I Desire Removal of 200 Cc Implants. I Have Little Breast Tissue. Do I Need A Maxtopexy or Not? (photo)

I Desire Removal of 200 Cc Implants. Little Breast Tissue. Maxtopexy or Not?

Doctor Answers 8

#ImplantRemoval Without Mastopexy

It is impossible to give you perfect answer, however in my experience you will most likely not need a mastopexy. You can always revisit this issue many months later if there is any sagging. See the below link for other options you might want to consider.

Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Lift after explantation

A mastopexy is the lifting of the breast tissue. From your photos this will not be needed. What is difficult to guarantee is how the excess skin will contract and where the original scar will be located upon removal. In an ideal world the skin the lower pole will contract somewhat and the scar (if you had an inframammry incision)  will sit hidden in the inframammary fold. I would almost certainly advise that removal only would be the first stage. It may be necessary if you have an inframammary incision to try and raise this scar during the procedure. I would certainly leave things for 6 months  - a year before considering anything else which you may well not need. If the excess skin is a problem long term this could be removed but I would not remove this in the initial phase as it may make the inframammary scar more visible.

Gary L. Ross, MBChB, FRCS
Manchester Plastic Surgeon
5.0 out of 5 stars 164 reviews

Treatment Options Following Breast Implant Removal

This an excellent question as it is one that many patients who desire removal of their breast implants, for any number of reasons, ask. For women with larger implants it is almost always recommended that a mastopexy following implant removal will provide the best result.  However, for patients with smaller implants, such as your 200 cc implants, the need for a mastopexy is more contingent upon skin laxity and remaining breast tissue.  Some women with smaller breast implants which have been removed prefer to have a fat transfer to restore the breast volume without the need for a breast lift or mastopexy. This is option might be one to discuss with your plastic surgeon before making a decision.  I hope this helps. 

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
4.9 out of 5 stars 69 reviews

Mastopexy after implant removal

Judging by the photos that you submitted, it is highly unlikely that you would need any sort of lifting procedure. First, the implant volume of 200 cc's is small. Second, your nipple position in relation to your inframammary fold is appropriate. When the nipple is low and there appears to be excess skin is the time a mastopexy is needed. I have removed implants for others in the past who seem to have your breast make up. They seemed to have done fine. Your breasts obviously will be smaller and may have more of a deflatted look but the need for a lift is highly doubtful. Hope this helps.

Scott R. Brundage, MD
Grand Rapids Plastic Surgeon
4.8 out of 5 stars 24 reviews

Breast Lift After Implant Removal

The implants are relatively small and your nipples appear to be well above the bottom edge of the breast where it meets the chest wall. I doubt that a mastopexy would be needed in your case. There will probably be some minor contracture of the tissues after the implant has been removed but it will be incomplete. The result would be a “deflated” appearance of the breast but the overall form and nipple position should be satisfactory. Best wishes!

Alexander G. Nein, MD, MS, FACS
Nashville Plastic Surgeon
4.5 out of 5 stars 29 reviews

Removing breast implants and mastopexy

I strongly disagree that removing implants (or mastopexy) has anything to do with skin tone. Your breast implants were sized and positioned properly and removing them should leave you breast looking and feeling like it would have looked if the implants had never been there (not necessarily how they looked when they were put in). 

Breast implants are pillow volume. They don't lift the breast, they only fill it out forward. An illusion of lift can be created in some situations but no actual lift occurs. Removing implants does not make breasts sag. They may look like they sagged because of the deflation effect but they don't drop. Implants and/or lifts don't "tighten" skin or tissues nor does removing them and not doing a lift stretch or loosen skin. This is also an illusion. 

Removing known implants (type and condition) can usually be done with local anesthetic only through an inframammary crease incision (a new one if the original wasn't done there) and the breast should return to what it would have looked like without the implants, aside from the scar. A mastopexy would add nothing except a scar around the areola or more and if needed can best be judged after the implants are removed with the simple procedure. Also, the capsule around the implant does not need to be removed unless there is something abnormal about it such as thickening or calcification. 

Scott L. Replogle, MD
Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

Mastopexy After Implant Removal Not Always Necessary

Skin elasticity is the major determinant of the need for Mastopexy after breast implant removal: the ability of the skin to retract or "snap back" after the reduction of breast volume will determine if there is any sagging.

There are numerous factors that influence skin tone or elasticity: amount of volume loss, genetics, age, sun exposure, hormonal influences are a few.

Your photos seem to indicate good skin tone and the volume of the implant to be removed is relatively small. It seems quite reasonable for you to try explantation (removal of implants) without Mastopexy.

Based on examination of your skin tone and other factors mentioned here, your surgeon can offer his/her best judgment, but could not guarantee a specific result.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.6 out of 5 stars 39 reviews

Breast Implant Removal and Mastopexy?

Thank you for the question and pictures.

Although, generally not possible to give good advice without physical examination I think in your case you will be best served with removal of implants WITHOUT  mastopexy surgery.   This approach will give your tissues the "benefit of the doubt”  allowing the  breast skin to contract back and avoid additional scarring. If the skin contraction is not adequate (and loose skin remains) then mastopexy surgery can be performed at a later date. Please keep in mind that this recommendation is based on your pictures and description and may be changed after direct  physical examination.

Generally speaking what breasts 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.

Consulting with a well experienced board-certified plastic surgeon in person will be helpful.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,484 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.