A breast lift at the time of explant for small breasts, will I have good results? (Photos)

It is difficult to make 100% accurate predictions following explant. There are a number of factors to consider including age (the breast changes over time irregardless of augmentation), weight change, skin stretch and residual elasticity.
Following removal, one can expect:
-Loss of volume- Not an exact correlation between pre- and post augmentation due to the changes over time. You may be bigger or smaller than you remember.
-Ptosis/sagging-Ptosis develops over time and may be worsened by the presence of an implant. If a patient has pre-explant sagging, removal is likely to worsen this to a certain extent. If there is no ptosis, it does not necessarily mean there will be no ptosis after removal.
-Skin laxity/stretch- There is inherent skin elasticity which will allow for some measure of snap back. However, the greater the volume differential pre- and post- the more likely there will be excess skin.
In my experience, it is usually a safe assumption that there will be some changes post removal which oftentimes may necessitate further operative intervention (i.e. lift), however this is often a function of size and length of time post op. Small implants which have only been in place for a short period will lead to an improved response/recoil post removal. Whereas larger implants which have been in for several years will often necessitate a lift.With regards to your specific question, you are certainly a candidate for a lift. However, you should be prepared for a significant change in volume and more specifically upper pole fullness. A good result is relative to expectations. 
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Verified Member
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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, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery.  At the same time or later, fat transfers can be performed if additional volume is desired.Best Wishes,Gary Horndeski, M.D.

The smaller the implant and the less the amount of time it has been since placement, the greater the chance the breasts will return to their preoperative state. It is very difficult to predict breast size following explant b/c breast implants and weight fluctuations over time tend to thin tissues, cause a decrease in size, and create more droop.  
It is not unreasonable to remove the implants and then observe a waiting period of six months before the determination for breast lift is made. This will give your breasts time to bounce back and your PS time to determine what type of lift, if any, is needed. 

Hello and thank you for your question and sharing your photo. Generally speaking, after removal of breast implants, breasts will look smaller and deflated. Many patients will need a breast lift after breast implants removal, which can be combined with liposuction and fat grafting to breasts to enhance the volume. I would seek consultation with a board-certified plastic surgeon for a full evaluation and advice.
Best wishes and good luck,

Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon


 

Without examining you it’s difficult to be 100% sure but based on the photos it looks like you would have a great result from a lift at the same time as your explant. The only way to know for sure is to book a consultation with a board certified plastic surgeon near you to see what your options are. Best of luck! 

Thank you for sharing. The amount of breast lifting needed will depend on how much your breast has changed over the last 11 years with implants in place. Some may need very little lifting and others may need a more formal breast lift. See your local board certified plastic surgeon who can examine your breast skin envelope.   Best wishes!

Dear sandyt123,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from breast lift after implants 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 thatsbeing brought together to support the breast and hence improves longevity.
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

Thank you for sharing your excellent question. Based on your pictures it appears that you have a good amount of breast tissue present so you should achieve a nice result with a breast lift at the time of implant removal.  Hope this helps.

I believe you have a reasonable opportunity to remove the implants and the capsules and still have a nice looking result.  It is important to discuss at length with a Board Certified Plastic Surgeon to formulate a plan that may give you the best possible result especially as the request for a "good result" is a bit nonspecific.  Overall I think you may end up being more satisfied with some sort of lift procedure and possible fat grafting, but that would be better determined during a full consultation. Best wishes.  WirthPlasticSurgery.com

I would echo the thoughts of some of the other surgeons.  I would recommend simply explanting and performing a capsulectomy at the first procedure.  Which may incidentally be an insured procedure in Quebec (i.e you may not have to pay. In BC this would be covered).
I think this would be best in terms of safety and ultimately patient satisfaction.  I am often pleasantly surprised how well the breasts recover in terms of appearance after removal of small implants.  Not infrequently after a period of a few months patients return to see me, satisfied with the appearance and not requesting any further surgery.
In the event that further surgery is requested/indicated the interval of a few months allows the soft tissues to tighten up, sometimes permitting a simpler lift procedure.  It also allows some psychological adaptation on your part to the appearance of your breasts without implants, which can be important in managing the expectations from any subsequent lift procedure.