidate for a new procedure called The Mini Ultimate Breast Lift.

	Best Wishes,

	Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

Your procedure could either be done in one or two stages and either approach is acceptable. The thing that would make the difference for me would be how far the nipple needs to be moved and how thick your breast tissue is. If you have thin skin and the nipple needs to be more than two inches, I would probably do it in stages to reduce the risk of losing circulation to the nipples.

Sean Younai, MD, FACS · Answer

Breast lift surgery at the time of breast implant removal and capsulectomy is performed routinely by me and many other plastic surgeons in Los Angeles. I have found it to be safe and effective, without need to undergo anesthesia twice!

John LoMonaco, MD, FACS · Answer

The most important issue is how much of a lift you need, and how much your tissues have been stretched by the implant over time.

	Patients with advanced stretching of the tissues and a lot of sagging, and those with large implants, often benefit froma lift done at a later stage.

Robert W. Kessler, MD, FACS · Answer

To answer your question definitively would require a consultation but generally speaking you can perform the implant removal, capsulectomy and lift at the same time. The limitations are based on the blood supply as you are approaching the breast from above and below. The degree of lift needed is going to dictate the safety of combining the procedures.
	Seek out a board certified plastic surgeon to evaluate you and outline the surgical plan which will help you achieve the results you desire.

	Good luck and I hope this was helpful.

Camille Cash, MD · Answer

Combining procedures is common and considered safe, but there is a limit.  The procedures you are considering to have done are often combined.  An examination by a board certified plastic surgeon is recommended to ensure that you are a good candidate to have them done at the same time.  If not, they can be broken into two stages.

Tom J. Pousti, MD · Answer

Thank you for the question.

	In person consultation will be necessary to provide you with precise advice. The main issue of concern is adequacy of blood flow given the extensive breast surgery planned. In my opinion, if the degree of breast lifting ( distance of movement of the nipple/areola complexes)  is significant, then you may be better off having the procedure performed in 2 stages. If the degree of breast lifting is relatively small (  shorter distance of movement of the nipple/areola complexes)  then it is likely that the procedure can be performed in one stage.

	 

	I hope this helps.

Curtis Wong, MD · Answer

is certainly a good concern but with a good game plan and appreciation of what was done on your breasts before, it should be safe to do everything you ask about. If your breasts are not that droopy, it certainly is an option to consider a mastopexy later. However, if you have advanced ptosis, a lift is required for a satisfactory outcome and a safe plan should be available for your situation. Please be patient with your results as it may take some time for the breasts to settle to what is a satisfactory outcome.

Milind K. Ambe, MD · Answer

Removing your implants (explantation) coupled with a capsulectomy and lift is a procedure I routinely perform in my practice. The main issue is adequate blood supply to the areola with a lift procedure. It also sounds like you might even need a small breast reduction unless your implant volume is high enough to get you from 32 C to 32G. Either way to fully address your concerns I would seek an appointment with a board certified plastic surgeon who performs this procedure on a routine basis. Good luck to you!

Samir Shureih, MD · Answer

With your preset size of 32G. Wanting removal of implant and capsulectomy. You probably will get a better result if you seperate the surgeries into two procedures. Removal of breast implant and capsulectomy. 3 months later can do the breast lift. Accurate positioning of the nipple areola and reshaping the breast will be more accurate.

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