400cc, textured explanted in 2019 & fat transfer 2021 - is it safe to reimplant & would I need a lift?

Thank you for your question and the photos. Provided that your internist feels like your white count is sufficient for surgery, you should be fine to have implants placed. I like the Sientra HSC+ Low Plus profile in this case if your desire is to mainly have some upper pole, but not be a whole lot bigger. You'd be amazed what a small volume implant 225-255 with this profile can do. Best of Luck!

A modestly sized implant would give you the desired fullness. You would not need a lift since your areolar is above the inframammary fold.

Only safe if your doctors feel you are stable for surgery and they are supportive of this surgery for you. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Putting implants back in may cause problems again. You may benefit from a mini lift. Using a circumareola incision, 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.

Best Wishes,

Gary Horndeski, M.D.

Great to hear your are better now! Believe it is safe to re implant. I also believe small implants with a small lift is a great idea. Maybe even a small lift around the areola only!

Best of luck,
Dr. Miguel Mota

It's difficult to assess ptosis because your arms may be raised in these photos. As for re-implantation, it is safe. Although your white cell abnormality is real, it is/was not from breast implants. Feel confident that an appropriate sized implant a that is round and smooth will give your confidence back about your breast appearance. I recommend implant placement in the subpectoral position via an inframammary incision to minimize the risk of capsular contracture.

You might consider a second round of fat transfer. Although unlikely there’s no way to know if your neutropenia was related to implants I would advise against putting implants in

You could try a small smooth saline implant behind the muscle to help give more upper breast fullness. Smooth saline implants are lot easier to remove if needed.

Dear Caligirl,
The elephant in the room here is why did you have your breast implants removed? Was it for the recall? Concerns about bia-alcl? BII? We also don't know your age, child bearing status, medical diagnosis. So, safety of reimplantation is difficult to determine. Discussions with your PMD, oncologist (presume you have one for the neutropenia) and plastic surgeon are definitely in order if you are considering a breast implant augmentation. You remain a great candidate physically, without the need for a lift. Good luck!

There really is no clear-cut answer, linking systemic illnesses with breast implants. That being said having a textured implant does show an increased risk for ALCL and possibly BII. A smooth round, gummy, bear implant would be an option for you, knowing that if you have symptomatology recur, the implant would have to be removed. Lastly, multiple rounds of fat transfer could improve your breast, fullness enough that you would be happy without an implant.