Look Normal After Breast Implant Removal?

Can I look normal after removing large breast implants and how much is the cost? I had breast augmentation in 2005 and the 450cc implants were place over the muscle so now I have lots of sagging. I want them removed but one doctor said this would be very difficult and he hadn't done one this bad but 2 or 3 times. Now I'm scared that I will never look normal. I need some advice and what kind of price I would be looking at? Thanks!

Doctor Answers 21

You can have a normal natural look after removing breast implants

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Explantation or removal of breast implants often leaves stretched out tissues. Traditionally, a breast lift or mastopexy is done to reshape the breast and take out extra skin. How much surgery is needed is very individual and depends on the size of the implants, the shape of your body, the condition of your skin.

I have found that some women do remarkably well with implant removal without an immediate lift procedure. A patient encouraged me to do just this as she wanted the least surgery possible. Remarkably, although the breasts looked extremely unattractive initially postoperatively, within 2 weeks, the skin had contracted and the breasts looked fine.

I now explain to patients that we can take out the implants and do an immediate lift, or we can take out the implants and wait and see what happens. If the skin does not tighten enough over time, a lift can be done as a secondary procedure. With this approach, even if a second procedure is needed, the skin removal will be smaller and the incisions shorter than if the lift were done at the time of implant removal. And so far, I have not had to do a secondary procedure. Everything has come back to shape when the pressure of the implants has been removed.

Bay Area Plastic Surgeon
4.8 out of 5 stars 56 reviews

Removing breast implants and having a lift

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Removing breast implants in an already droopy breast will give a very saggy deflated breast unless a lift is performed. It is the very rare patient who would be happy with the appearance.

If the previous implants were in the over the muscle position, circilation to the nipple will unfortunately be lower and the lift more risky.

However an experiened surgeon can perform a safe but effective surgery without undue risk to the nipple. Remember, the more aggressive the lift, the more the nipple circulation will be compromised.

I agree that trying to fix droopiness with an over the muscle is not an ideal move.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Appearance after breast implant removal a tough problem

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A 450cc implant is not necessarily large. It really depends on the size of the patient and the amount of skin their breasts have. I agree with others that it sounds like you may have had significant sagging before your first surgery-hence the larger implant and positioning on top of the muscle. Old school thinking was that the placement above the muscle helped lift the breast more than under the muscle. More recent thinking is that when properly performed, sub muscular placement will give about as good a lift. Women with sagging breasts have skin that tends to stretch too easily and trying to correct this with larger implants on top of the muscle tends to what is called the "rock in the sock" appearance sometime down the road.

Combining implant surgery and breast lifting has always been one of the most challenging procedures for plastic surgeons. I tell my patients that while I shoot for a single operation correction they need to plan mentally and financially for at least two operations. Next, they need to decide whether they want to change their implant size or simply get rid of the implant all together.  

I refuse to do any sort of breast lift in a patient who is actively smoking and I stage the implant surgery and lift surgery in all patients with a significant smoking history. These people are high risk for wound breakdown, implant infection and nipple slough. I am also very cautious in re operations on patients in whom I did not do the first operation. In these patients I never know what the first surgeon did that may compromise my operation and I've found the operative reports of other surgeons to be unreliable. There is no substitute for having been there the first time.

It is possible to correct the situation described above but not without risk and possibly additional scarring. Do your homework first and prepare yourself for additional scars, substantial expense over what your original surgery cost and the need for revisionary work.

Barry Stuart Handler, MD
San Diego Plastic Surgeon

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Breast implant removal

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It is difficult to predict what the breasts will finally look like after the implants are removed. It depends a lot on how much breast tissue you started with and how large the implants were in relation to the native breast tissue volume that you had. More than likely, you would need a lift of some sort but this may be better put off until the tissue retracts after the implants are removed.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breasts change with implants so not the same after removal

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Large implants above the muscle can be particularly problematic in terms of the way they affect the breasts. The weight of the implants without any support other than the skin leads to stretching and so when the implants are removed the look can be quite a bit different. It is usually a better idea to replace with smaller implants and go under the muscle, and perhaps a breast lift to deal with the extra skin.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

You can look normal after removal of breast implants

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Most who elect breast augmentation will wear implants throughout their lives, and if done for the right reasons most could not imagine being without breast implants. There are a very few who have beast augmentation and wish to go back to what they once were. A prime cause is having breast implants for someone other than yourself. Once you have decided that the implants are not you it is possible that the skin envelop has been stretched, or the breast tissue thinned over the surface of the implant.

A breast lift or mastopexy at the time of implant removal may be a good solution to the loose skin or low nipple position. I have learned however that it often pays to remove the implants and be patient and allow the skin to recover and the breast to 'shape' itself without the influence of the implant. This will often eliminate the need for a breast lift and additional scars. The simple removal of breast implants is not difficult, and need not be expensive.

Best of luck.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Removing implants will lead to sagging appearance

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Unfortunately you had the implants placed above the muscle so this often causes more skin stretch. When the implants are removed you will probably have sagging breasts and require a lift. If you have fully committed to having the implants removed then you can discuss with your surgeon ways that the corrective surgery can be done. One option I offer patients with saline implants is to deflate the implants several weeks before the surgery so we can see what the remaining breast looks like. This way the patient can get an idea of what the appearance will be like with just removing the implants.

Best Wishes

Dr. Peterson

Marcus L. Peterson, MD
Saint George Plastic Surgeon

Breast implant removal and sagging (ptosis)

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We know that a traditional breast reductionwill result in some correction of the sagging. In many instances, I have removed implants and allowed time the breast to shrink down to a stable size and shape (typically 6 months). At this point I have often found that the breast lift I performis less agressive than one I would have performed at the same time as implant removal. Patients are sometimes surprised and satisfied with the appearance of the breast without pursuing any additional surgery.

An experienced plastic surgeon can provide you with advice and guidance.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast lift for sagging

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Unfortunately, your breasts will probably be sagging since they are already with the implants. Removing the implants will make it worse. To correct this, a lift may be performed at the same time as removal.

Surgery Designed for an Experienced Surgeon

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While it is a tricky surgery and you should do with an experienced surgeon, it is possible to address the sagginess with a breast lift.  You may want to also consider a smaller implant under muscle as well.

The price of breast implant removal like most procedures vary significantly among regions and even within the same area. We currently charge starting at $1500 - $2000 + MD Anesthesia for breast implant removal alone.

To ensure quality work at most cost effective prices, consult with board certified plastic surgeons that own their own nationally accredited facilities. These surgeons must maintain the highest standards to keep accreditation. Moreover, the surgeons are motivated to ensure quality and properly trained staff (to minimize time and frustration in surgery), private and comfortable facilities (to ensure continued referrals), and less waste (to ensure that they can remain competitive financially with other centers).

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 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.