Is it preferable to wait for a lift after an explant and why? Is there any way of knowing if you will need one? (photos)

Thank you for sharing your excellent question and photographs.  Waiting after removal allows your tissues time to heal and retract to their new shape/appearance.  This allows you to then consider the improvement that a lift would entertain, as well as allow for a more predictable result.  Although nothing replaces an in-person examination it appears that you will have some breast tissue sagging, along with a lower nipple placement with explant alone, but no one can offer certainty as to what your outcome would be with explant alone.  Hope this helps.

It is difficult to make 100% accurate predictions following explant. There are a number of factors to consider including age (the breast changes over time irregardless of augmentation), weight change, skin stretch and residual elasticity.
Following removal, one can expect:
-Loss of volume- Not an exact correlation between pre- and post augmentation due to the changes over time. You may be bigger or smaller than you remember.
-Ptosis/sagging-Ptosis develops over time and may be worsened by the presence of an implant. If a patient has pre-explant sagging, removal is likely to worsen this to a certain extent. If there is no ptosis, it does not necessarily mean there will be no ptosis after removal.
-Skin laxity/stretch- There is inherent skin elasticity which will allow for some measure of snap back. However, the greater the volume differential pre- and post- the more likely there will be excess skin.
In my experience, it is usually a safe assumption that there will be some changes post removal which oftentimes may necessitate further operative intervention (i.e. lift), however this is often a function of size and length of time post op. Small implants which have only been in place for a short period will lead to an improved response/recoil post removal.
With regards to your specific question, without an in-person exam it is difficult to make a prediction. Much will depend how long they have been in place, how large, and how much you have changed over time. Delay may allow you to avoid the additional scar burden. However, you run the risk of an additional procedure to reach your desired goal.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
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