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

Question

Timeline and Relevant Information: Before Breasts Implants: -1997, Dr. Alexander Villicana -20 yrs old -no kids -34 AA/B- perky - 115 lbs - Athletic build, gymnast After Breast Implants: -34 C/D -20 yrs old -saline implants over the muscle though nipple, can’t see scar, no surgery complications 20 years After Implants: -42 yrs old - now 36 D/DD - 140lbs - 2 children-breastfed both-20/17 years ago - last 5 years developed capsular contracture 4 in left breast/right breast sag/stretch marks

Daniel Barrett, MD · Answer

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

Connie Hiers, MD, FACS · Answer

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.

Matthew A. DelMauro, MD, FACS · Answer

Hello, and thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) Based on your photos, breast lift surgery after implant removal and total capsulectomy may be a good option to improve the shape, contour, and perkiness of your breasts. The surgery can be designed to minimize scar appearance. If you decide to pursue surgery it’s very important that you find a surgeon whom you are comfortable with and trust and who evaluates you in-person and tailors an individualized treatment plan for you and your aesthetic goals. Best of luck!Matthew A. DelMauro, M.D.

Tania Medina de Garcia, MD · Answer

Hello dear!!
Thanks you for your question. It is my pleasure to help you with your concerns.
You can be your own best version, and you can definitely achieve amazing results with plastic surgery in order to improve your breasts. For you, I recommend an anchor incision breast lift, after explant.
I suggest you to make an appointment with a board certified plastic surgeon for a good evaluation and to talk about your goals.
I hope this is helpful.  Good luck :)

Tom J. Pousti, MD · Answer

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.

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

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