Explant for bottom out after breastfeeding?

Question

Hello! I’m 35 and just had my first child in Feb. got implants Nov of 2022 and needed a revision for bottoming out but got preg in May of 2023. My implants are 690cc (way too big) and after pregnancy/breastfeeding they’re even bigger. Want to remove them until after done having kids - what can expect looks wise? I want to BF future children so scared to do a lift or revision right now. Should i just deal with it?

Philip J. Straka, MD, FACS · Answer

This is an excellent question as many patients with breast implants are in your same situation.  As a breast implant removal surgeon for over 25 years, I often recommend that patients hold off on doing a simultaneous breast lift (mastopexy) at the time of breast implant removal if they are planning future pregnancies and breast feeding.  Breast changes during pregnancy and breast feeding may negatively affect the cosmetic outcome of a breast lift.  Also, with such large, heavy breast implants, it is often beneficial to allow several months to even one year to allow for fluffing of the breast tissues and retraction of the breast skin BEFORE doing a breast lift.

Alan Gonzalez, MD, FACS · Answer

Hello @kg12369, thank you for your question. It is possible to have implant removal six months after you finish breast feeding the reason to wait is so that your breasts have time and space in order complete the changes in your breast after giving birth related to breastfeeding. Also, is important that you know that the explantation does not affect breastfeeding, we recommend wait 1 year after the explantation if you want to continue with more pregnancies, so you will already have your breasts recovered and healed. Regarding the surgery, my preference is to combine the removal of breast implants with immediate repositioning of the breast tissue to address the projection of the upper pole and medial areas using the BRALAN Technique (Breast Reconstruction Anatomical Lift Augmentation) as the results will be adequate and will have a minimal L-shaped scar. If you are thinking of having a breast explant, consultation with a plastic surgeon with experience in this procedure is essential to ensure optimal results. Best regards.

Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation for Adipose Therapeutics and Science" (IFATS), Member of the Colombian Society of Plastic Surgery (SCCP).

Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation for Adipose Therapeutics and Science" (IFATS), Member of the Colombian Society of Plastic Surgery (SCCP).

Emre Guvercin, MD, FEBOPRAS · Answer

What you’re experiencing makes perfect anatomical sense, and you do have a safe path forward that respects your wish to breastfeed future children.Why everything feels worse after pregnancy & breastfeedingYou started with very large implants (690 cc) and already had bottoming out before pregnancy. Pregnancy and breastfeeding then:Increased breast weight and volume even moreFurther stretched the lower pole skinWeakened internal support structuresSo this is not a failure on your part &mdash; it’s biomechanics.If you explant now, what can you expect looks-wise?After explant alone:Your breasts will be much lighterVolume will decrease significantlyThere may be looseness or ptosis, especially after pregnancyShape may look “deflated” temporarilyThat said, many women in your situation still feel huge relief because the weight and downward pull are gone.You’re right to think about breastfeeding &mdash; but here’s the key pointYou’re correct to be cautious about traditional aggressive lifts.However&hellip;This is exactly where a Push-Up Lift comes inA Push-Up Lift is not the same as a classic mastopexy.It:Repositions your own breast tissue upward (treats bottoming out)Uses minimal, strategic skin excisionPreserves ducts, glandular tissue, and nerve supplyPreserves future breastfeeding potentialAvoids cutting through the central glandIn other words:

Chet Mays, MD · Answer

Thank you for your inquiry!  It depends on how much breast tissue you have prior to implants.  We would love to meet with you to discuss your concerns.  Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

David Rankin, MD · Answer

Hi. generally speaking, your aesthetic result will depend on how much breast tissue you have, size of implants (which we know), nipple/areola position, etc. It would be best to get a consultation with a plastic surgeon who specializes in breast explants. Until, you are seen in person it is difficult to have a realistic expectation. It is true that a great lift may limit your ability to breast feed in the future. Good luck with your decision.

Shaher W. Khan, MD · Answer

Hello, thank you for your question. I have attached a detailed video that specifically answers your provided question. Everyone's results can differ after explant and depend on things such as age, height, and weight. It is important to ensure that if you are having symptoms of breast implant illness, that you have the entire implant and capsule removed by a board-certified plastic surgeon.

Daniel Barrett, MD · Answer

Dear kg12369,
generally speaking, you can remove your implants after you stop breastfeeding. Since your implants are big, your breasts will probably have some stretching. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

The technique I recommend is explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Camille Cash, MD · Answer

An in person evaluation is best but from the provided information you could likely expect sagging when the implants are removed.  It is fine to wait until you are finished having children and breastfeeding before considering having your breasts lifted.  You could also consider a smaller implant at that time if desired.

Connie Hiers, MD, FACS · Answer

The 690 cc implants are way to large and heavy for most women. If removed, you will be smaller and will sag because of how the large implants stretched your skin. You could try Renuvion with the removal to help tighten your skin with minimal incisions.  Removal and Renuvion should not affect breast feeding.

Explant for bottom out after breastfeeding?

Answers (11)

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