Would it be possible to remove under local anesthesia without a lift and still look semi-decent? (photos)

I am 26 years old. I got 420cc saline implants in december of 2010.I went from 36A/34B to 36C/34D.I currently breastfeed my baby and size varties 36D to 36DD. I want to explant without a lift as I plan to breastfeed with future babies and do not want to injure my breast tissue/nipple/ducts with a lift. What are the chances of my breasts looking semi-decent without a lift, considering I am going to be 27 when explanting? I am okey with them being on the saggier side. Does tissue fluff a little over time?

Doctor Answers 7

Implant removal

Based on your photos, I would have to say that your breasts will not look very good with the implants out. As it stands right now, with the implants in place, you would benefit from a mastopexy. Breasts do not "fluff' and if anything sags more over the course of a persons life due to the changing composition of the tissues that make up the breast.

Having said that, if you are ok with sagging, removal under local anesthesia is possible. Removal without removing the capsule puts you at an increased risk for fluid pocket formation after the implants are removed.

Newnan Plastic Surgeon
5.0 out of 5 stars 10 reviews


Breast tissue does not "fluff" over time. However, breasts can become fuller naturally with hormonal changes and weight gain. You could consider even exchanging your implants for smaller ones. Without an examination, I cannot tell how much natural breast tissue is present, but I suspect most of your volume is from the implants. I would suggest meeting with a board certified plastic surgeon and discussing all your options.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews


Congratulations on your new baby! 

In all likelihood removal under local anesthesia would be possible.  An in-person exam and consultation would be needed to be sure you are a good candidate.  From your pictures I cannot tell where your placement incision is located, but while you are breastfeeding, I would recommend removal via an inframammary incision. If you had placement via a peri-areolar incision and do not wish for inframammary, it would be better to deflate first and finish breast feeding before attempting removal.

Following removal your breasts will be saggier and a bit deflated.  They will have some bounce back, especially as you are breast feeding.  Once you stop breast feeding they will shrink quite a bit.  At that point you can consider options for lift or augmentation.

Always ensure you are being treated by a surgeon certified by the ABPS.  

All the best to you.

Sara R. Dickie, MD
Buffalo Grove Plastic Surgeon

Implant removal

Thank you for your question. Women chose to have their implants removed for a variety of reasons and situations. I would imagine that you will have a fair amount of tissue excess and that the nipple position will be quite low with simple implant removal. You seem to be petite and 420cc is a relatively large implant. You might consider just having them purposely ruptured w/ a needle in your plastic surgeon's office. The saline will just get absorbed. You can then see how you look, and that may help you determine what additional steps you may or may not want to take. Hope that helps.

Paul J. Leahy, MD
Leawood Plastic Surgeon
5.0 out of 5 stars 6 reviews

Breast implant removal

Based on your photos and your story I think you are a great candidate for implant removal. Whether or not it can be done under local really can't be predicted with just a photo. You would need a physical exam for that. You may also want to consider having them deflated in an office setting so you can see what you will look like. You don't even HAVE TO remove the deflated implants.  Based on your pictures your breasts should look very natural without implants. They will definitely be a little saggy but i don't think they will look deformed. In most cases the breasts do "fluff up" after deflation or removal. They look kind of "caved in"at first but usually look much better as early as a few weeks later. 

Mary Gingrass, MD
Nashville Plastic Surgeon
4.9 out of 5 stars 42 reviews

Would it be possible to remove under local anesthesia without a lift and still look semi-decent?

Thank you for the question and pictures. Although no one can predict with certainty, based on your description and pictures, I think that you will end up with a nice outcome (hopefully what you consider "semi-decent") once your breast implants are removed.   yes there will be some "acting" and I would expect some "bounce back" of breast skin/tissue over the course of several month/year.

If all that is being done is removal of the implants ( no capsule work)  then they may be safely and comfortably removed under local anesthesia for  a relatively calm patient. I generally individualize the type of anesthesia to be used based on the specific patient's  personality and  situation.

Generally speaking, what your breasts will look like after explantation depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back), the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation).

Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will potentially influence the factors discussed above. If you take these factors into consideration and apply them to your specific circumstances you may get a good idea of what to expect after the implants are removed.

 Patience is definitely indicated after removal of breast implants; it will take many months/year for the skin to “bounce back” and for you to see the final appearance of the breasts.

In "borderline" cases where there is doubt whether breast lifting is necessary or not, I advise patients to undergo explantation only and to give their breasts the benefit of the doubt  before deciding whether breast lifting would be beneficial.  In your case, assuming you have patience and the ability to delay gratification, you may wish to avoid further surgery (include breast lifting) until you have completed pregnancies altogether.  

 I hope this, and the attached link (dedicated to breast implant removal surgery concerns) helps. Best wishes.


Would it be possible to remove under local anesthesia without a lift and still look semi-decent?

Most likely, the implants can be removed under local anesthesia. In some cases, I can just deflate them without removing them. Without an in person evaluation, it is hard to predict the final result but based on the picture only, you should look fine. However, A breast lift can be done in some cases without damaging the breast tissue. See link below for examples. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 63 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.