Question Regarding Expected Breast Size After Explant (Photo)

Question

I had breast augmentation 15 years ago with saline implants; left implant was replaced with silicone 8 years ago due to capsular contracture. Both implants (430cc saline, 445cc silicone) will be removed soon, with fat transfer (150cc per breast) without capsulectomy. Initially flat-chested at 150lbs during my first surgery, 34D/36D at 165lbs after the left implant replacement surgery; now 225lbs, wearing 42DDD/E. Hoping for full C cups post explant? Is this realistic or should I expect smaller?

Gary M. Horndeski, MD · Answer

At size 42, each 300 cc of implant removed corresponds to 1 cup size change. If you are a 42 DDD then you may only go down 1 to 2 cup sizes. More important than implant and fat transfer is the breast lift. 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. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Shaher W. Khan, MD · Answer

Hello, thank you for your question. Transitioning to fat transfer after implant removal can yield different results, and there are several factors to consider regarding your desired outcome. Please see the attached video that discusses your situation and question in detail. Ultimately, having an open discussion with multiple board-certified plastic surgeons about your goals and concerns will help ensure that you are on the same page regarding the outcome and doing what is best for yourself!

Daniel Barrett, MD · Answer

Dear anansi2u2,
since you initially didn't have much breast tissue, you can expect to have the same size as prior to surgery probably with some loose skin on breasts. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Alan Gonzalez, MD, FACS · Answer

Hi @anansi2u2, thank you for your question. In my experience, all explantations must be accompanied by a total capsulectomy, because the capsules can cause future inflammatory processes if left in the body. From the hundreds of breast implant removals I have performed I can attest that the capsules are not reabsorbed by the body. This being so, my surgical intervention would initially involve a breast reconstruction, since removing the volume that gave the prosthesis will require repositioning the tissues. In this way, you would get an aesthetic result with which you would be happy, since it is not convenient to make fat transfer to the breasts at the same time as the explantation, it is advisable to wait 4 to 6 months to prevent the fat from dying or risk of infection. In this case the incision would be periareolar in an L shape to avoid making a T shape. It is best to consult with one or more board certified plastic surgeons for more information and options tailored specifically to your needs. To shed more light on this, I have included a video and link to one of my articles, best wishes!

Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science" Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science" Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Charles G. Polsen, MD · Answer

The best reference would be the size your breasts were prior to implant placement. With the size of your implants I would also highly suggest a lift to help obtain the size/shape you wish to maintain.

Camille Cash, MD · Answer

You will lose much of your breast volume when the implants are removed.  Initially the fat transfer will provide some of the lost volume, but it may not all take so it's difficult to predict where you'll end up.  You may want to consider a smaller implant instead if you want a more predictable determination in cup size.

Connie Hiers, MD, FACS · Answer

Taking out your implants will probably decrease your breast size 3 cups. Adding the fat may not actually give an additional cup because not all the fat survives. However, you may find you are happy with your new size.  You might consider just removing the implant first and see how you like your size.

Question Regarding Expected Breast Size After Explant (Photo)

Answers (7)

More Breast Implant Removal Questions

Will ruptured Sientra smooth implant removal or exchange get rid of my breast implant illness symptoms?

Mastopexy w/implant pain - do patients say it's really bad?

I am planning to get my breast implant removed and was wondering if I have to also lift the breasts after the removal?

Capsule removal after explant, what's the recovery time & how painful is the surgery?

I have bottomed out 3 times- should I explant?

Will I have issues with the other capsule being left in?

WE SEND PRETTY
EMAILS