415 & 450cc, small cup prior - lift or no lift with explant? (Photos)

Question

I have had 415 and 450 cc implants for 3 years, no children, no weight loss. Was a small a cup prior. Will I need a lift with capsulectomy and explant?

Shaher W. Khan, MD · Answer

Hello, thank you for your question. Whether you will need a breast lift (mastopexy) along with your explant and capsulectomy depends on several factors, including your breast tissue quality, skin elasticity, the degree of sagging, and your desired aesthetic outcome. Please see the attached video to discuss your question in detail. In summary, whether you need a lift during your capsulectomy and explant depends on your individual circumstances. Consulting with a qualified plastic surgeon will provide you with the best guidance tailored to your needs, allowing you to make an informed decision about your procedure and desired outcomes. Don’t hesitate to express all your concerns and goals during your consultation to ensure you achieve the best possible result.

Alan Gonzalez, MD, FACS · Answer

Hello @Akisej, thank you for your question. The answer to your question of whether or not you need a lift with capsulectomy and explant depends on your specific goals and aesthetic concerns. After the removal of implants, the skin and tissues of the breast may be stretched or sagging, leading to a less-than-ideal appearance. If you decide to have a lift after removing your implants, the most optimal option would be immediate reconstruction with the BRALAN technique (Breast Reconstruction Anatomical Lift Augmentation) combined with a breast lift.  The BRALAN technique is designed to give natural results by rearrenging the breast tissue while also lifting and reshaping the breasts. I link a video that sheds more light on the matter. Whenever considering any surgical procedure such as breast implant removal (explantation), it’s important to consult with an experienced plastic surgeon who can explain all options thoroughly to make informed decisions based on your needs and specific anatomy.  Best wishes! Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science”  Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Finny George, MD · Answer

Hi, thank you for sharing your question. To determine an exact plan without an exam wouldn’t be accurate. It seems that your may have descended out of the original pocket. A lift procedure along with an internal bra would solve the problem and likely avoid future issues.

Raffy Karamanoukian, MD, FACS · Answer

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Daniel Barrett, MD · Answer

Dear Akisej,it is hard to tell for sure without an examination. You can get implant removal and wait to see the final results. Later you can decide do you need a breast lift or not. 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

Gary M. Horndeski, MD · Answer

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 Wishes,

Gary Horndeski, M.D.

Shana Kalaria, MD · Answer

Likely you will only need breast implant removal without capsulectomy or a lift because you are young and your skin quality looks good. If you desire a lift later on, you can do that as an option, but I would recommend just the removal for now. Please find a board-certified plastic surgeon. Good luck!

Connie Hiers, MD, FACS · Answer

Your nipples are in a good position, but your implants have sagged from the weight. If removed, you will have extra skin. An examination is needed to see if the lift could be done at the same time as the removal, or would it need to be done later. If your breast tissue is very thin around your nipples now, a lift could damage the blood flow to your nipples and cause them to die. You might consider tightening your lower pocket and going down in size that better fits your frame and tissue.  Remember, you were not happy with your breasts before implants and may not be happy once removed.

Nancy de Kleer, MD, FRCSC (Plast) · Answer

Based on your photos, I don't think a lift will be beneficial to you, as you nipple appears to be in a good position and there is not much tissue to lift.   I recommend removing the implants, giving the tissues time to retract on their own, and then making a decision about a lift in a year or so.

Douglas Taranow, DO, FACOS · Answer

It depends on what your breast expectations are.  If you like the size, then keep the implants and either perform a mastopexy or a capsulorrhaphy (stitching the bottom of the capsule and possibly the base of the breast to elevate them.
If you want to remove them, then your breasts will certainly deflate and you will require a mastopexy (breast lift).

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