After breast implant removal it appears that most breasts appear very empty looking. Will that change over time?

I always tell patients who request or require implant removal that their breasts will not look like their pre-operative breast appearance. This is more true the longer they were in place, and the larger the implants.A breast lift works by removing skin (losing breast volume, but only about 30 grams of skin) and creating a higher, tighter skin brassiere. But without the implant volume, you can't expect a "more filled out look." This is particularly true with the flattening of the ribcage, stretch of breast skin, and compression of breast tissue that occurs with any breast implants, and more with large(r) ones.Unless you plan to remove the left implant as well, placement of new implants (the present generation of cohesive silicone gel implants cannot "leak" and take a tremendous force to rupture them) after capsulectomy is the best choice for most women after single implant rupture. I take rupture to mean you have saline implants and have deflated the one side, or you have much older (>10 years) silicone implants and have confirmed rupture, NOT just a MRI report and no objective signs.See one or more ABPS-certified plastic surgeons who do lots of breast surgery and discuss all of your options. Then you can make an informed choice that will give you the best outcome and the least risk of regretting a hasty decision or incorrect one. Best wishes! Dr. Tholen

After breast implant removal, the breasts do indeed look empty and often baggy.  That is because the weight of the implant stretches the skin and displaces the volume of the breast tissue, particularly underneath.  With time this may improve... or it may not as much as you like.  In some settings, it is safe and reasonable to do a lift at the time of removal.  Another approach is to do fat grafting either during or after implant removal with or without a lift.  

My experience after almost 17 years in practice is that most Breasts return pretty close to their pre augmentation size and shape after deflation or implant removal within a couple of weeks,   unless of course your size and shape has changed since your augmentation.  A Breast lift will tighten the skin envelope and by rearranging the Breast tissue as well as removing extra skin, will give you a fuller look.  I like to tape up a sagging Breast so the patient can truly appreciate how much volume they have without the distraction of the sagging skin.  i recommend an in person exam with a board certified plastic surgeon to discuss your options.  You are at no health risk from a deflated implant in and of itself, but they can become uncomfortable if they fold up.  And of course the asymmetry is always a problem.  I hope this helps! 

I think that you need to be evaluated in person. If you have enough breast tissue, the implant can be removed and the lift might be able to be performed at the same time.

You're right - and that's because they are.In general, the larger the implants (relative to your frame and the amount of breast tissue you had) and the longer they were in, the less likely you will return to your pre-operative appearance; or even close.  In fact, depending on the degree, you would almost certainly need a lift to tighten the loose and excess tissues and, if you're willing to consider it, smaller implants.  Not just for volume but also for shaping.  As you've suggested there is that empty look, which is unavoidable after all the breasts have been through.You can do it in stages, and there are certain advantages to that.  Removing the implants and doing a lift at first, and then giving your body a change to heal on its own before assessing makes a lot of sense.  You can then undergo insertion of a small implant, revision of the lift (if indicated) or, hopefully, nothing at all.  You should of course discuss all of this with your own plastic surgeon.I hope that this helps and good luck,Dr. Alan EnglerMember of RealSelf100

It is important to have an explantation of a deflated implant soon prior to any health problems from mold biotoxins or bacterial infections.  I would recommend bilateral total capsulectomy with an internal lift to help shape the breast at the same time.  If a patient has low NA complexes or excess skin, this can also be removed at the same time.