Should I have explant and lift in 1 procedure or 2? (Photos)

You will find that there is no "standard" practice; in other words, opinions and practices will vary. For this reason, best to clarify the planned procedure directly with your (carefully selected) plastic surgeon.


Generally speaking (in my opinion), unless the breast implant capsules have thickened (and/or are otherwise symptomatic),  are associated with the ruptured silicone gel breast implants, or if the patient has concerns about "medical conditions" related to the breast implants, capsulectomy is not universally necessary.  For these patients, en bloc removal of breast implants is a good procedure.


On the contrary, capsulectomy can expose you to additional risks, such as bleeding and minimal size loss.  In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity).


Similarly, whether to lift breasts at the same time as  removal of breast implants or "stage" the procedures is a decision that is best individualized.   Every patient starts out with different anatomy, different goals/expectations, as well as different  preferences…
 I have found in my practice, that when breast lifting surgery is definitely going to be necessary in order to achieve an aesthetically pleasing outcome, MOST patients prefer to have the breast lifting performed at the time of breast implant removal.   Most patients simply do not wish to undergo two operations, if avoidable.


 On the other hand, there are patients who (where safety considerations such as potential for loss of blood supply to tissues…), benefit from a two-stage approach.   For example, there are patients who benefit from the following operation: removal of breast implants and capsulectomy surgery,  if indicated based on the patient's clinical situation and examination (in the first stage).  A second stage breast lift may be more accurately planned and more safely executed.
 
  In "borderline" cases where there is doubt whether breast lifting is necessary or not, I advise patients to undergo explantation only and to give their breasts the benefit of the doubt  before deciding whether breast lifting would be beneficial.  Patience is definitely indicated after removal of breast implants; it will take many months/year for the skin to “bounce back” and for you to see the final appearance of the breasts.
 
 As you can see, there is much to consider (which is why nothing replaces individualized care,  centered on good communication and good judgment, provided by a well experienced board-certified plastic surgeon). 
My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as well. Working together you will come up with a good plan to achieve your goals.  


  I hope this helps. Best wishes for an outcome that you will be very pleased with.

Explant
alone results in the highest patient dissatisfaction and most patients require
a 2nd operation.  It is easier
to do both at the same time and I recommend explantation using The Bellesoma
Method.  The implants are removed, your
breast tissue is reshaped created upper pole fullness, elevated higher on the
chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation
and the ability to breast feed are maintained, if not injured during your
previous surgery.  The capsules can be
removed if there are indications such as infection or calcification but often they
are left in place to preserve breast volume and minimize complications.  Best Wishes,Gary Horndeski, M.D.