What should I expect with breast implant removal?

Question

Hello Dr's, Back story: 700cc implants placed periareolar incision (botched), and then removed 3-4 years later and replaced with current implants, 350cc by a different surgeon. Silicone, smooth, natrelle, and under the muscle. Is it possible to get back to my pre op state, or relatively close? Should I be at a lower/higher weight for surgery? (Ex. lose 5lbs) Would that make a difference? Suggestions or advice is appreciated. Thank you

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

Gary M. Horndeski, MD · Answer

After explantation, patients are often dissatisfied because of the hanging skin envelope. For that reason, many patients undergo a simultaneous lift. The technique I recommend is explantation 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. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Donald R. Revis Jr, MD · Answer

Good morning,
I think you can get back very close to your preop appearance by removing the capsule and the implants, placing a drain for five days, and then wearing a tight compression bra 24/7 for 12 weeks. It works beautifully and it really doesn't matter if your weight is a little higher or lower!

Daniel Barrett, MD · Answer

Dear Lmpyspcprncss,
it is hard to tell for sure without an examination. You can get implant removal and wait to see the final results and then decide whether you'll need another surgery. 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

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Nothing replaces an in-person examination of your tissues but I would expect good contraction of your breast skin and tissue after removal although the skin will be looser than pre-augmentation.  Hope this helps.

James Knoetgen, III, MD · Answer

Breast implant removal, also known as explantation, is a surgical procedure to remove breast implants from the body. Here's what you can generally expect before, during, and after the procedure:
Before the Procedure:
1.	Consultation: You'll have a consultation with your plastic surgeon to discuss your reasons for implant removal, your expectations, and any concerns you may have. Your plastic surgeon will also evaluate your health history and the condition of your implants.
2.	Medical Evaluation: Your plastic surgeon may order medical tests, such as mammograms or ultrasound, to assess the condition of your breasts and implants and to plan the surgery accordingly.
3.	Preoperative Instructions: Your plastic surgeon will provide you with instructions on how to prepare for the surgery, which may include avoiding certain medications, fasting before the procedure, and arranging for someone to drive you home afterward.
During the Procedure:
1.	Anesthesia: Breast implant removal can be performed under local anesthesia with sedation or general anesthesia, depending on the complexity of the surgery and your preferences. Your plastic surgeon will discuss the anesthesia options with you before the procedure.
2.	Incision: Your plastic surgeon will make incisions to access the breast implants. The location and size of the incisions will depend on factors such as the type of implants, their placement, and whether any additional procedures, such as breast lift, are being performed.
3.	Implant Removal: Your plastic surgeon will carefully remove the breast implants, along with any surrounding scar tissue (capsules), if necessary. They will take precautions to minimize damage to the surrounding breast tissue and preserve the natural shape of the breasts as much as possible.
4.	Closure: After removing the implants, your plastic surgeon will close the incisions with sutures or surgical adhesive and apply dressings or bandages to the surgical sites.
After the Procedure:
1.	Recovery: You'll be taken to a recovery area where you'll be monitored as you wake up from anesthesia. Most patients can go home the same day, although some may require an overnight stay depending on the extent of the surgery and individual circumstances.
2.	Postoperative Care: Your plastic surgeon will provide you with instructions on how to care for your incisions, manage any discomfort or swelling, and when to follow up for a postoperative visit. You may need to wear a supportive bra or compression garment to aid in healing and reduce swelling.
3.	Results: After the initial healing period, you'll start to see the results of the implant removal. Your breasts may appear smaller or have a different shape compared to before the implants were placed. It's important to have realistic expectations about the outcome of the surgery, as the appearance of the breasts may continue to evolve over time.
4.	Follow-up Visits: You'll have follow-up appointments with your plastic surgeon to monitor your healing progress, address any concerns, and discuss any additional procedures or treatments that may be desired, such as breast reconstruction or cosmetic enhancement.
Overall, breast implant removal is a relatively straightforward procedure with a predictable recovery process. However, it's essential to choose a skilled and experienced plastic surgeon and carefully follow their instructions for optimal results and a smooth recovery.

Connie Hiers, MD, FACS · Answer

No, your breasts will not return to their original shape due to the stretching with such large initial implants.  Loosing 5 pounds will not make a difference in your breasts. You might even consider going again smaller, like 250 cc's.  You do now have a size that is much better proportioned to your frame.

Douglas Taranow, DO, FACOS · Answer

Your breast augmentation was not botched, but your implants are still too high with a round upper pole and the lack of fullness inferiorly and the nipple/areola pointing straight forward.  
Removing your implant now does not require any weight loss or gain.  There is a chance that you may benefit from a breast lift (Mastopexy) if your skin has stretched due to the length of your augmentation.
Best wishes.
Dr. Taranow

Camille Cash, MD · Answer

It is likely that you would benefit from a lift when you have your implants removed.  The skin has stretched over time to accommodate for the implants.  The skin will retract to a degree but you will likely have some skin laxity without the implants.

What should I expect with breast implant removal?

Answers (9)

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