Going from 34D to 32A. What should I expect post surgery and what are my options going forward?

Dear Elle251,
it is hard to tell for sure without an examination. Your implants can be removed using the same incision. 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

thank you for your question, it is difficult to comment with that picture, but the answer depends on your anatomy. In general, you may be able to only have your implants removed without a lift, especially if you add volume, using your own fat injected in the area above the capsule. It is best to have a virtual consultation to discuss options, of course.

Unfortunately, you have not provided photographs. However, most women who undergo explant also need a breast lift. The technique I recommend 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 from your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

That is going to be significant change. Lift, to tighten the loose skin would be needed. Sometimes, depending of the appearance of capsule, partial or total capsulectomy may be needed. Volume can be replaced with fat grafting but it is long and expensive proces (2-3 stages). In person consultation with a board certified plastic suirgeon with experience in breast implant removal/reconstruction wouldhelp. Good luck.

Hello @Elle251, thank you for your question. It really depends on the surgical technique use by the specialist doing the surgery. ITo prevent future inflammatory processes, it is imperative that the capsules around your implants be removed as well. In order to provide anatomical projection to the breast, whenever I remove breast implants, I always perform a breast reconstruction with the BRALAN (Breast Reconstruction Anatomical Lift Augmentation) technique. Depending on the case, a lift might be necessary. You can have a breast fat transfer after the explant to get better results. I link a video about the healing process of the scar. If you are considering a 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. International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Fat grafting may help restore some volume, but not the same volume as implants. You might even consider going with something smaller. An examination is needed to see if a lift is required. You will be flatter and have more loose tissue because of the stretching by the implants.

Your results after implant removal will depend on the size of the implants, the elasticity of the skin, and the length of time they've been in place. From your information it is likely that you would benefit from some degree of lifting procedure, but an examination is needed to know for sure. Your surgeon will be able to use the prior incisions to remove the implants, so unless you have a lift no additional scars are necessary.

Removal of your implants with mastopexy (either lollipop or anchor depending on your size) will be an easy recovery with usually only a couple of days off from work. I do not use drains (unless I perform a capsulectomy and only if there is moderate bleeding).
I like to wait to do the fat transfer post explantation so the fat does not end up in the old pocket. Fat grafting to the breast usually increases the size by 1/2 cup size per procedure. You may require 2-3 treatments depending on how much of an increase you desire.
Best wishes.
Dr. Taranow