Breast Implants removal and areola reduction?

Question

Hello, I have silicone implants. However, they are uncomfortable and give me constant aches. For that reason, I am considering to remove them, while at the same time, have an areola reduction. If that was the case (doing this two procedures at once), I would like to know if I would still need a breast lift. In addition, I would like to know how much would that approximately cost? (I live in LA). Thank you!

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

Gary Lawton, MD, FACS · Answer

For explant surgery, it is almost always best to remove
the capsule in its entirety.  This will allow the space to heal.  If
you leave the capsule in place, it does not heal.  It will also change the shape of the breast in a way which may make it unnecessary for you to have a lift, especially in combination with nipple aerator reduction.

Tom J. Pousti, MD · Answer

I am sorry to hear about the complications you have had with the breast augmentation procedures.    Physical examination would be necessary to provide you with an accurate assessment and advice. This physical examination will also be important in evaluating important factors such as skin elasticity, position of the nipple/areola complexes on the breast mound, the amount of native breast tissue present, and the size of breast implants present etc. These “characteristics” will be important when it comes to providing recommendations to patients considering breast implant removal. For example, determining whether a patient would benefit from breast lifting, will be dependent on many of these factors.  I generally recommend removal of breast implant capsules if the implant capsules are thickened and/or symptomatic.
Generally speaking what breasts look like after explantation depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back), the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation). 
Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will potentially influence the factors discussed above. If you take these factors into consideration and apply them to your specific circumstances you may get a good idea of what to expect after the implants are removed.
When it comes to costs of surgery, there may be many “variables” involved. The specific surgeon's credentials/experience level (or lack thereof), the specific geographic area you are looking at, the different operations available, the location of the procedure (quality of surgery facility), type/quality of anesthesia provider,  type of breast implants… are some of the potential variables involved.  You will find some average costs of surgery on this website and on individual plastic surgeons' websites as well.
In regards to outcome of the planned procedure, more important than costs of the procedures will be careful selection of your plastic surgeon. I would suggest starting with the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery to obtain a list of well experienced board-certified plastic surgeons.
Then, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. Ask to SEE lots of examples of their work AND preferably speak/see patients who have had similar procedures done.
Be very careful with your decision-making. You will find, while doing your due diligence, that there are many different “specialties” who will offer their services to you; again, I strongly recommend you concentrate on surgeons certified by the American Board of Plastic Surgery.  I would also suggest that you do not base your selection of plastic surgeon primarily on costs of surgery; keep in mind that revisionary surgery may be more costly in many ways.   I hope this, and the attached link  (dedicated to breast implant removal surgery concerns), helps.  Best wishes.

David J. Wages, MD · Answer

Thank you for your question.  No online reviewer can give you complete advice to your specific inquiry, one should have an exam and assessment of your tissues to determine your specific needs.  Generally speaking, one can have removal of implants and a periareolar reduction.  This is limited to the size of the areola and the laxity of the tissues.  If one has extremely lax tissues and a large implant then one may need more of a lift than can be done with the periareolar technique.  I would recommend starting with a face to face consult with a Board
Certified Plastic Surgeon who has experience in these areas. During your visit
your surgeon should be evaluating your health to determine if you are a good
surgical candidate and examining your tissues to get a sense of what type of
procedure your tissues will allow. Only with a hands on exam can this be
determined. Once an exam and opinion is rendered then you can decide if surgery
is right for you. The surgical costs vary from surgeon to surgeon and location as well as if one needed the additional lift.  A range could be from $5,000 to $8,000 in the Boston area.  Good luck.

Michael J. Brown, MD · Answer

Hi,

Thanks for posting your question. I am happy to try and help you. It is
important to remember that a board certified plastic surgeon will be your best
resource when it comes to an accurate assessment of your situation, and
concerns.

Having said that, a breast lift is a good option to be done with a breast implant removal. The costs will vary based upon the situation and where you live.

Best wishes,

Dr. Michael J. Brown
Northern Virginia Plastic Surgeon

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