Can I have a breast reduction after having implants removed 7 years ago?

Question

I had breast implants removed 7 years ago with a simultaneous lift (no complications with the implants or surgeries). Afterwards, I was a C cup but after years of hormone replacement therapy, I'm now a G cup. During a recent consultation with a board certified surgeon, he said I couldn't have a reduction because I had implants previously and they cause blood flow loss. This was before examining me. Is this blanket statement true? I thought each case varied with respect to blood flow.

Zoran Potparic, MD · Answer

You seem to be a perfect candidate for breast reduction using liposuction, minimal breast tissue excision and lift. Using liposuction to reduce breast volume instead of extensive resection of breast tissue(which can jeopardize blood supply to nipple/areola/skin) will allow safer surgery. In your age breast tissue have 70-90% of fat content and liposuction is for that reason most efficient way of volume reduction still preserving major blood supply from various sources. Good luck.

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs or told us your bra size, just your cup size.  Is the reason for the reduction neck, shoulder and back pain or for cosmetic reasons?  I recommend you consider an alternative technique called The Bellesoma Method.  This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief without excessive reduction.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained, if not injured during your previous surgery.  Since you have had previous breast surgery, you are at a higher risk for complications including nipple necrosis.Best Wishes,Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear mel77133,
generally speaking, breast augmentation is not a contraindication for breast reduction. If you are considering a surgery, I would suggest you to 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

Erik Miles, MD, FACS · Answer

You can have a breast reduction after implant removal and mastopexy as you described. The surgery is however a little bit more complicated.  It helps the surgeon to know the technique used for your breast lift so that the maximum amount of blood flow to the nipple can be maintained. Your old surgery records would be helpful.   If your records are not available, some assumptions can be made by your surgeon after examining you, however you are at a slightly increased risk of having blood flow issues to your nipple and areola.  Seek a consultation from a board-certified plastic surgeon who is experienced with breast surgery. Your situation is not that unique, and an experienced surgeon should be able to give you some options.  Best wishes to you.

Jon S. Wilensky, MD · Answer

Yes, it is possible to have a breast reduction surgery after having breast implants removed. The specific requirements and recommendations may vary depending on your individual circumstances and the expertise of your plastic surgeon. It’s important to consult with a board-certified plastic surgeon who can assess your situation and discuss your options for breast reduction.

Diane I. Duncan, MD, FACS · Answer

Assuming your removal was done correctly and has fully healed there should be no contraindications against a breast reduction. I would recommend consulting with a board-certified plastic whose results you like, and do your research (which it sounds like you are )). Best of luck!

Robert L. Kraft, MD, FACS · Answer

You can have a reduction.  If you have gained weight, the question would be whether your BMI is in line with insurance criteria.

Melinda Haws, MD, FACS · Answer

You are correct, it is posssible to repeat a breast lift or to repeat a reduction of the breasts.  It’s a varsity type of plastic surgery case that not everyone  offers because the risks of nipple/tissue loss are higher. If you have access to your old operative note, it helps.  It also is best to minimize your risks of healing problems by not smoking or vaping and keeping other things like diabetes under strict control. See a board certified plastic surgeon who has a special interest in revision breast surgeries and get an inperson exam to find out what your personal risks may be. But yes, it’s possible but higher risk.

Marc J. Salzman, MD, FACS (retired) · Answer

The basic answer is, yes can have a re-reduction. It's best if you can provide operative note from the first surgery. I'm confronted with this exact scenario often. Most of the time, the blood supply is left coming from the bottom and the extra breast tissue can be taken out with liposuction or removed from the side of the breast. The skin can then be tightened with elevation of the entire breast onto the chest wall. I would try to find a plastic surgeon in your region with demonstrated expertise in revisionary cosmetic breast surgery. Best of luck.

Can I have a breast reduction after having implants removed 7 years ago?

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