Can you have capsule removal, breast lift and fat grafting at the same time in one surgery?

Question

Can you have capsule removal, breast lift and fat grafting at the same time in one surgery? Removal due to very unnatural results. Want one surgery only, first surgery traumatic recovery affecting physical & mental health. Experiencing symptoms of BII also. Age 41, 5 ft 8, weight 55kg, slender build, A to D cup. Prior to surgery in peak physical health and extremely active. Told by original surgeon & 2nd opinion not able to have consultation for removal until 6 months after first surgery

David Rankin, MD · Answer

In my practice, many patients do elect to have a breast lift when undergoing breast explant surgery. I do recommend waiting at least 6 months post explant surgery before having a fat graft to the breast. That allows for adequate healing time, increased patient safely, and a greater probability for a successful transfer.

Alan Gonzalez, MD, FACS · Answer

Hello @BAquestions23, thank you for your question. Yes is possible, everything depends on the surgical technique of the specialist performing surgery. after te capsules are remove, complete capsulectomy it would be necessary to carry out a preventive biopsy on each capsule. In any case, I do not perform breast fat transfer during a breast implant removal procedure because for me, the breast explant must be performed with a breast reconstruction in which the mammary tissue is placed adequately in place again. If the fat seeding is done at the same time, it might get infected or die; there is no guarantee the seeding will stick. If you are considering this procedure, a consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Randal Haworth, MD, FACS · Answer

It is possible to have capsule removal, breast lift, and fat grafting done in one surgery, but it would depend on several factors such as the extent of the procedures and the surgeon's recommendation. It is crucial to find an experienced and qualified plastic surgeon who specializes in breast surgery and can provide you with a detailed assessment of your specific needs.

However, given that you are experiencing symptoms of Breast Implant Illness (BII) and have had a traumatic recovery from your previous surgery, it may be essential to address your concerns and symptoms with your surgeon as soon as possible. Some symptoms of BII can be severe and may require prompt medical attention.

It is concerning that your original surgeon and the second opinion doctor have told you that you cannot have a consultation for removal until six months after the first surgery. If you feel uncomfortable or unsure about the advice given to you, it may be a good idea to seek a third opinion from a different plastic surgeon. It's important to prioritize your physical and mental health and seek the best possible care for your needs.

Overall, the decision to have multiple procedures done at the same time will depend on your specific case and the surgeon's recommendation. It's crucial to communicate your concerns and goals with your plastic surgeon and work together to create a safe and effective treatment plan.

I hope this helps,
best of luck !

Shaher W. Khan, MD · Answer

Hello thank you for your question. Fat grafting is not advised, given the risks for fat necrosis. It is malpractice to do fat grafting because 30-50% of the fat will inevitably die and form clumps of dead fat that may hurt and cause unnecessary pain and worry with self monthly breast exams. It is not advised to have implant and capsule removed at the same time as a lift. There are many risks associated with having both of these procedures done at the same time, including but not limited to, nipple necrosis and risks with anesthesia.

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Anna Steve, MD · Answer

Sorry to hear that you are experiencing symptoms of breast implant illness (BII). Yes, you can have breast implant removal, removal of the capsule, and fat transfer all in one surgery.

Daniel Barrett, MD · Answer

Dear BAquestions23,
I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Zoran Potparic, MD · Answer

Breast lift and fat grafting after implant removal is frequently performed in our practice with excellent result. Partial or total capsule removal is done when indicated (hard, calcified, thick capsule, suspected BID, BI related ALCL). All of these procedures can be done together. Hope this helps. Good luck.

Michelle Copeland, MD, DMD · Answer

Thank you for your question! Yes, multiple breast procedures can be done at the same time. During a breast lift, your surgeon will remove excess skin, reposition the nipple, and re-drape and tighten the remaining skin to support the breast. If you want more volume, you may benefit from a fat transfer, where your own fat is removed from another part of your body (like your hips, tummy, of thighs) and specially prepared and placed into your breasts. This can help improve contour and shape. The great thing about these techniques is that they can now be done with minimal scarring and performed as an outpatient procedure without the need for general anesthesia. I suggest making an appointment with a board-certified plastic surgeon to discuss your options in more detail!

Connie Hiers, MD, FACS · Answer

Most surgeons will not do a lift and fat grafting at the same time for safety to the fat. Also, not all women who have implants removed can have a lift safely. The implants often have thinned and stretched the tissue so much that the main blood supply to the nipple is from skin. A lift would cut that blood supply. An examination is needed to see what can be done at the same time.