1 capsulectomy + 2 lifts later = Another capsule, thin skin and sagging. How should I move forward with an explant? (photos)

Question

I'd like to remove my implants after two failed attempts of having full, symmetrical breasts. I can feel my implants and rippling through my skin and realize I don't have much tissue. How should I move forward with an explant? Are there techniques to avoid inversions, folds, indents? Which steps should I take to achieve perky symmetry? I also would like to have a baby(ies) in the year to five years (no rush). What should I keep in mind? My current breasts depress me. I love the rest of my body!

Alan Gonzalez, MD, FACS · Answer

Hello @ziggyjoy, thank you for your question. It depends on what you want to achieve. If you are considering removing the implants permanently, I would recommend an explant, removing the prosthesis as well as the capsule and then performing a mammary reconstruction to re-configure the mammary tissue and achieve symmetry. If there is not much breast tissue you could have a breast fat transfer 3 or 4 moths later to assure that the fat cells do not die. A breast explant with mammary reconstruction the surgical technique preserves many of the ducts through which milk is transported to the nipple, so you should be able to breastfeed. For more information and recommendations, it is best to consult one or more board-certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS.

Richard Baxter, MD · Answer

It would be very important to know the details of your previous procedures, but based on the photos my guess is that you won't be happy with the size and shape of your breasts after explant. A Strattice internal bra is an excellent option for cases of recurrent contracture especially when there is thin coverage.

Daniel Barrett, MD · Answer

Dear ziggyjoy,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kevin Tehrani, MD, FACS · Answer

Thank you for your question and posting appropriate pictures. You seem to be a good candidate for removal of your implants and replacement of volume using your own fat. Your final size would likely be slightly smaller than you are right now. It is best to have a virtual consultation to make sure you are a good candidate for this operation.

Connie Hiers, MD, FACS · Answer

With removal, you will not have perky.  A lift may have to be postponed until you have healed for safety to your nipples. You might consider going down in size and another lift.

1 capsulectomy + 2 lifts later = Another capsule, thin skin and sagging. How should I move forward with an explant? (photos)

Answers (5)

More Breast Implant Removal Questions

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Answers (5)

More Breast Implant Removal Questions

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Will I still look bottomed out if I just get implants removed? Would a capsulotomy make the appearance better?(photo)

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