Can I exchange my implants without another lift? (Photos)

Question

Female 43yrs 138lbs 5’5 with Previous 500cc Saline implants UTM with Anchor Lift in 2013. I have a mild Capsular contracture on left breast and would like to exchange my implants with possibly a smaller size and reduce by 100-150 cc or I can leave at 500 to avoid another lift. My question is can I do this exchange without another lift or do I absolutely need it? I wear a sports bra faithfully to sleep every night to avoid sagging. Any suggestions to help with a high cost. I also have rippling in left side not in right. Any advice will be great. Are exchanges absolutely necessary or can I just repair the left one and wait?

Gary M. Horndeski, MD · Answer

Your breasts are wider than the chest wall and the nipple-areola complexes are asymmetrical. I recommend smaller implants such as 350-400 cc. At the same time, you will need an eccentric donut mastopexy to reposition the nipple-areola complexes more centrally.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Tyler Frew, MD · Answer

Hi there, Thank you for sharing your history so clearly. Whether you can exchange without another lift mostly comes down to your skin. If you stay close to your current size, many women do well with an exchange alone. If you go 100 to 150cc smaller, the skin that was stretched by a 500cc implant can look loose or droopy once that volume is gone, and that's when a lift is usually recommended, sometimes at the same surgery.
A few educational points. For capsular contracture, the usual fix is removing the old implant and the tight scar capsule and placing a new smooth implant, though a thin, healthy capsule can sometimes be left. Switching from saline to silicone is a good way to reduce rippling, since saline ripples more, and the new implant should be chosen by your chest width, not just the cc number. Fixing only the left side is possible if you keep the same size and type, but if you change size or switch to silicone, doing both sides usually gives better symmetry. To be honest, a sports bra at night is fine for comfort, but I'm not aware of strong proof that it prevents sagging.
An in-person exam is needed to know what's right for you, and it's fair to ask for pricing on one side versus both. All the best!

Muge Sevindik, MD · Answer

First of all, you appear to have capsular contracture related to your saline implants, so they need to be replaced.
Whether you prefer to maintain your current size or go smaller, you will still need an inverted-T breast lift. Even if you keep the same implant size, the breast tissue on your left side has already sagged, and this can only be properly corrected with a lift.
Therefore, I recommend breast implant replacement combined with an inverted-T breast lift (mastopexy). We can use new round implants to achieve a fuller, lifted, and more symmetrical appearance.

Yasemin Aydinli, MD · Answer

Your photos show large implants under thin, stretched skin with stretch marks, and rippling on the left. When capsular contracture is treated, the capsule is removed, and this makes the skin envelope looser than it is now. If you also go 100 to 150 cc smaller, the skin will have even less to fill, so a straight exchange usually gives a deflated result that sags quickly. Keeping the same size reduces that risk, but the left side would still be looser after the capsule is removed, and matching the two sides is less predictable without a lift. A repeat lift uses your existing anchor scars, so it does not add new ones. I would also change to cohesive silicone implants, which ripple much less than saline in thin tissue. If the contracture is mild and not painful, there is no urgency, and waiting until you can do it properly is better than operating on one side only, which rarely gives symmetric breasts.

Mert Demirel, MD · Answer

Whether you need another lift depends on your skin, not on the implant exchange itself. After 13 years, the skin that holds the breast has been stretched by a 500 cc saline implant, and the question is how much of that skin can still shrink back once the implant is smaller or replaced.
If the implant is only changed for one of similar size, the breast usually keeps its current position and a lift is often not needed. If you go 100 to 150 cc smaller, the skin has less to fill, so there is a higher chance of looseness or a lower nipple position. A smaller implant is not automatically a reason for a lift, but it is the main reason one becomes necessary, and that is decided by examining you standing.
Mild capsular contracture on the left and rippling on the same side point to the left implant as the one that needs attention first. Treating it usually means removing or releasing the scar capsule, and many surgeons replace the implant at the same time, because the pocket has been opened anyway and a new implant lowers the chance of the problem returning. Repairing only the left side and waiting is a reasonable option if your symptoms are mild and stable, as long as you monitor it, because capsular contracture can progress. If the breast becomes firmer, painful or changes shape quickly, see your plastic surgeon soon rather than waiting.
I cannot tell from photos whether your skin still has enough recoil. An exam with measurements of your nipple position and skin quality will answer the lift question.
Before you decide, bring these topics to your appointment: whether both implants should be exchanged for a matched look, what happens to the shape if you keep 500 cc but only treat the left side, and what would reduce the risk of the contracture coming back.

Can I exchange my implants without another lift? (Photos)

Answers (5)

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