65 yr old with leaking silicone. Is it possible to get them removed, then get a fat transfer and lift?

When I remove the breast implants as well as the capsules, I normally do not suggest a lift or fat transfer at the time of surgery. With the technique I use, most of my patients will not require a lift. It does take about 1 year after the explant for complete results. Each individual has specific needs.

Thank you for your inquiry! A lift and fat transfer is an option after implant removal is an option. We would love to sit down with you and review your options. Schedule a consultation with a Board-Certified Plastic Surgeon to discuss your goals.

Yes, you can remove your implants. if they are leaking, it would be best to remove them. A breast lift would definitely be indicated for tuberous breasts and to correct the asymmetry. Fat transfers can be done but realize these will not add a a lot of volume. Fat transfers may add a half cup size. Tuberous breasts have a lot of fibrous tissue and fat may not be as predictable as in more fatty breasts.

It would be difficult to give you good advise without series of photos or better, in person evaluation. You should definitely have your implants and portion or entire capsule removed. In that time breast lift should be performed. Later on, fat grafting to augment and further shape both breast, may be considered. Hope this helps. Goo luck.

Hi, the most important issue to address is the leaking silicone implants. If this has leaked into the breast tissue, it is more challenging to completely remove. With above the muscle implants, there is an increased of healing issues with a mastopexy. Depending on the physical exam findings, it would be best to remove the implants and perform a mastopexy with fat grafting as a second surgery after you have healed. Once you have been evaluated by a board certified plastic surgeon, a surgical plan can be developed.

Dr. Eric J Wright

The technique I recommend is explantation with 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 if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Dear OK Coco,
it is hard to tell for sure without an examination. 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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hello @OK Coco, thank you for your question. All of the above are possible. My preference is to combine breast implant removal with immediate repositioning of the mammary tissue to address projection of the upper pole and medial areas using the BRALAN Technique (Breast Reconstruction Anatomical Lift Augmentation) since the results will be adequate and have a minimal scar in the shape of an L. Also, you would not need to worry if your breast was tuberous in the beginning. Remember to have a complete capsulectomy. If you are considering breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Thank you for sharing your question. Yes, technically all the above is possible but be aware breast tissue has incredible "memory" so when you remove the implants you will return to a more tuberous breast appearance.

Yes, what you’re describing is definitely possible, though there are some important factors to consider given your history and goals. Here’s a breakdown based on your situation:
1. Implant Removal
• Leaking silicone implants can and should be removed, especially after 15 years. The fact that they’re above the muscle may make removal a bit more straightforward.
• If there’s a capsular contracture or rupture, the surgeon may also perform a capsulectomy (removal of the surrounding scar tissue/capsule).
2. Fat Transfer
• Fat transfer is a viable option for many women who want a more natural look and feel without replacing implants.
• It’s especially helpful for volume replacement, especially in the upper pole of the breast which tends to deflate after implant removal.
• Success depends on:
a. Your available donor fat (common areas: abdomen, flanks, thighs).
b. How your body retains the fat (some of it gets reabsorbed – usually 50-70% stays long term).
3. Breast Lift
• A lift is often necessary after implant removal, especially after long-term use, to reposition the breast tissue and nipple and improve shape.
• A lift ca also help address the tuberous shape, especially when combined with fat grafting.
• Since you’ve had tuberous breasts and asymmetry, you may need a customized approach, possibly involving glandular reshaping or areola reduction, depending on how much correction was done during your earlier surgeries.
4. Tuberous Breast Consideration
• Tuberous correction is still possible even after implant removal.
• Fat grafting can be especially helpful in softening the tight, constricted lower pole of a tuberous breast.
• A lift may be more complex, but many surgeons are very experienced in post-implant, tuberous correction.
5. Age Consideration
• Age isn’t a barrier as long as you’re in good overall health and cleared for surgery.
• Surgeons may take more care evaluating your skin elasticity, healing ability, and fat availability.