The likelihood of sagging after breast implant removal (explantation) depends on several factors: Implant Size and Duration: Larger implants and long-term use tend to cause more stretching of the skin, which can lead to sagging once the implants are removed. Skin Elasticity, Age, and Genetics: If your skin is elastic, it may retract more after implant removal, helping your breasts return to their natural shape. In contrast, less elastic skin can result in more sagging. As you age, skin and breast tissue naturally lose elasticity, increasing the chance of sagging. Breast Tissue and Volume: If you have a smaller amount of natural breast tissue or if the implants replaced a lot of your natural tissue, the loss of volume after explantation may cause the breasts to appear deflated or sag. Other Factors: Previous pregnancies, breastfeeding, weight fluctuations, and the position of your nipples before implantation can all influence the outcome. Some women may opt for a breast lift (mastopexy) during explant surgery to reshape and tighten the skin for a firmer, more youthful appearance. Others may use fat transfer or simply let time pass to see how the skin naturally contracts. Each individual response to explantation can vary significantly. It is important to consult with an experienced plastic surgeon who can customize your surgical plan and determine the best technique for you based on your individual anatomy and goals. Dr. Krishna Vyas, MD, PhD, MHS Harvard, Johns Hopkins, & Mayo Clinic Educated Double Fellowship Trained Aesthetic Plastic Surgeon New York, New York