F, 25, 58KG, 1.50cm, prefer to remove implants & have fat injection, do I need a lift too? (Photos)

Hello, thank you for your question. I understand that you're feeling unhappy with your breast augmentation results and are considering your options for correcting asymmetry. Please see the attached video that answers your question in detail. If you’re feeling uncomfortable and unhappy with your current results, it’s absolutely reasonable to explore options for removal and correction. Consulting with a qualified plastic surgeon will help you navigate this process effectively and allow you to make informed decisions about your body and your desired outcomes. Remember, your satisfaction and comfort are the most important factors in your decision-making.

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

Removing 175-250 cc implants and placing with 70-75 cc of fat will provide inadequate volume. The technique I recommend is explantation and mini lift. Using a circumareola incision, 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. At the same time, fat transfers can be performed for additional volume.

Best Wishes,

Gary Horndeski, M.D.

Hello @Sincere666162, thank you for your question. Performing a total capsulectomy is important if you are considering an explant. The most optimal and aesthetically adequate option would be immediate reconstruction with the BRALAN technique (Breast Reconstruction Anatomical Lift Augmentation) and a lift. I link a video that sheds more light on the matter. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Dear Sincere666162,
based on your photos, it looks like you might need breast lift after removal of implants. My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Once removed, you may need a lift since one breast naturally sits lower than the other. With fat, you can usually obtain about a half cup increase and sometimes up to one cup. Please discuss this with your surgeon.

You can elect to remove your implants at any time, however it is important for you to make an informed decision before proceeding with more surgery. It is unlikely that you will have significant improvement in asymmetry by simply adding 75cc of fat to the smaller breast. You have volume and shape asymmetries as well as differences in your folds which will each contribute to your overall look. Be sure to discuss with your surgeon your goals for surgery as well as what you can realistically expect before making a final decision on how to proceed.