Should I get a lift after breast explant and en bloc? (photos)

Thank you for the question. Don't be surprised if you receive a variety of differing responses.

Generally speaking (in my opinion), unless the breast implant capsules have thickened (and/or are otherwise symptomatic), are associated with the ruptured silicone gel breast implants, or if the patient has concerns about "medical conditions" related to the breast implants, capsulectomy is not universally necessary. For these patients, en bloc implant removal of breast implants is a good procedure.  In your case, given that encapsulation is present, capsulectomy would be indicated.

On the contrary, capsulectomy can expose patients to additional risks, such as bleeding, size loss, contour irregularities and other serious complications. In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity). For example, attempting to remove very thin capsule densely adherent to the patient's rib cage may expose the patient to significant bleeding and/or entrance into the thoracic cavity.

Whether to lift breasts at the same time as   removal of breast implants or "stage" the procedures is a decision that is best individualized.   Every patient starts out with different anatomy, different goals/expectations, as well as different  preferences…
 I have found in my practice, that when breast lifting surgery is definitely going to be necessary in order to achieve an aesthetically pleasing outcome, MOST patients prefer to have the breast lifting performed at the time of breast implant removal.   Most patients simply do not wish to undergo two operations, if avoidable.

In "borderline" cases where there is doubt whether breast lifting is necessary or not, I advise patients to undergo explantation only and to give their breasts the benefit of the doubt  before deciding whether breast lifting would be beneficial.  Patience is definitely indicated after removal of breast implants; it will take many months/year for the skin to “bounce back” and for you to see the final appearance of the breasts.
 
 As you can see, there is much to consider (which is why nothing replaces individualized care,  centered on good communication and good judgment, provided by a well experienced board-certified plastic surgeon). 
My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as well. Working together you will come up with a good plan to achieve your goals.  
Best wishes.

 
 

First an examination is needed to see if a lift can safely be done with the explant. "En bloc" surgery is used for a radical surgery in cancer patients and is not the capsule removal. You can have the capsules removed, especially if they are thick. I suggest going for consultation and discussing your options.

Dear rena378,
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. 
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