After explant, I have a flat pancake look and can't get a bra to fit. What can I do?

Im sorry that you are upset and feeling blue but you have a few options.  Obviously the best treatment would be to get new implants.  I understand that financially that is difficult for you but perhaps you can find a university training program that has a resident clinic that offers cosmetic procedures at a reduced rate.  You can also use fat to fill the void of the implants but that would require surgery and would also incur costs.

Get a loaded bra to help fill it in when you are dressed. Save some bucks and get new smaller implants. Consider fat transfer for a half cup change.

I'm sorry to hear of your frustrations after implant removal. You may want to go for a professional bra fitting to help find a style that you like. Implants would typically be advised to help improve shape, but you mentioned they are not currently in your budget.

I'm very sorry for your experience.  This is a good, if painful, example of why surgeons are often reluctant to remove implants unless they really have to - it's nearly impossible to replicate the breast shape and volume that women have become used to without at least smaller implants.  Removing 425's is a very dramatic change and no amount of skilled surgical technique can make up for that loss of volume.  Having smaller implants put in at some point is the best choice.  Fat grafting may help, particularly for a smaller volume, but it's less predictable and not necessarily that much less expensive.Otherwise, I would recommend that you continue to research bra and bra options, including inserts.  It's not the same, but it's about the best option at this point, and certainly the least expensive.  And safest.I'm sorry for the way you're feeling now but I hope that this helped and good luck.Dr. Alan EnglerMember of RealSelf100

The best way to avoid this is an internal lift at the time of explantation in order to decrease breast diameter, increase projection, and create a fold if it is not there.  Options now are fat transfer but this is about as expensive as more implants.