I have had implants for 4 years, now I would like to get them removed. Is it necessary to do a lift or fat grafting? (Photo)

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

Thanks for your question and the photos you provided. Your breasts with implants look natural and appropriate for your frame. That being said, if you remove the implants your breast will look similar to your pre-surgery chest. Now however, your skin on the breast is stretched and may need some skin tightening modalities. Take your recovery day by day and allow yourself to heal. After 3 months you can decide if you want fat grafting -/+ a lift. Good luck!

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. 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.

Hello @RoAlm4, thank you for your question. . Removing breast implants is a complex and specialized procedure that requires a high degree of expertise especially if it's done with mammary reconstruction, which in my opinion gives the best aesthetic result and is the right approach. When breast explantations are done with reconstruction, the position of the implant does not matter since there is a repositioning of the mammary tissues that improves the appearance of the breast. An inverted J-shaped incision would be made periareolarly in this case to avoid making a T. If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS.

Dear RoAlm4,
it is hard to tell for sure without an examination. You have an option to get implant removal, wait until you are fully healed to see the final results, and then decide whether to get a fat transfer or lift. 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

Whether or not it is "necessary" is completely up to you. You might consider just removing the implants and see how much breast tissue you have and how much sag. You might be pleasantly surprised.

415 cc implants are large, but your breasts are not very ptotic. If you can handle it psychologically, I think you should have implant removal with complete en bloc capsulectomies and no additional procedures. I would wait 6 months to a year to see how much of your skin contracts and your breast tissue decompresses. You breasts may look funky for the first few weeks or even months, but it will get better over time and you may not need any additional procedures to look good. If you do a lift upfront, you will have permanent scars that you cannot eliminate. Even worse, your skin will be maximally stretched out and your tissue maximally compressed so you don't actually really know what you're working with, and once skin and tissue is cut and rearranged it can't be put back. And if you end up wanting fat grafting, you will have better fat graft take when your tissue are less inflamed. At the end of the day, your body usually heals and restores itself without any additional procedures, and you lose nothing except a transitional period of letting your breasts go back to their natural state. Removal alone is also a much easier recovery for you.

When you have your implants removed you will lose the volume that is currently provided by the implants. Depending on the amount of natural breast tissue you have you may be okay with the overall look, but they will look deflated. If you are wanting a perky look and upper pole fullness you may want to consider a small implant for overall shape enhancement. See a board certified plastic surgeon near you to learn more.

Based on the size of the implants, the removal would leave a large volume loss. While there may be a role for fat grafting, it should be noted that this is most likely a staged procedure (multiple surgeries). A lift procedure may give the best result and with less surgery over time. A full consultation would be necessary and I recommend you work with a Board Certified Plastic Surgeon.