Should I wait to replace implants after an explant?

Unless there are extenuating circumstances, most patients can achieve a good outcome with a single stage procedure, i.e. remove and replace the implants during the same setting. It may be necessary to make some adjustments to the pocket, but doing this can save the need for a second operation.

If your implants are already under the muscle, it is very reasonable to consider a 1-step approach to replacement with smaller implants along with any other revisions necessary. This is more convenient than the 2-step approach. There are sometimes occasions when doing the implant removal and replacement in 2-steps is better, so in order to give you a more detailed answer, you would need an in-person consultation. Hope that helps.

Although your specific issues can only be determined by physical examination, there is no good reason to change implant pockets. Subpectoral placement is the optimal site and by switching sites you make going back to the subpectoral site very difficult if or when you decide that over the muscle wasn't a good choice. Further, removing implants with the intent of replacing them later makes no sense now that we have great abilities to modify your current pocket when changing implant size to smaller. I think it would behoove you to visit other surgeons who specialize in revision breast surgery.

Unfortunately, you have not provided photographs or told us your bra size. The best option for you may be 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. 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.

Thank you for the question. In most cases, exchange the implants in one stage is possible and adequate, although it is hard to determine whether this is a good option for you without photos or in-person examination. I wish you the best of luck. Vasileios Vasilakis, MD. Double board-certified, fellowship-trained plastic surgeon, Houston. TX.

Dear aw8283,
it is hard to tell for sure without an examination. You can get implant removal and later get new implants. Another option is to remove implants and get smaller ones at the same time. 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

Really difficult to give you sound advice here as we can not examine you to determine how much breast tissue you have. The options that are available generally is: to completely remove the implants, remove and replace with going smaller, removal of implants and fat transfer to the breast to help improve the upper pole fullness, remove and have a lift performed.

Again there is a variety of options, it just depends on the particular patient and circumstances and desires.

Hope that helps.

There are times when it does make sense to do breast surgery in stages. This may be the case with you but I don't know enough about your case to give a better answer.

I would suggest going down in size and lifting if needed. You might be happy with 250-350 cc range and would probably fit your tissue and frame better. You did not show photos, so I cannot be more precise. Remember, you were not happy before implants and may not be happy if just removed because of all the sagging skin. Also, with keeping implant in, less lifting may be needed. Sometimes, internal tightening of the pocket is sufficient and can avoid an actual lift.

It is difficult to answer your question without a full examination and review of your desired result in person. In general, the implant moratorium from 1992 to 2007, (where many women elected to have their implants removed) taught us that many patients experience severe depression, (similar to the anxiety and depression experienced by women that undergo mastectomy for breast cancer) when they have their breast implants removed. I would therefore recommend that you consider mastopexy with internal sutures to decrease the size of the pocket and replacement of a smaller implant at the same time. There are many approaches to reach the same goal which is always patient satisfaction.