Want to explant 420cc, under muscle saline implants - do I also need a lift?

As you have stated, you "don't mind a little sag and would rather not have all the scars and extra downtime," i would suggest just having the explantation and reserving the lift for a possible secondary procedure. I suspect that there is a very good chance you will find the appearance acceptable and not feel a need for the mastopexy.

Hi there. You will have some sagging with explantation only. Whether it is to a degree that is acceptable to you, that is dependent on your expectations. Since you have saline implants, an option is to have your implants deflated in clinic, and allow your breast several weeks to settle. After that, you can assess how you feel about the appearance of your breasts and will have a better idea of whether you want to proceed with explantation only or explantation with lift.

Dear dciam6,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

In my opinion, you will likely need a lift after explant. Because your implants are under the muscle, it is more safe to perform a mastopexy or lift at the time of implant removal. I would recommend seeing a highly trained plastic surgeon with experience in breast surgery.

Removing your implants will cause you to loose a lot of volume, at least 2 cup sizes. Ideally, a breast lift would give you the best results but with scars and extra expense. If you don't mind saggy breasts, similar to what you have now, you can avoid a lift. The breasts will be no more saggy than they are now.

I appreciate your concerns however you have a combination of fairly large saline implants and breasts that are fairly ptotic with those implants. The lift will most certainly be needed anfter implants are removed. I understand the concern about the scarring, however, they allow your plastic surgeon to lift and shape your breasts in a most attractive fashion. Also attentive scar care minimizes the scarring in many individuals. Come see me or another board-certified plastic surgeon in our area to explore the best options for you. Good luck.

Hello!
With explantation, patients may decide if they want to pair the procedure with a lift and/or fat transfer to provide some volume. A good portion of patients who see me are happy to try the explant and see how it turns out, delaying further surgery to a later time - which is totally fine. You should be absolutely sure you want to remove the implants - that is the most important thing. The lift at the time of explant would leave you with a more finished result, but if you are unsure, you should wait.
Best of luck to you!

Thank you for sharing your question and photographs. For optimal results I do think you will need a lift with implant removal but it depends on your goals and an in-person examination of your current tissue quality. Seek out a series of in-person consultations for the best advice and treatment plan.

The technique I recommend is explantation and lift using The Bellesoma Method. 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.

Best Wishes,

Gary Horndeski, M.D.

Best to be seen in person to discuss concerns like this. Based on your photo, I would expect that you would get the best shape with a lift, but examination would be helpful to see how much better it would be. Fat transfer can be a helpful addition as well, to give back lost volume after implant removal and help improve the shape of the breasts.