23 year old saline implants - Should I have my implants REMOVED or just a LIFT? (Photos)

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 nipple sensation (in 95%) is maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Thanks for your question. It’s relatively common with age and weight fluctuations for the skin to stretch and hang off the implants - this is referred to as a waterfall deformity.
Since you have saline implants you could do deflate your implants to get a better sense of what volume you’d have without implants. It can help you make a more informed decision.
Both choices are reasonable though - implant removal and lift or just implant replacement and lift.
I would not recommend just doing a lift. These implants are quite old and maybe they’ll last another 5-10 years but higher chance of them rupturing sooner than later and then you’d require another surgery.
Make sure to see a board certified plastic surgeon and review their implant removal/ lift examples to make sure you’re going to be happy with that result.

Dear Exciting734,

I recommend my patients to replace implants every 10 years in order to reduce the chance of complications. 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

Congratulations on your remarkable weight loss! Losing 60 pounds is a significant accomplishment, and it truly reflects your dedication and hard work. Based on your photos, you appear to be an excellent candidate for a mommy makeover, which may include a revision tummy tuck (abdominoplasty), breast implant exchange, revision breast lift (mastopexy), and liposuction.

To give you a better aesthetic result, I would recommend a redo breast lift to acheive a lifted, more youthful appearance of the breast and nipple and to remove the extra skin that has stretched in the lower part of the breast. As far as whether or not to replace your implants versus removal, it all depends on how much breast tissue you currently have versus your overall size goals. You would need a physical exam to better assess this. There is no "expiration" on implants and no need to replace on any certain time frame if you aren't having any compications from them such as rupture. But if you are having a revisional breast lift, but need the volume of an implant, I would recommend replacing the implants with new cohesive silicone ones. I would also likely recommend the use of some type of surgical mesh (type to be determined based on your goals) to create an internal support bra and provide more long-lasting results.

As far as your abdomen, your existing abdominal scar can be utilized during the tummy tuck to remove excess skin and re-tighten your muscles, improving the overall contour of your midsection. I would discourage a reverse tummy-tuck, as I don't believe it would achieve a smooth, contoured abdomen.

I would also perform liposuction of the outer breast/armpit region, flanks and upper abdomen for additional contouring.

I strongly recommend consulting with a surgeon who has extensive experience in revisional cosmetic surgery to ensure the best possible outcome. I wish you the best of luck in achieving your aesthetic goals!

Greetings, in your case, the ideal would be to remove the implants and perform a facelift without implants, since you have sufficient tissue to do so. It would be good to evaluate your case directly.

From the photos you are a candidate for a breast lift which will remove excess skin and raise the nipple position. Since you're having the lift it makes sense to replace the implants, select smaller implants, or even remove them all together. Begin by visiting with a board certified plastic surgeon near you for an evaluation.