Explant + capsulectomy. Would the surgeon go through the same incision around areola or make a new one under the breast? (Photo)

Hello @ziggyjoy thank you for your question and showing your pictures. You can contemplate 2 options taking into account the reasons why you want to remove the implants. If they are medical (health) reasons, putting in new implants, even if they are small, is not an option. You can consider improving the volume and projection with fat transfer to the breasts. It is very visible that there is a capsular contracture and if it is possible to release the contracture at the same location where the incision was made to do the breast augmentation. Now, as to the time to perform the fat grafting surgery before pregnancy depends, being you a lean person you can do it before pregnancy, in fact it will benefit you so that the breasts have projection and support and do not fall so much after breastfeeding. If what you want is to do an explantation with capsulostomy is not convenient to do the fat transfer to breasts in the same procedure, it is advisable to wait 3 to 4 months to avoid the fat to die or risk of infection. In this case the incision would be periareolar and inverted J-shaped to avoid making a T. Best wishes! Alan Gonzalez MD, FACS.

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

Hello, thank you for your question. If you do plan on doing a lift after removal of the implant, it is a good idea to wait until after pregnancy. During pregnancy the breast will change, they will get bigger and then smaller. You may have more excess skin after breast feeding. Fat grafting maybe an option but not the solution or a quick fix. Again waiting until after will be beneficial. Then you can look into options of fat grafting and/or lift depending on what you want your breasts to like afterwards.

Thank you

Dear ziggyjoy,
it is hard to tell for sure without an examination. Generally speaking, it is possible to use the same incision for the removal of implants. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Your surgeon will likely use the areolar incision when removing your implants. I encourage you to speak to her/him about your preferences. If you are intending to have breast surgery in the future I advise you to wait until after pregnancy and breastfeeding. Many changes can occur to the breasts during that time. I would not recommend fat grafting based on your photos.

Your surgeon will probably use your same incision. You do not appear to be a candidate for fat transfer since you do not appear to have any donor fat. If you are planning to have children, wait until you have had all the children you want and then consider a lift. Who knows, you might actually gain some breast tissue after pregnancy. It does happen sometimes.

The explant and the capsulectomy can be done frequently through your existing incision. I would not rush into fat grafting if you are considering pregnancy. Also a formal consultation would be necessary and I recommend a Board Certified Plastic Surgeon. There may be a role for explant and capsulectomy through and inframammary fold incision as this could be used again at the time of your lift procedure after pregnancy. Discuss with your surgeon.