Draining saline implants before removal, is this routine?

Draining saline implants before removal is not necessarily the only way of removing them. Most surgeons  will certainly do that at the time of explantation. You should ask your surgeon what the benefits are of the recommended procedure.

Many women are concerned about the size of their breasts after implants are removed.  Often times, draining saline implants before allows the woman to get an idea of what size she will be and the appearance of her breasts afterwards.  This will help the patient decide if she needs a lift or will be satisfied with the volume without the implant.  Many women who undergo explant alone are dissatisfied because of the hanging skin.  Explant and a simultaneous lift are usually performed.  The technique I recommend is 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 and the ability to breast feed are maintained, if not injured during your previous surgery.  At the same time or later, fat transfers can be performed if additional volume is desired.Best Wishes,Gary Horndeski, M.D.

Dear GrantStreet,in most cases implants can be removed under local anesthesia. Some plastic surgeons will drain saline implant prior to removal, others won't. 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

Recommend that you should ask your PS his/her reason for draining and then waiting six weeks to explant.  Removal of breast implants under local is reasonable and can be done in about 10 minutes. This is not an unreasonable plan, but I would have to examine you to determine if it would be a recommendation I would make.  I would just take the implants out rather than deflate and wait.   I am not sure that either approach can be faulted.  When they are deflated, the pockets will contract.   Once implants are removed, there will likely be flattening and drooping that can be corrected in large part with a breast lift.  In general, 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. No one can truly predict this as each soft tissue envelope will respond differently, but you may do well with just removal. Give yourself six months for the breasts to heal and then reevaluate.

Deflating  saline implants prior to surgery can assist greatly in the planning and ultimate outcome of implant replacement surgery.   It allows for the determination of current size if unknown.   In addition, the soft tissue envelope can be better evaluated to determine if and what kind of mastopexy (breast lift) is required.   Make sure your surgeon is Board Certified and that you feel comfortable with the plan leading into your surgery. Best of Luck! 

The reasons for deflation before revision will depend on your expectations, size, shape and asymmetry. The deflation will help your surgeon to find out the exact size of your implants and the amount of asymmetry. 

If you are absolutely positive that you just want your implants removed,regardless of the cosmetic result,  it is not a necessary step. Removing saline implants without a capsulectomy is also a simple procedure that can also be done under local anesthesia. It is possible that your surgeon is concerned about how things are going to look once the implants are removed, and if you will ultimately be happy with your decision. Deflating the implants gives you a chance to see what you will look like without them first. If you are not thrilled with your natural appearance now 16 years later, you can then entertain the option of replacement with a different size implant (and what that size might be) or possibly change the appearance with a fat transfer or a lift.Having done this several times over the years I have been surprised at decisions made by patients. Some I thought looked fine decided to replace with smaller implants, and others who had been planning to do more procedures were pleasantly surprised that they liked how they looked without needing to replace them or have additional procedures.

I will drain saline implants in the office to give patients a preview of what life will be like without implants. Occasionally they change their mind and want new implants placed.

Draining the implants before removal is an option.  It is helpful in that it allows the skin to begin to contract prior to removal of the implant shell.  Some surgeons drain the implant immediately prior to removal while others do it in advance of the surgery.  It is safe to proceed either way.

The only advantage to external drainage of saline implants prior to removal is to see what the size/shape of the breasts will look like after the removal and perhaps to see if there are any capsule problems that need attention. Generally a simple removal (without capsule adjustment or removal) of saline-filled implants can be done under local anesthesia with a small incision in the inframammary crease and the implant is drained just prior to removal.