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

Question

I had 365g Natrelle 410LX implants placed under the muscle (just barely under the muscle as it was needed to fill lower pole entirely. Right side filled out almost perfectly, left you can still see old shape. Had this done 12 years ago. Want them out. If I explant and do a fat graft session will I be able to have nicely shaped breasts? I hope for a big B cup or small C post-op. My bra size was 38b pre-op and I’m now a 36d. Any thoughts would be greatly appreciated thanks for your time.

Farbod Esmailian, MD · Answer

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.

Kenneth Hughes, MD · Answer

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.

Camille Cash, MD · Answer

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.

Gary M. Horndeski, MD · Answer

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.

Daniel Barrett, MD · Answer

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

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

Answers (6)

Answer: Explant and The Bellesoma Lift

Answer: Explant and The Bellesoma Lift

Answer: Implant removal

Answer: Implant removal

Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.

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

Answers (6)

Answer: Explant and The Bellesoma Lift

Answer: Explant and The Bellesoma Lift

Answer: Implant removal

Answer: Implant removal

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.