Should you get a lift at the time of explant or wait 6 months then lift?

Question

4 different consults: 1. Do implant removal under local with no drains then lift at a later time. 2. Go under and do explant, leaving capsules, with drains, and lift later. 3. Capsules must come out. Do capsulectomy then do a lift 6 months later. (this DR sited risk of infection as a reason to wait on the lift) 4. Do Capsulectomy and lift at the same time. This makes it really hard to pick a DR because they all say different things. I'm willing to travel to surrounding states of FL.

Camille Cash, MD · Answer

In many cases the implant removal and lift can be done at the same time.  This is often preferred by patients as it includes one trip to the operating room and one  recovery.  There are circumstances where it may be recommended to break it into stages, such as patients who are wanting to are borderline for needing a lift or who are trying to avoid a lift.  These patients may choose to remove the implants and allow the breasts to heal before determining if they want to proceed with a lift.  Review before and after photos of each surgeon's work, ask lots of questions, and select the board certified plastic surgeon with whom you feel most comfortable and confident.

Chet Mays, MD · Answer

Thank you for your inquiry!  Are you have concerns with your breasts?  This could change the answer.   We would love to sit down with you and review your options.  Schedule a consultation with a Board-Certified Plastic Surgeon to discuss your goals.

Kenneth Hughes, MD · Answer

The smaller the implant and the shorter the amount of time it has been since placement, the greater the chance the breasts will return to their preoperative state. It is very difficult to predict breast size following explant b/c breast implants and weight fluctuations over time tend to thin tissues, cause a decrease in size, and create more droop.
Usually removing them and performing a lift at the same time makes the most sense as some patients clearly need a lift and only want to go through one surgery. If you are borderline, it is not unreasonable to remove the implants and then observe a waiting period of six months before the determination for breast lift is made. This will give your breasts time to bounce back and your PS time to determine what type of lift, if any, is needed.
Leaving a capsule behind is preferred if it is thin and pliable. If there are calcific components, or silicone granulomatous material, or if the capsule is deforming the breast tissue, then removal of the capsule may be warranted. Removing a capsule unnecessarily could result in bleeding and slight tissue loss.

Gary M. Horndeski, MD · Answer

I prefer to do a lift at the time of explant as this results in 1 operation and is less expensive. The technique I recommend is explant 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.

Daniel Barrett, MD · Answer

Dear lma123,
it is hard to tell for sure without an examination. Generally speaking, both options can be good. 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

Should you get a lift at the time of explant or wait 6 months then lift?

Answers (5)