Explant on preciously tuberous breasts with fat graft. Will my creases ever disappear? (photo)

It is always difficult to predict how things will look after implants are removed, especially since you have had them for some time.  Judging by the preop photos, I would say that you should be prepared for the possibility of needing to reposition the nipple and areola (lift) as well as fat grafting.  I would say that it would be likely that you would need more than one surgery, i.e. further fat grafting to achieve an aesthetically pleasing result.The one thing you should be advised is that the fat grafting is really for contouring rather than give you size.  Yes it will give you some volume, but its goal is to shape the breast.I would recommend you see a board certified plastic surgeon that performs breast revision surgery.Hope that helps.

The smaller the implant and the less the amount of time it has been
since placement, the greater the chance the breasts 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.  
Usually removing them and performing the lift at the same time makes
the most sense as some patients clearly need a lift and only want to go
through one surgery.  If you are borderline, 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.Breast fat transfer is a great tool to balance breasts, improve
symmetry, and gain up to one cup size in volume.  In general, 200 cc per
breast is typically the upper limit of fat injection recommended by
most plastic surgeons.  It is not that more cannot be injected; but on
average, this has been determined to be the most that can be expected to
live during one transfer.  Multiple transfers would be required for
additional cc's.  In general, the abdomen and thighs are preferred donor
sites but fat from other areas can be used.
Some of the retention rate will depend upon the amount of fat
transferred, as smaller volumes will likely have a higher
survival.  Occasionally, a patient can resorb a great deal of the fat
despite optimal transfer procedures. I typically transfer from 250 cc to
400 cc or so per breast.  
Results are largely dependent upon the skill of the
surgeon, his/her ability to remove fat without creating contour
deformities, and your expectations. You would need a consultation with a
board certified PS to determine your available fat stores.

In order to maximize the outcome you will likely need a lift along with the fat grafting.  Please be aware that fat grafting does not produce the same look as implants.  Often times touch ups are needed as the fat does not always "take" evenly.  Be sure to see a board certified plastic surgeon near you to learn more.

I recommend explantation and a lift using a no vertical scar technique.  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.  If you were a B before augmentation, you should still maintain a B size.Best Wishes,Gary Horndeski, M.D.

Dear Trustworthy38,
This will depend on technique used for primary surgery but there is a chance that your breasts will have a nice shape once you get implant removal and fat transfer. 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