Process of removal - do I have options?

Good question! Typically, the breast tissue will decompress, commonly referred to as fluffing postoperatively, and the skin tightens to some degree for many patients. This can occur for months to even one year after breast implant removal surgery. The degree of fluffing and skin retraction is highly variable from patient to patient due to several factors such as patient age, the thickness of one's subcutaneous breast tissue, and skin elasticity. Procedures considered for improving the appearance of the breasts after breast explant surgery include the addition of volume with fat transfer and/or skin tightening by a breast lift, referred to as a mastopexy. You mentioned that you have had some weight fluctuation. If you have gained some weight since undergoing breast augmentation, you may have additional fatty tissue of your breasts causing your natural breasts to be larger than before your implants were put in and you may not need any fat grafting. The best way to estimate what your breasts would look like after breast implant removal, and to see if fat grafting is even necessary, I recommend an in-office examination by a plastic surgeon who is very experienced in breast implant removal surgery. I have been performing this surgery for over 25 years. You can also refer to my website at drstraka.com. I wish you the very best of luck with your surgery and outcome!

I wish you the best of luck!

Thank you for your question. Yes, you do have options. Depending on the surgeon you go with, you will be given different options. No matter what surgeon you go with, please make sure you find a surgeon that will removal the implant and entire capsule. You need to ask your surgeon if they will perform an En bloc or 100% total capsulectomy.

Dear CSKI990,
it is hard to tell for sure without an examination. Since you had smaller breasts and now have large implants, it is most likely that you will have saggy breasts after removal. In that case, breast lift is the best option. 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

Thank you for your questions and the details provided. 650 cc is a large implant and therefore not only the size of your breasts will change but also the shape. It is very likely that you will also need some form of breast reshaping , such as mastopexy / breastlift.
If however you had at least some "pre-breast augmentation breast volume", you might be able to have just the mastopexy procedure; if this is not the case, fat grafting will be a good option for you to restore some volume.

All the best

Andrea Marando
Plastic and Cosmetic Surgeon
Manchester, UK

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.

Hello @CSKI990, thank you for your question. In case of an explantation with total capsulostomy, the surgical procedure would involve a breast reconstruction with my BRALAN technique in which the breast tissue is properly put back in place. In this way, you would achieve a quite natural and satisfactory aesthetic result. In this case the incision would be L-shaped periareolar, which allows your cleavage to be free of any trace of scar. In case you wish to improve the size and proportion of the breasts with a fat transfer, it is advisable to wait 3 to 4 months to avoid necrosis or risk of infection of the fat or tissues. The best course of action is to consult with one or more board certified plastic surgeons for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD, FACS. 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)

Hi, thank you for sharing your question. Large implant removal can often leave a big volume deficiency that fat grafting alone will not replace. Discuss your options with your surgeon after a proper in person evaluation.

Fat can be added, but only into breast tissue and not into the implant space. With such large implants, what tissue you have has been stretched and thinned and may not hold much fat. You might consider going down in size to a more natural size for you. Your pockets can be tightened internally. Do remember that you were not happy with your breast prior to surgery and may not be happy once removed. You will be flat and probably sag from the stretched out skin.

When you have the implants removed you will lose the volume they provided. You will likely have loose, stretched out skin from the presence of the implants. Depending on the amount of weight gain you've had you may have slightly bigger breasts naturally but not likely enough to take up the stretched tissue. You can elect to have a lift alone to help reshape the breasts or perhaps consider a smaller implant. Visit with a board certified plastic surgeon near you to learn more.

There are many options available to you if you choose to remove your implants. If you proceed with removal alone, you would likely be flat, and have some ptosis or drooping as your skin has stretched from the large implants. Another option would include removal with lift, if you now have sufficient tissue of your own to have a nice result. You could also do removal with fat grafting for more volume, or removal with lift and fat grafting. Your surgeon can help you make this determination based on your examination and goals, but you certainly do have options!