How likely will my breasts return to normal after explant surgery? Total Capsulectomy or Capsulotomy? Possible complications?

Question

I'm in my mid 20s and had silicone implants (250cc and 275cc) placed under the muscle 2 years ago. My right side has grade 2 capsular contracture, doesn't hurt just sits a bit higher than left side. I made the decision without giving much thought and just want to be back to my natural self. I didn't have much breast tissue before, went from size A to small C. In my situation, how likely will my breasts return back to normal? Would a total capsulectomy be the best recommendation? Thanks

Camille Cash, MD · Answer

Your breasts will not look the same as before augmentation, but due to the smaller implant size and your age you will probably regain much of your prior look. You will lose the fullness and volume that the implants provide.  Since an examination reveals better information I encourage you to discuss your questions with your surgeon.

Tom J. Pousti, MD · Answer

Thank you for the question.   Nothing will replace in-person evaluation when it comes to providing you with good advice. If I were seeing you in consultation, I would want to get a good idea of what breast size/shape you would be pleased with. This may be best communicated with the help of goal photographs and/or  computer imaging.  Then, once we have established what your goals are, I would be able to help you determine whether breast implant removal surgery alone versus downsizing of breast implants (plus any maneuvers necessary) would be necessary to achieve an outcome that  you would be pleased with.
 
Generally speaking, what your breasts will 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.
 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.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 block removal of breast implants is a good procedure.
On the contrary, capsulectomy can expose you to additional risks, such as bleeding and minimal size loss.  In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity).

I hope this, and the attached link (dedicated to breast implant removal surgery concerns) helps. Best wishes.

Sean T. Lille, MD · Answer

The final look following the removal of implants from a breast augmentation surgery depends upon your DNA, age, and the laxity of your breast skin. In addition, ancillary procedures including a capsulectomy and whether you had certain pathologies requiring removal of the breast implants will also affect your final look. Moreover, the longer you have the implants will also affect the ability of your skin to contract following the implant removal.  Every case must be individualized based upon these characteristics.  Taking all these factors into consideration and having a candid discussion with your physician will help make the best option for you. Good luck!

Gabriel Chiu, DO · Answer

Without seeing you for an in-person consultation, it 
is hard to predict the outcome of your breasts after explantation. Several
factors will impact your result aside from the implant removal. Over time, the
skin's elasticity may decrease, impacting the ability for the skin to bounce back.
Significant or frequent weight changes will impact the elasticity and the
volume of your breast tissues. Age and life changes like pregnancy will also
influence how well your breasts will rebound.

From your information, I believe you will have less trouble
than the average explant patient in rebounding to a close and reasonable
recovery due to the smaller implant size, the relatively short time you have
had the implants, your age, and your original cup size. The only significant
factor you have not told us about is any life changes, like pregnancy. If you
have had a pregnancy or other significant life impact, you may need additional
procedures to achieve the look you once had, like a breast lift or fat grafting
along with your explantation. A consultation with a board certified surgeon to
review your options would help decide the best surgical plan moving forward.
Thanks!

Lisa Cassileth, MD, FACS · Answer

Breasts snap back well after small implant removal. Make sure your surgeon repairs the pec muscle, as it looks a lot better!!! And it's nice to have your pec muscle fully functional again. If you've got a cap con, have him/her take out the capsule on that side too. These are often associated with biofilms and there's a small risk of chronic seroma if it's left behind. Final idea... small volume fat grafting. Since you had a breast aug for a real reason in the first place, a little fat looks great to make up for the lost implants partly and leave breasts filled out looking, not droopy.

How likely will my breasts return to normal after explant surgery? Total Capsulectomy or Capsulotomy? Possible complications?

Answers (8)

Answer: Removal and Replacement Options

Answer: Removal and Replacement Options

Answer: Removing implants less than 350

Answer: Removing implants less than 350

Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.

How likely will my breasts return to normal after explant surgery? Total Capsulectomy or Capsulotomy? Possible complications?

Answers (8)

Answer: Removal and Replacement Options

Answer: Removal and Replacement Options

Answer: Removing implants less than 350

Answer: Removing implants less than 350

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.