Will my breast look worse than before after explant? (Photos)

Question

I am considering having an explant of my implants. Personally speaking, I do not think they suit my lifestyle anymore - I'm more active and fit, so I find that these implants are starting to feel uncomfortable. I have had 255c Mentor implants placed under the muscle and have had them for 2-3 years already. I'm currently 23 years old and am quite worried about how they will look. I didn't have much tissue to begin with but I have gained 5kgs since and have started to fill up around my body.

Payman Danielpour, MD, FACS · Answer

In my opinion and with my previous experience removing a lot of implants, I think that after 6-12 months you will have a nice result.  it will take time for your skin to retract and you will have small and cute breasts.  I wouldnt worry!

Finny George, MD · Answer

Hi, thank you for your question.Typically, removal of implants without any additional procedures will likely result in deflated and sometimes droopy breasts. Your skin has had 3 years to conform to the increased volume from your implants, by removing them now, you may have some excess skin that may sag. There are options to fill that volume or avoid sagging, but this should be discussed with your board certified plastic surgeon. I hope this helps. Best of luck!

Sugitha Seneviratne, MBBS, FRACS (Plas), FACCS · Answer

Hi,
Thank you for your question and images. Your breasts prior to augmentation have a nice shape so implant removal alone is likely to result in a good outcome but with some potential loss of volume due to the effect of the implants on your breast tissue and a degree of skin stretch. These changes can improve over a few months. You will be a good candidate for fat grafting to the upper poles and cleavage given your recent weight gain to achieve the aesthetic of augmentation without the use of implants. This has been a very effective technique for my patients. Hope this is helpful and best wishes.

Gary M. Horndeski, MD · Answer

I recommend explantation using a modified Benelli approach.  Using a circumareola incision, the implants are removed, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage.  Through the same incision, fat transfers can be placed, if additional volume is desired.  Best Wishes,Gary Horndeski, M.D.

Donovan Rosas, MD · Answer

The downsides of removal are primarily aesthetic.
It is difficult to make 100% accurate predictions following explant. There are a number of factors to consider including age (the breast changes over time irregardless of augmentation), weight change, skin stretch and residual elasticity.
Following removal, one can expect:
-Loss of volume- Not an exact correlation between pre- and post augmentation due to the changes over time. You may be bigger or smaller than you remember.
-Ptosis/sagging-Ptosis develops over time and may be worsened by the presence of an implant. If a patient has pre-explant sagging, removal is likely to worsen this to a certain extent. If there is no ptosis, it does not necessarily mean there will be no ptosis after removal.
-Skin laxity/stretch- There is inherent skin elasticity which will allow for some measure of snap back. However, the greater the volume differential pre- and post- the more likely there will be excess skin.
In my experience, it is usually a safe assumption that there will be some changes post removal which oftentimes may necessitate further operative intervention (i.e. lift), however this is often a function of size and length of time post op. Small implants which have only been in place for a short period will lead to an improved response/recoil post removal. Whereas larger implants which have been in for several years will often necessitate a lift.With regards to your specific question, smaller implants which have only been in for a short time in a younger individual are the least likely to need further surgery. You might consider staging (removal first, followed by delay to assess the need for anything further).
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Verified Member
RealSelf Top 100
RealSelf Hall of Fame

Kenneth Hughes, MD · Answer

The smaller the implant and the less the amount of time it has been since placement, the greater the chance the breasts will return to their preoperative state. It is very difficult to predict breast size following explant b/c breast implants and weight fluctuations over time tend to thin tissues, cause a decrease in size, and create more droop.  Usually removing them and performing the lift at the same time makes the most sense as some patients clearly need a lift and only want to go through one surgery.  If you are borderline, it is not unreasonable to remove the implants and then observe a waiting period of six months before the determination for breast lift is made. This will give your breasts time to bounce back and your PS time to determine what type of lift, if any, is needed.

Christine Rodgers, MD · Answer

HI,  It really is impossible to say, but if I had to bet, I would say that your breast should return to the way that they looked before. You have gained some weight, so they may droop a bit more, but the implants have not been in too long and your skin tone looks good.  Therefore, I do not think that you will have a tremendous amount of sag.Good luck,Dr. Christine Rodgers

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  No way to be certain but based on your age, and size of implants, you should largely return to your pre-surgery breast appearance. Hope this helps.

Daniel Barrett, MD · Answer

Dear anonymous172,
it is hard to predict how will your breasts look after removal of implants. There is a chance that they will be the same as they were prior to breast augmentation. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kamran Khoobehi, MD · Answer

Your before pictures show that you would have been great candidate for fat grafting. I would recommend implant removal and fat grafting. Please see the link. This patient had saline implants that I deflated and then did fat grafting. After picture are 9 months post one session of fat grafting

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