What Will Breasts Look Like if Implants are Removed?

Question

I had implants oct 2009 but imcapsulation so had them redone oct 2010, (teardrop) but i am not happy with them, they are very hard and hate them, asked my surgeon if i can have them removed but said please dont have them removed and reccomended i take some drug for 6 months, but have to have a liver test befor!! im not happy to do this and wondered what my breast will look like if removed, was 34b and now 34d behind muscle. hope someone can give me answer. san7

Elizabeth Slass Lee, MD · Answer

Plastic surgeons have traditionally done breast lifts in the same surgery as implant removal. The theory behind this was that the stretched out skin and breast would be very saggy without the implant. It is, in fact, possible to just remove the implants and wait to see how the breast reshapes. I have been amazed at how well breasts tighten up in the weeks after explantation, and so, have stopped doing immediate lifts. Patients have to understand that a secondary lift procedure can be done later, should the breasts remain overstretched and droopy. I have not yet needed to do a revision lift. Also, if your implants are saline filled, they can be easily deflated in the office, allowing you to see how the breasts reshape before going to the operating room to take the implants out. This gives a patient a chance to see how she looks and feels without the implants so she can decide what operation she would like, lift, repeat augmentation or just implant removal, and have it done in one surgery. If you hate your implants, taking them out is an option. If this surgeon will not remove them, see another one.

Jed H. Horowitz, MD, FACS · Answer

Technically, there will be excess skin after implants are removed, breasts will look smaller and sag. It still varies greatly between patients because age, genetics, environment, skin elasticity, etc. will affect the results. There are a number of options you can choose from if you want your implants to be removed. In our office, there is regular breast lift, natural breast augmentation, or California Lift. The last two is almost the same in the sense that they both uses fat transfer.
Find a  board-certified plastic surgeon that has extensive experience with your case and discuss realistic goals and expectations. Best of luck! #RealSelf100

Richard Zienowicz, MD · Answer

Breasts should look as they did prior to your implants depending on the size of the implant and the length of time the implants were in place. Discuss with your surgeon for best estimation of what you can expect.

Lu-Jean Feng, MD · Answer

There are several factors that determine the result of a breast implant removal. Your skin could stretch back under several conditions: If your breast tissue did not decrease over the period from your original breasts; If your pectorals major muscle maintained its bulk; If your pectorals major was not cut during insertion; Or if it was cut during insertion, it was repaired successfully after explantation; If your rib contour was not altered by the implants. In other words, your skin has to be supported by adequate volume in the breast. In general, breasts with sub pectoral implants tend to do better than sub glandular implants after explantation, because the breast tissue is less stretched by the implants. Breasts that had no contracture tend to do better. Your question is a good one but complicated to answer. I have many videos that address concerns with breast implants.

Brian K. Reedy, MD · Answer

For most patients, your breasts will return to their pre-augmented condition.  I will often wait to address droop until 3-6 after explant as the tissues often contract nicely.  However each patient is unique.

Richard J. Bruneteau, MD · Answer

Unfortunately a small percentage of
breast augmentation patients develop severe capsular contractures which require
implant removal.  These cases are
often refractory to surgical procedures, medical management and massage. When
this situation arises, the only solution may be implant removal.

The majority of patients who
undergo implant removal for severe capsular contracture have good aesthetic
results and don’t usually require secondary surgery.  When severe capsular contractures occur, the implants are
typically forced in a superior direction. 
This prevents downward pressure on the implant pocket and breast tissue
and ultimately minimizes the potential for breast sag.

Occasionally,
breast sag develops in combination with severe capsular contractures and breast
lift surgery is still necessary following implant removal.  In some cases this can safely be done
in combination with explantation. 
In other cases, a breast lift can be avoided utilizing this approach.

It’s
important to have a thorough discussion regarding this topic with your plastic surgeon. 
Your surgeon should be able to outline their plan and alleviate your
anxiety.

Camille Cash, MD · Answer

If you elect to have your implants removed there are several factors that will influence your final look.  The size of the implants, the length of time they've been in place, your age, genetics, skin elasticity, and weight loss or gain are some factors that have an impact.  I encourage you to meet with your surgeon to discuss your concerns and learn more about your options.

Tracy Kayan, MD · Answer

Breast implants do not work out for everyone, and if you think that you are one of these people, it may be wise to remove them and remove the anxiety and hassle you may be associating with them. After removal, your breasts will be less projecting and have less volume on the top portion, and there may be some excess skin and even hollowing of the upper portion of the breast. You can always consider taking them out and seeing how they look after 6-12 months, then deciding if you want to do further procedures such as a lift to remove some of the extra skin, or taking fat from other places in your body and transferring it to your breasts to increase size and fullness without the need for another implant.

Christa Clark, MD, FACS · Answer

Much of what your breasts will look like after having implants depends on the quality of your skin.  If your skin is in decent shape, then after removing the implants there is a good chance that your breasts will look fine.  I have found that the breast skin and tissue can recover quite nicely given several months.  It sounds like you have capsular contracture (thickened scar capsule) and that your surgeon has advised you to take an asthma related medication that anecdotally may soften the capsule.  My recommendation would be to NOT take the medication---it may not help at all and why put something in your body where you need to monitor the liver?  Have the implants and capsule removed since you sound like you have capsular contracture, request the pectoralis muscle be repositioned to its anatomic attachment, and give your tissue a chance to recover.  It might be that you will need a lift, but I would stage that and see what your skin and tissue can do on its own.

Myles Goldflies, MD · Answer

It sounds like you have 2 strikes already.  I don't know if you are a baseball fan at all, but it doesn't have to be 3 strikes to be "out."  If you keep having problems like this and "hate them," you should have them removed.  As far as the result with removal, you should expect to have a little less tissue than before the implants because the contracture will usually thin your tissues, unless you gained some weight.  Shape will not be exactly as it was before, but hard to predict.  Since you are on the "other side of the pond," you might want to look into the polyurethane implants, which I believe are available in Europe.  I had a fair amount of experience with them in the US back in the 80's and was always amazed at how they could be used in someone with repeated capsules......and they gradually got softer!  Odds were always against someone with bad capsular contracture, usually recurring with more surgery, unless the polyurethanes were put in.  But that was back in the 80's before the days of submuscular......