Will my breasts be ruined if I take my implants out or will they just go back to how there where before? (photos)

Question

I currently have 390cc implants which I have had for 5 years. The make me feel so much bigger than I am and I just feel they are so heavy. In the next few years me and my husband want to have babies and I want to be able to breast feed. I worry when I am feeding my babies my already big boobs will double and I will hate carrying them. But I am also terrifying I will take out the implants and will hate my boobs even more. Do you think they will be incredibly saggy and empty with removal?

Sugitha Seneviratne, MBBS, FRACS (Plas), FACCS · Answer

Hello, thank you for your question and images which are helpful but consultation and examination will provide a far more accurate prediction of your likely aesthetic outcome after explantation surgery. Your pre-augmentation breast shape, nipple position and skin quality appear good and are predictors of a good outcome after explantation. Further predictors of a good outcome are the fact that you have not breast fed, don't appear to have upper pole striae or stretch marks and your implants are of reasonable size (the larger the implant, the greater the risk of skin stretch and breast tissue pressure related atrophy or thinning). In my experience, in the three to six months after explantation surgery, your skin and breast tissue will improve and is worthwhile keeping in mind, in addition to the changes in breast volume which are likely due to your anticipated pregnancy. Best wishes and I hope this perspective was helpful.

Pejman Aflaki, MD · Answer

Hello and thank you for your question and sharing your photo. Generally speaking, after removal of breast implants, breasts will look smaller and deflated. Implant size, skin elasticity and the amount of time since implant placement are the key factors that determine how your breasts will look like after implant removal. Generally speaking, options include removal and observation, removal and breast lift,  removal and fat transfer for a natural volume enhancement, and finally removal and lift and fat transfer. You should discuss all these options with your surgeon. If you are unsure, you can just have the implants removed and decide what you would like to do after a period of observation and after you are done with pregnancies and breastfeeding. I would seek consultation with a board-certified plastic surgeon for a full evaluation and advice.
  
Best wishes and good luck,
  
Pejman Aflaki, M.D.
  
Johns Hopkins-trained double board-certified plastic surgeon

Dhaval M. Patel, MD · Answer

Thank you for your question and photo! Unfortunately the implants have stretched out your breasts and they will not go back to how they were pre op.  I suggest getting a Breast lift after removal to reconstruct the remaining breast tissue.  Best of luck!Dhaval Patel
Double Board Certfied
Plastic Surgeon
Chicago
Hoffman Estates
Oakbrook
Orland Park

Natalie Ngan, FRACS (Plast) · Answer

Considering removal of breast implants can be a difficult decision.  Predicting the appearance of breasts after the implants are removed can also be difficult.  There are many factors that I take into consideration when seeing women for explant surgery.  The main factors include:
The size of the implants - the larger the implants (in relation to your body size) the bigger the change to your breast appearance after removal.
Skin quality - insertion of implants stretches the skin. The better quality your skin is, the more it will retract well after implant removal and your breasts may look fairly similar to prior to implant insertion.
Your expectations - in my experience, women who wish to have their implants removed have very different goals from when they were inserted. The more realistic your expectations, the more satisfied you will be after explantation.
Based on your photos (which is never as accurate as assessment in person), you look to have good skin quality and had a reasonable amount of breast tissue prior to implants.  If you feel that they are too big, it would be worthwhile considering removal prior to having children.  Good luck!

Richard Nadal, MD, FACS · Answer

Hi and welcome to our forum!
I expect some collapse
of the breast following explantation. The presence of an implant effaces
or stretches out the overlying breast tissue, soft tissue and skin. Following
removal, the empty space will collapse upon itself. However, over time, at
least partial correction is achieved naturally as the skin and soft tissues
readjust over 3 months or so. If the shape remains unfavorable, a secondary lift can be performed 3 months later. As you plan on expanding your family, it may be wise to delay the lift until the family is complete.
The need for secondary lift following explantation relates
to the size of the implant, its duration of implantation, and overlying
skin quality.
Best
wishes...

Kenneth Hughes, MD · Answer

The smaller the implant and the less the amount of time it has been since placement, the greater the chance the breasts will return to their preoperative state. It is very difficult to predict breast size following explant b/c breast implants and weight fluctuations over time tend to thin tissues, cause a decrease in size, and create more droop.  
It is not unreasonable to remove the implants and then observe a waiting period of six months before the determination for breast lift, smaller implants, or breast fat transfer is made. This will give your breasts time to bounce back and your PS time to determine what type of lift, if any, is needed.  A property executed breast implant surgery should have no impact on breast feeding as the ducts should not be disturbed.

Gary M. Horndeski, MD · Answer

Many women who undergo explant alone are dissatisfied with the excess hanging skin, empty appearance and require a lift.  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.  At the same time or later, fat transfers can be performed if additional volume is desired.Best Wishes,Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Perthbarbara,
It is hard to predict how will your breasts look once you remove your implants. There is a chance that they will be saggy and you may need a lift in order to get good results. If you are considering a surgery, I would suggest you to 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

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  Based on your apparent skin quality, I would expect your breasts to return closely to your original shape and size.  This is best determined, however, with an in-person examination of your tissues.  See a series of surgeons in consultation to discuss the best option.

Camille Cash, MD · Answer

The way the breasts appear after implant removal is influenced by several factors.  Some include size of implants, time they have been in place, quality/elasticity of the skin, and weight gain/loss.  You will lose the volume the implants provided and can expect some droop to the breasts.  The skin will contract to some degree.  If your intention is to have children in the near future and breast feed you may want to wait until you have completed your family if you are considering a lift.

Will my breasts be ruined if I take my implants out or will they just go back to how there where before? (photos)

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