Why does explant and lift decrease pre implant size? (photo)

Dear shicira,
breast lift doesn't reduce the size of breast tissue, it only removes the skin and reshape the breasts. You can remove the implants and wait to see the final results of your surgery and later get breast lift if you are not satisfied with the shape of your breasts. 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

The smaller the implant and the less the amount of time it has been since placement, the greater the chance the beasts 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.  
It is not unreasonable to remove the implants and then observe a waiting period of six months before the determination for breast lift or breast fat transfer 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. Fat graft take should always be optimized with the best blood supply available.
Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

Thank you for sharing your question and photograph and sorry to see your implant issues.  For most patients an "external" lift is sufficient and can be used to reposition or reshape a woman's natural breast tissue into a more pleasing appearance after explantation.  The choice of suture is at the discretion of the surgeon.  Hope this helps.

The technique I recommend is explantation 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 and the ability to breast feed are maintained, if not injured during your previous surgery.  At the same time or later, fat transfers can be performed if additional volume is desired.Best Wishes,Gary Horndeski, M.D.

It is difficult to make 100% accurate predictions following explant. There are a number of factors to consider including age (the breast changes over time irregardless of augmentation), weight change, skin stretch and residual elasticity.
Following removal, one can expect:
-Loss of volume- Not an exact correlation between pre- and post augmentation due to the changes over time. You may be bigger or smaller than you remember.
-Ptosis/sagging-Ptosis develops over time and may be worsened by the presence of an implant. If a patient has pre-explant sagging, removal is likely to worsen this to a certain extent. If there is no ptosis, it does not necessarily mean there will be no ptosis after removal.
-Skin laxity/stretch- There is inherent skin elasticity which will allow for some measure of snap back. However, the greater the volume differential pre- and post- the more likely there will be excess skin.
In my experience, it is usually a safe assumption that there will be some changes post removal which oftentimes may necessitate further operative intervention (i.e. lift), however this is often a function of size and length of time post op. Small implants which have only been in place for a short period will lead to an improved response/recoil post removal.
With regards to your specific question, the changes in size post explant vs. pre-augmentation are often a function of time and the changes that occur to the native breast (weight changes/hormonal changes). Additionally, the process of tightening the breast envelope and skin removal can also play a (small) role in the ultimate post op volume. 
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
RealSelf Hall of Fame

Hello, and thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) As women age, their breasts change. For instance, the breast tissue shrinks in response to altered hormone levels, and the supporting structures that make breasts perky become less supportive (resulting in more breast sagging). Having breast implants can accelerate some of these changes. Fluctuations in weight may also change the absolute/actual size/volume of the breasts as well as the apparent/relative size/volume in relation to the rest of the body. 
Anyway, if you decide to pursue surgery it’s very important that you find a surgeon whom you are comfortable with and trust and who evaluates you in-person and tailors an individualized treatment plan for you and your aesthetic goals. Best of luck!
Matthew A. DelMauro, M.D.

Removal of implants nor a lift will decrease pre implant breast size.  The lift will reshape the tissue that you have by removing excess skin and lifting the nipple position.  The amount of native breast tissue present is not changed.  If you have concerns about the permanent sutures I recommend that you discuss them with your surgeon so that you can feel comfortable with his/her reasoning.  

You can remove implants and wait till tissue settled then decide if you want or need lift. i offer my patients explant and fat grafting instead of implants . Please see the link.

Thank you for the question.  There are many variables that may influence what  patient's breasts look like after breast implant removal surgery.
 
Generally speaking, what your breasts will look like after explantation depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back), the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation).
Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will potentially influence the factors discussed above. If you take these factors into consideration and apply them to your specific circumstances you may get a good idea of what to expect after the implants are removed.I hope this helps. Best wishes.