Saline breast implant removal without lift. Will I be happy with the results? (Photo)

Hello @Harbor, thank you for your question. My opinion is that a breast implant removal should always be combined with an immediate breast reconstruction to reposition the tissue and improve the upper pole projection and medial areas using the BRALAN Technique (Breast Reconstruction Anatomical Lift Augmentation) as the results will be adequate in terms of aesthetics and will have a minimal L-shaped scar. In my experience, I prefer to perform this procedure under general anesthesia for my patients' safety. If you are considering a breast lift, consultation with a plastic surgeon experienced in this procedure is essential to ensure optimal results. Best regards. Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation for Adipose Therapeutics and Science” (IFATS), Member of the Colombian Society of Plastic Surgery (SCCP).

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Dear Harbor,

based on your photo, it looks like you would need breast lift after implant removal. My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity.


Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hello ,
Thank you for your question.
At 55 years old with 20-year-old submuscular saline implants and fibrous breast tissue, you may be a reasonable candidate for breast implant removal under local anesthesia without a lift—particularly if your overall health is good and you're seeking a lower-risk, less invasive procedure. However, the aesthetic outcome will depend heavily on your skin elasticity, the amount of natural breast tissue remaining, and whether capsular contracture or significant thinning has occurred over time. Without a lift, it’s common to experience some degree of breast deflation, ptosis (sagging), or asymmetry post-explant, especially after long-term implantation. While some patients are satisfied with a more natural, softer result, others may find the aesthetic change less favorable without additional surgical reshaping. A thorough in-person evaluation with your surgeon will help determine if your skin and tissue will retract adequately on their own or if a lift might ultimately be recommended for optimal contour.

Removal under local is a simple procedure with no down time and easy recovery. You can assess how your breasts rebound after and make a decision about a mastopexy (breast lift) later depending on what you’re expectations are. I would predict that you would want a lift to help reshape, tighten and lift you’re breasts. Thank you.

Hello, thank you for your question. In my opinion, it is best to have breast implant removal completed under IV sedation anesthesia. It is not possible to remove the implant and capsule under local anesthesia to ensure you are rid of your signs and symptoms of breast implant illness. After implant removal, only time will tell if you need a lift. Removal of the implant and capsule with a lift poses risk for unnecessary lengthy surgery. It can take 12-18 months for the breast tissue to "fluff" after removal of implants. I hope this answers your questions.

If you remove your saline implants the skin will hang and you will be dissatisfied. The technique I recommend is explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided and the nipple sensation (in 95%) is maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question and picture. Only you can answer if you would be happy. It depends on the look you are willing to accept. Based on your pictures, you would most likely end up with a very deflated and flat upper pole of your breast and quite a bit of droopiness, likely more than you have now. Otherwise, if you did a lift along with your explant you could avoid so much droopiness of the breast.
Be sure to see a Board-Certified Plastic surgeon with experience in explantation for your consultation.

Hello. One of the benefits of saline implants is that they can be deflated easily in the office without implant removal. After adequate time is given for the breast skin to retract, you may have a better idea of what your breast will look like without the addition of the lift. It is possible that some of your glandular ptosis (excess skin below the nipple areolar complex) may improve. If you are satisfied with the appearance of the breasts after deflation, simple implant removal would suffice. If you would prefer more upper pole volume without the addition of an implant, I would recommend mastopexy with auto augmentation, a procedure that involves transfer of the lower breast tissue to the upper portion in order to provide more upper pole fullness. Fat grafting can also be performed to give additional volume. I hope this helps.

You have sagging now and will have sagging and decrease in volume with implants removed. I cannot tell you what will make you happy. However, if you wish to not sag, consider getting a lift. You can also ask your surgeon to just deflate your implants. You can then see how you will be without implants and can decide if you want them just removed or add a lift.

Based on the submitted photo a lift would be recommended with implant removal. Your breasts sag now with implants. Removing the implants will take away volume and make them appear to sag even more. One option is to have the saline implants deflated in the office and let the breasts settle. You can then determine at a later date if you simply want to remove the implant shells or have a lift as well.