Breast implant removal for capsular contracture after 20 years - will breasts be saggy and wrinkly?

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

At the time of implant removal, your surgeon will decide if the capsules need to be removed and may lead to additional volume loss. At that time, you may benefit from a lift depending on how much excess skin you have.

Best Wishes,

Gary Horndeski, M.D.

Hello @CocoChanel11 thank you for your question. Surgical procedures vary from surgeon to surgeon. The explantations I perform are definitive, that is, the prosthesis is removed and the breasts are reconstructed with the existing tissue the patient has in order to achieve the best aesthetic result. Due to the experience of so many explantation surgeries practiced in these 21 years I consider that the L-shaped incision is the minimum and smallest scar possible in this surgery. Is important that you consult with several board certified plastic surgeons. Best wishes!

Dear CocoChanel11,
it is hard to tell for sure without an examination. 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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Based on your descriptions of volume, cup sizes and capsular contracture, it is highly likely that you would end up rather flat/deflated and/or saggy without a lift procedure to reshape the remaining tissues, but a full consultation would be necessary to advise you on your options. I recommend you work with a Board Certified Plastic Surgeon.

An in person exam is always best, but based on the information provided it is likely that you would require a lift after your implant removal to avoid sagging breasts. If there is not adequate native tissue a small implant may be advised to help shape the breasts.

Removing implants will decrease your volume and leave more loose skin. You might be a candidate for fat transfer to help restore volume, or you might consider going smaller. Also, skin tightening procedures with radiofrequency, like ThermiTight, can be helpful