Replacing breast implants after 10 years?

Question

I've had my breast implants for 10 years now - 360cc Mentor silicon high-profile partials - and I've never been 100% happy with the scarring, but always been happy with the shape. However in the last few years I think they've changed shape, feel further apart, and I don't like the side profile. I also sometimes have some tightness in the left breast. So I think it's time to replace. I have excess fat on my abdomen, so I'm thinking of potentially removing the implants and doing fat transfer - is this possible? If not, is it possible to redo the implants and change the shape? I think teardrop and closer together would look better. See pics - larger red marks are just from my sports bra. But the scars can be seen.

Ellen Ozolins, MD · Answer

Thank you for your question. Fat transfer can replace your implants because you have excess fat on your abdomen, but it will provide subtle fullness and won’t give the same volume level as 360cc implants. If you want to maintain or enhance your current breast size while changing the shape and positioning, replacing your implants will be a good option. Since you mentioned liking the teardrop shape, this could be a great choice to achieve a more natural, anatomical look with more fullness at the bottom of the breast. Additionally, repositioning the implants closer together can help correct the spacing issue you've noticed. Also, during the procedure, your surgeon can address any capsular contracture or scar tissue contributing to the tightness in your left breast. Scar revision can also be done at the same time as your implant replacement to improve healing. However, a consultation with your surgeon will allow you to explore both options and determine the best way to achieve your goals while addressing the tightness and scarring concerns you’ve had.

Leland Deane, MD, FACS · Answer

If you're generally happy with the shape, I would leave the implants in place. Changing to a shaped implant (teardrop) will not change the profile significantly. The scarring from the incisions can be electively revised. Fat transfer for large volumes for augmentation is not a good treatment in present times.

Matthew S. Kilgo, MD · Answer

Hello,Breast implants do not need to be changed at the 10 year mark. However, if you are unhappy with the appearance of the implants , it would be a reasonable thing to consider. It is possible to perform fat grafting at the time of implant removal. However, the results are more subtle than what you would get with an implant exchange. If you decide not to replace the implants, you should get some type of implant imaging – either a breast ultrasound or an MRI. The FDA recommends implant imaging at 5 to 6 years after implant placement. I hope this helps.

Wayne I. Yamahata, MD · Answer

If you removed your implants, it is highly unlikely that you will be able to replace the 360cc volume with fat transfers. The scars can be revised. There are many potential reasons why your breasts shapes have changed. One, for example might be capsular contracture.  To truly diagnose the cause and possible treatment options would require a physical examination. Seek a consultation with a board-certified plastic surgeon.

Chet Mays, MD · Answer

Thank you for your inquiry! We would love to see you in person and discuss your options.  Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals!

Gary M. Horndeski, MD · Answer

You cannot replace 360 cc implants with 360 cc of fat as it would not be successful. However, you may benefit from replacing your implants with smaller implants and at the same time do fat transfer to create more fullness. It would be nice to plicate the pockets inferiorly and laterally to push the breasts up higher and more medially. The scars can also be revised at the same time.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Camille Cash, MD · Answer

If you are generally happy with the implant size and shape it is better to leave them alone.  You can consider scar revision to improve the scars if desired.  I would warn against fat transfers to the breasts as this can cause microcalcifications that may interfere with future mammography readings.

Connie Hiers, MD, FACS · Answer

You will not have this volume with just fat transfers. At best, a cup is gained. Your lateral pockets could be tightened. I am not a fan of the textured implants because of increased long term risks.

Darryl J. Blinski, MD · Answer

Based on your nicely posted photos, you have many options, so best to do in person of virtual consultation. If you wish implant, she moved and liposuction with fat under ultrasound, guided injections, can be accomplished to approximate the same size with previous scar visions of the infra creases. Ranges from $8000-$15,000. Again best to virtual consult with.

Mats Hagstrom, MD (license on probation) · Answer

Plastic surgeons cannot move your breast on the chest wall, but can control where the implant is placed.
Breast Augmentation outcomes are based on three variables.
The first is patient candidacy.
This includes variables like breast position on the chest wall, breast divergence, breast shape, and potential breast droopiness.
The second variable is implant selection in regards to shape size and type.
The third variable is the surgeons ability to put the implant in the correct anatomic location.
 Your scores could’ve been improved with the revision.
Did you follow up with your surgeon and talk to him or her about your concerns? 
Transfer is not going to deliver anything in comparison to the result of your breast augmentation.
If you want to maintain augmented breast, then you should not have your implants removed.
10 years implants replacement seems reasonable, especially if you’re interested in having revision procedure.
I suggest you follow up with your plastic surgeon or schedule in person consultations with other plastic surgeons in your community.
If your plastic surgeon is still in practice and you should obtain your medical records, especially a complete set of proper before and after pictures and copy of your operative report.
These can be helpful for any new surgeon taking over your care.
 it is possible to do fat grafting in conjunction with explantation, but I think you may be disappointed with the outcome.
Best,
Mats Hagstrom MD

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