360cc are too large. Would I need a lift with an explant? (photo)

Hello and thank you for your question.
Based on the photographs provided, it looks as though your nipple areolar complex is in a good position in relation to your inframammary fold. Although the appearance of the breasts can be somewhat unpredictable after explanation, I would recommend an explant only without a lift, particularly if you're concerned about scarring. You also may want to consider fat grafting to restore some of the upper pole fullness after implant removal. Good luck. I hope this helps.

Dear Randomnameee,

60 cc difference in your implant size should not necessarily equal the need for a lift. If I were you, I would prepare for one because in the operating room if the smaller implant is placed, and there are not good aesthetics between the implant and your natural breast, then a breast lift may be needed in real time. It is best to seek opinions from several different board certified plastic surgeons to prepare yourself for this potential option.

Best,

Earl Stephenson, Jr, MD, DDS, MBA

ESJ Aesthetics

Dear randomnameee,


determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question. Since you originally had B-cup breasts and your 360cc teardrop implants have been in place for about three years, it's possible that your skin and breast tissue have stretched to some degree. Teardrop implants tend to provide significant fullness in the upper part of the breast, and removing them may lead to a deflated appearance. Whether or not you will need a lift after explantation depends on your skin's elasticity. If your skin has good elasticity and your nipples remain positioned above the inframammary fold after the explant, a lift may not be necessary. If you dislike the larger size of your current implants but still want some volume, you could consider exchanging them for smaller implants (e.g., 200-275cc) and undergoing internal bra support (capsulorrhaphy). Another option is fat transfer, which can provide a subtle and natural shape if you are concerned about volume loss but prefer to avoid implants.

When considering explant surgery, whether a lift is necessary depends on several factors, including the amount of skin elasticity you have and the degree of sagging. Since your implants were 360cc, removing them could potentially leave your breasts with less volume, causing a deflated appearance. You would need a lift to enhance the aesthetic of the breast. A lift could be performed at the same time of the explantation, or your surgeon could explant and see how your skin responds. If you’re still not satisfied with the shape post-explant, a lift could be performed later to improve contour and position; this will require scars on the breast.


It's important to have a detailed conversation with your surgeon about your goals and concerns, as they can help guide you toward the best solution for your body and desired outcome. They may suggest waiting a few months post-explant to see how your breasts settle before deciding if a lift is necessary.


Dr. Krishna Vyas, MD, PhD, MHS
Harvard, Johns Hopkins, & Mayo Clinic Educated
Double Fellowship Trained
Aesthetic Plastic Surgeon
New York, New York


ABOUT DR. VYAS
Dr. Krishna Vyas, MD, PhD, MHS, is a highly trained plastic surgeon specializing in aesthetic surgery and breast surgery, including breast augmentation, reduction, lifts, and gender-affirming surgery (such as chest masculinization and feminization). With advanced training from institutions like Harvard, Mayo Clinic, and Johns Hopkins, Dr. Vyas is recognized for his expertise in breast and chest sensory nerve preservation and restoration. His PhD in clinical and translational science focused on stem cells, fat grafting, and improving outcomes in aesthetic surgery and breast surgery. Dr. Vyas has served on the editorial board for several medical journals and platforms and has over 200 research papers and talks. His research focuses on aesthetic surgery, regenerative medicine, stem cell biology, fat grafting, breast surgery, and gender-affirming surgery. Recognized for his expertise, Dr. Vyas was appointed an Instructor of Surgery at Mayo Clinic and served as an Assistant in Surgery at Harvard Medical School and Massachusetts General Hospital.

Thank you for your question. I have been in practice for over 30 years and revision of breast surgery is a large portion my practice. In your case, you do not have enough breast tissue to perform explantation and have an aesthetically appealing result. You may want to consider changing to smaller implants and performing an internal bra-capsulorrhaphy. I wrote the very first paper on this in 1999. You are an excellent candidate to downsize and perform a lollipop type lift. You should be able to have an excellent result. Best wishes to you.

Explants often result in dissatisfaction due to the hanging skin. At this time, I recommend 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.

If you didn't feel like you needed a lift before your augmentation, there is a good chance that 6 months after explant alone, you would probable be satisfied with your breasts. MY philosophy is that unless it is absolutely clear that a lift is needed, it's better to wait. You can't "undo" a lift, but you can always do one later. Also, sometimes a simple peri-aereolar lift under local anesthesia can be done in a delayed fashion. Best wishes.

In general you can reduce size by 200 cc or so with good skin elasticity without a lift and treason a good shape. At 360 cc, it is likely they will appear deflated after explantation.. An in person examination would be necessary to govern you the best opinion. Consideration of a smaller implant or fat grafting g could be considered. Another approach is to remove the implants and after 3 months then decide the best option.

Dear randomnameee,
You appear to be very young with good skin elasticity. So, you may not need a breast lift after removal of your breast implants. You can have the explantation done and see how your skin responds and stage the lift if needed at all. Good luck!