Necessary to Replace Breast Implants After Explantation and Lift?

I have had 450cc over the muscle implants for 5 years and have lots of stretched/sagging skin. I'm having implants removed and lift done. My doc said the lift would make me an A cup and I would need to implants to be bigger. So my question is, if breast are this small is an implant necessary? I know it helps w/ cleavage but what how would they look without new implants?

Doctor Answers 23

Explantation of Large Implants and Lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is difficult to provide specific answers to your questions, but this is generally a difficult problem to address and achieve a nice aesthetic result. This problem usually results from having a larger implant placed over the muscle in an effort to avoid doing a breast lift. This is a poor choice because it inevitably results in gradual thinning and stretching of the tissues, and sagging or descent  of the implant, resulting in the so called rock-in-a-sock phenomenon. The correction is difficult as it almost always requires a lift which carries a high risk of nipple or skin loss because of the thinned tissues. If you end up with an A-cup when it is all done, you may not be happy with the size or shape. You could then subsequently place a more appropriately sized implant (under the muscle) and you could get a good result as the breast tissues have now been appropriately repositioned for a new implant.

Reshaping breasts after removal of large implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Only a surgeon who has personally examined you can give you specific advice, but there are a few general comments that apply. The implants you have are on the large side, and so reshaping the breasts after stretching and sagging is often a bit of a challenge to get a nice shape. If your surgeon has estimated that you will be an A cup then there probably isn't a lot of breast tissue to work with. The majority of patients in you situation will get a better look by downsizing rather than removing the implants and relying only on the lift for a perky shape.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Do Breast Implants need to be Exchanged or can they just be removed?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You have said you would be an A-cup following removal of your breast implants, so the question is for you to decide is that enough for you..

I suggest that rather than focusing on bra sizes, that you gather several pictures of breasts of the size and shape that you feel are want you want. 

Bring the photos with you to your plastic surgeon and discuss your concerns using them as a reference. This will help you to make an informed decision.

Fredrick A. Valauri, MD
New York Plastic Surgeon

Are implants necessary...

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi there-

Only you can decide whether or not your goals would be met without an implant.. Your breasts would of course be very small, but shapely.

If fulness of the breast (if not a larger size) is important to you, you will probably be best served by having implants replaced. 

Explantation and lift is a great procedure if you want smaller breasts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The best breast size for you is a personal decision. I am really not able to accurately predict a patients breast size after implantation and lift, but I can say that removing the implants makes the breasts smaller. So if small breasts are what you want, you do not need to replace the implants. Remember too that if you have the lift and decide later that the breasts are too small, you can have implants put back in.  If you are not sure now what you want, waiting to re-implant will give you the chance to see how you feel with your new, perky smaller breasts

Elizabeth Slass Lee, MD
Bay Area Plastic Surgeon
4.8 out of 5 stars 56 reviews

Breast lift after explantation and replacement

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your goal regarding cup size is personal. Consider: 1. breast shape and beauty. 2. cleavage and 3. upper pole breast fullness. The lift will: 1. tighten loose skin 2. lift the nipple 3. improve breast shape. You may wish to add a small implant to maintain 1. beauty 2. better.shape and 3. upper pole fullness.

Burr von Maur, MD
Orange County Plastic Surgeon
4.6 out of 5 stars 22 reviews

Breast lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

They will look lifted and small. Exactly how depend on what you have of breast tissue. But expect to be small. If that does not bother you then do it without the implants.

On the other hand if you are not sure, do the explant and lift. If you do not like it later then an implant can be put in at a later stage,

Samir Shureih, MD
Baltimore Plastic Surgeon

New implants after explantation - yes or no?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

From what you describe, you will be much smaller after the implnts are removed. The plan for a mastopexy is wise because the skin and breast tissue are stretched out and will need reshaping.

For my own patients who have saline implants and face this dilemma, I offer to puncture the implants and aspirate the fluid a few days before surgery. Then I tape up the breasts to simulate the mastopexy. This gives the patient a preview of the result. If the patient feels that the breasts look too small, we use implant sizers to determine a new implant volume. Of course, this is not an option for patients with silicone implants.

For patients with silicone implants and/or for those who do not want implants anymore, it is perfectly reasonable to have the explantation and mastopexy to get the best lift possible, and then have implants replaced at a second procedure if the change is too radical.

Bruce E. Genter, MD, FACS
Abington Plastic Surgeon
4.3 out of 5 stars 17 reviews

Not necessary, but may give better results

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is incredibly difficult to remove implants and get a result that is one that doesn't leave someone disappointed, either you or your surgeon or both. Traditionally I have down-sizd the implants and performed a skin only mastopexy. Without examining you, I cannot tell if this would be an acceptable method for you.

You will be smaller

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is somewhat difficult to say without a picture. In general a lift or mastopexy reduces the saggy/excess skin and reshapes what breast tissue that remains so by the very nature of the procedure your breasts will be smaller. To give the breasts some volume and fullness and implant is often recommended. If you have a lift and decide later that you desire more fullness/volume then implants can be placed later.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.