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

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! 

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!

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.

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.

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.

In general terms, I can tell you the following based on my experience and training with patients in your situation. Your breasts won't ever be what they were pre-operatively, but you have some things working in your favor for returning to a more normal appearance after explantation. These are: relatively small implant size, relatively short duration of implantation, and a relatively low grade capsular contracture. You may be able to get by without a total capsulectomy. Don't be afraid to get several opinions. Whatever you do, ensure that you are seeing a board certified or board eligible plastic surgeon as these individuals will be best qualified to address your concerns. Good luck!

Hello and thank you for your excellent question. Many women are concerned about the appearance of their breasts after implant removal. I suggest that you consider a simultaneous lift (if needed) and fat grafting to help add some volume to your breast at the time of implant removal. The procedure is well-tolerated, and patients are generally very pleased with the results. This decision should be based on a detailed discussion with equal input from both you and your surgeon.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck! 

Best,
Jon Ver Halen, MD FACS 
Harvard educated plastic surgeon

With such small implants, under the muscle and in a young patient I suspect implnat removal will leave you with close to where you started but it takes about 6 weeks after explant to get there so be patient.