Deformed Breasts After Implant Removal? (photo)

Question

375cc smooth silicone partial unders (Mentor, cohesive gel) placed 6 1/2 years ago, via transaxillary and small nipple incisions. Due to severe chest / back / neck / arm pain and symptoms of Fibro. / RA, I decided to have them removed. Explant was 4/3/2013, and results are hideous. Doc said my breasts would bounce back and didn't need a lift during consultation, now he's dismissive / vague. Sorry pictures are bad, but hope it's enough to get an idea. Please help me hang in there... Thanks.

Kenneth Hughes, MD · Answer

If your breasts were tubular and had ptosis before the original implants were placed, then the breasts should look worse after 6.5 years following implant removal. Allow at least 3 months for the breasts to heal and contract and then additional decisions can be made. Breast implants over time tend to thin tissues and create more droop. In addition, age tends to cause a decrease in size and additional droop. If you need them revised, find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast implant revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

Jed H. Horowitz, MD, FACS · Answer

Good day! Generally after explantation, the shape and size of the breast will be unpredictable. The breast will be smaller and possibly sag more. Still, it varies between patients depending on their age, duration and size of the implant, or previous state of their breasts like existing anatomy, deformity, previous surgeries, underlying personal and family medical conditions, nicotine use, and other factors. Improved appearance can also be achieved through natural breast augmentation or mastopexy in conjunction or after explantation. Do not hesitate to contact your surgeon about this and discuss realistic goals and expectations. Best of luck! #RealSelf100

Richard J. Bruneteau, MD · Answer

Your picture suggests
bilateral breast hypoplasia, breast ptosis, and what appears to be a tubular
breast deformity.Without preoperative
pictures, it’s hard to know how much sag was actually present before your
original breast augmentation.It’s always difficult to predict how the breast will
react to implant removal.In some cases,
minimal sag will develop while in other cases, severe sag may occur
necessitating breast lift surgery.Unfortunately, it takes three to six months for the
breasts to stabilize after implant removal.It’s therefore important to wait at least six months before proceeding
with breast lift surgery.During this period, it’s important that you maintain
close contact with your plastic surgeon.Your surgeon should be able to evaluate your progress and formulate a
treatment plan that addresses your anatomic findings and achieves your
aesthetic goals.

Jourdan Gottlieb, MD · Answer

These photos illustrate how unpredictable the outcome of implant removal can be. I am not sure what advice I might have given before surgery, but I do agree that doing a lift at the time would not have been something I would have urged. 

	It would be helpful to have seen before surgery photos. The current appearance is similar to that of a patient with tuberous breast deformity, and your description of pre-op status does not sound like what you have today. 

	It is early, and there really are no options to do anything before letting the tissues heal over the next 3 months or so. 

	It may be that some sort of lift will be helpful, but it is also likely that some sort of volume increase will be a consideration--either implants or fat grafting. 

	Stay in touch with your surgeon. All the best.

Tom J. Pousti, MD · Answer

I am sorry to hear about the stressful experience after removal of breast implants. As you know, no one can (with any degree of certainty) predict exactly how a woman's breasts will look after removal of breast implants.  As a matter of fact, I think patients may have the best idea of what their breasts may end up looking like, given that they know what their breasts look like before having undergoing breast augmentation surgery.

	 Nevertheless, at this point, your best/only option is patience...  Again, whether you will be pleased enough with the long-term outcome not to seek additional surgery remains to be seen.

	 Best wishes.

Steven Wallach, MD · Answer

Being that you are only two weeks out it is hard to predict what the final appearance will look like. I would have said the same thing before surgery. It is difficult to predict how they would respond.

Jack Peterson, MD · Answer

I have two comments on this situation.

	First, since you are less than two weeks out, you need to give this several months to see your final result. Much will depend on the natural elasticity of your breast envelope and healing. I would give this at least 3-6 months before you do anything. In my experience it is difficult to predict who may/may not need a mastopexy following removal of implants. 

	Next, for other readers out there, this whole issue of collegen vascular disease from silicone gel implants has been evaluated and there is no credible evidence that gel implants cause collegen vascular disease.

Samir Shureih, MD · Answer

You had the breast implants for 6 years, there is some stretching of the skin, there is 6 years of aging. Wit all that there is no way one can oredict what will be the shape of the breast after explant of the breast implant. Your doctor can guess, but it depends on your skin, and the amount of skin stretch and the aging process, as well as if you had any weight gain?loss, prgnancies and so no.
With removal of the implants, some of the skin will retract in the first 6-12 weeks. Then you may need a breast lift,

Diana L. Elias, MD (retired) · Answer

Your photos show that your natural breast size is quite small and your shape is somewhat "tubular". I suspect that when you are finally healed in another 3-6 months, your nipples will still be too low. There is a good chance that some type of revision will be required. In the meantime, though, as hard as it is, be patient and let your body complete the healing process.

	Diana L. Elias MD

Deformed Breasts After Implant Removal? (photo)

Answers (9)

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