What can be done to restore pre-implant appearance? (Photos)

I’m sorry to hear you’re not happy with your results. Since they’ve been in for a short period of time it’s likely things will bounce back fairly well. Resetting the fold is important but relatively straightforward. Removal of the capsule will allow the tissue to heal back to the muscle. One benefit of subfascial placement is the muscle wasn’t disrupted and doesn’t need to be repaired.
The cleavage will likely return to its baseline shape.

You’re asking very precise and appropriate questions — and the short answer is yes, much of what you’re describing can be improved, but it requires structural revision, not just implant removal alone.Let’s address your points directly.1) Can pocket tightening restore pre-implant cleavage width?Yes.If the implants were medially over-dissected (~0.5 cm), a medial capsulorrhaphy (pocket tightening) can be performed at the time of explant to:Narrow the cleavage spaceReduce implant-related medial stretchAddress the “tented” or lifted cleavage skin you’re noticingThis works best when:The capsule is still relatively young (yours is ~8 months)There is no severe capsular contractureThe correction is reinforced properly (suture technique ± autologous tissue support)Pocket tightening is a standard and effective part of revision surgery in cases like yours.2) Can the inframammary fold (IMF) be raised back to its original position?Yes — to a meaningful degree, especially since the fold was lowered a known amount (~2 cm) and the surgery is still relatively recent.IMF restoration can be done by:Recreating the IMF with internal fixation sutures to the chest wallUsing capsular tissue or dermal support to reinforce the foldPrecisely excising excess lower-pole skin if neededThe earlier this is addressed, the more predictable the result tends to be.3) Will explant alone restore the pre-implant look?On its own, explant + capsulectomy rarely restores a true pre-implant appearance, because:The skin envelope has been stretchedThe IMF has been surgically alteredThe breast footprint has changedThat’s why structural correction is key.4) What gives the closest result to your pre-implant state?The most effective strategy usually includes:Total explantationTargeted pocket tightening (especially medially)IMF reconstruction / elevationSupportive reshaping of your own breast tissueIn many cases, this is best accomplished with a Push-Up Lift–style revision (supportive mastopexy) — not to make the breast larger or “lifted,” but to:Re-center your own tissueRemove stretch-induced redundancyRebuild internal support so the breast sits where it used toThis can be done without implants and tailored to be as conservative as possible.6) What cannot be guaranteedIt’s important to be honest:You may not return to a perfect pre-implant stateSome skin stretch and footprint change is permanentHowever, significant improvement and a very natural, pre-augmentation-like appearance is achievable with the right revision approach.

Dear Tasteful670786,

it is hard to tell for sure without an examination. 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

Thank you for sharing your story — your questions are very thoughtful and relevant for anyone considering explant surgery with aesthetic restoration in mind.
Here are a few key considerations based on your situation:

I'm sorry you are unhappy with your implants. Because you have only had your implants in place for eight months you should have pretty good skin retraction after full healing is complete. Visit with your board certified plastic surgeon what is recommended for you to help you achieve your surgical goals.

If you don’t have a capsular contraction, you don’t need a capsulectomy.
Most likely you just need to have your implants removed.
Most likely, you should do this sooner rather than later if you wanna get your original look back.
Patients who had implants for many years, typically do not get their original look back.
If the implants are removed soon after the procedure, typically things go back to normal.
I wouldn’t make this too complicated.
Just have the implant removed and see how it looks.
If you look at anatomy books, you’ll see that the central pectoralis muscle doesn’t have fascia.
Best,
Mats Hagstrom MD