Managing Expectations. Breast Implant Removal and Lift? (photo)

In 2005 I had saline implants placed under the muscle, they were about 350 CC, along with a benelli lift. For the past two years I've been researching having them removed. Two PS have recommend deflating the implants in order to determine if I need a lift prior to removal. But one said that I may not have enough tissue for a lift and I will be left with very sad, saggy breasts. I'm okay with very small breasts, I just don't want sad and saggy. Thoughts. I'm 46, 5'2", 115 pounds.

Doctor Answers 5

Managing Expectations. Breast Implant Removal and Lift?

You may want to have the implants removed and wait. A lift can be performed later if necessary.

Find a plastic surgeon with ELITE credentials who performs hundreds of breast implant removals, breast augmentation revisions, and breast augmentations each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Implant removal

You most likely will have less breast tissue now than you did prior to implants, so you may find a very small implant beneficial to the outcome. If you are expressly opposed to implants, you can have a lift without, and if you are unhappy, have a small implant placed, or explore the option of fat grafting.

Patti A. Flint, MD
Scottsdale Plastic Surgeon
4.6 out of 5 stars 54 reviews

Managing Expectations. Breast Implant Removal and Lift? (photo)

Your pre-op photo clearly indicates that you do not have adequate breast tissue and a lift would not help in terms of restoring volume, it will actually decrease the size of your breasts.  Deflating the implants is not a bad idea, but does not seem necessary, given your pre-operative condition.  If you are not happy with the shape of your breasts, it is because the implants are high-riding and you have too much upper pole fullness.  Your upper pole needs to have a smooth slope, instead it is prominent and convex.  This is most likely due to capsular contracture which can be corrected, allowing an improved shape.  Please make sure you are under the care of a plastic surgeon certified by the American Board of Plastic Surgery and with enough experience in this particular area.

Ruben B. Abrams, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 19 reviews

Breast Lift after Breast Implant Removal

Implants do exert pressure on surrounding breast tissue, potentially thinning breast tissue  and sagging. Sagging naturally has progressed since you had your augmentation, as 8 years have passed. There is nothing wrong with small breasts that are perky and youthful. This usually requires a simultaneous breast lift during the explantation. Some patients look similar to how they started after explantation, especially if they have gone with small implants and have great skin tone.  Because you did have some mild sagging before surgery requiring a Benelli or donut lift, I would anticipate that your tissues may be more prone to aggravated sagging after your implants are removed. Therefore I would anticipate some looseness and sagging after implant removal. You already have a scar around the nipple and large nipple/areolar size. It would make sense to remove the implants and then tighten the skin envelope with at the very least a Vertical breast lift, so that the areola size can be reduced and proportional to the smaller breast mound. I would anticipate a small breast which is fine, but without an exam it is hard to say how much tissue and skin there is to work with. Worse case scenario, in the situation of a lack of tissue, a contour depression can result in an area, but that can always be managed with future fat injections. I rarely find a need  to deflate the implant first to determine your management options. A good physical exam is usually enough to formulate a surgical plan and give you an idea of potential outcome.

Hayley Brown, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 88 reviews

Managing Expectations. Breast Implant Removal and Lift?

In patients your size with relatively modest sized submuscular implants I basically never do a lift at the time of explantation and rarely do I have a patient come back for one. By about six weeks after the removal you can expect, in all likelihood, to look just like you did before surgery plus 8 years of aging of the tissues. It's always best to wait because we do not want to do surgery that turns out to be unnecessary.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.