How dramatically will explanting affect my breasts?

Question

I had my implants in around 11 years ago when I was like 22 or 23. I had a very good, full breast profile, but one was around 125 cc smaller. Got 150cc and 250cc saline implants that have since gotten mild contracture. I’m unsure what to expect when they’re removed. Deflation? Misshapen? Were the implants likely not large enough to be too concerned? Will they change shape after recovery? I went from around 34B to 34C.

Alan Gonzalez, MD, FACS · Answer

Hello @PhoebeMcGee, thank you for your question. My opinion is that a breast implant removal should be combined with immediate breast reconstruction to reposition the mammary tissue and improve projection of the upper pole and medial areas using the BRALAN Technique (Breast Reconstruction Anatomical Lift Augmentation) since the results will be adequate in terms of aesthetics and have a minimal scar in the shape of an L. 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. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS),   International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Emre Guvercin, MD, FEBOPRAS · Answer

Hi there &mdash; this is a very reasonable concern, and the good news is that your implants are relatively small, which works strongly in your favor.You went from about a 34B to a 34C with 150 cc and 250 cc saline implants, and they’ve been in place for about 11 years. That means your breasts were never excessively stretched or overfilled.What can you realistically expect after explant?In most cases like yours:Your breasts return close to their original volumeThey may look softer and slightly less firm at firstSome mild looseness or deflation is normal early onShape often improves gradually over several months as the skin contractsBecause your implants weren’t large, dramatic deformity is unlikely.Will they look misshapen or collapsed?That’s uncommon with implants in this size range.Mild capsular contracture can temporarily distort shape, so some women are actually pleasantly surprised by how natural things look once the implant and capsule-related tension are gone.Do you need a lift?Not automatically.If your nipples are still in a good position and you’re comfortable with a natural, softer breast:Explant alone may be enoughIf, after healing, you want:More upper-pole fullnessBetter projectionA perkier shapeThen a Push-Up Lift (which reshapes and repositions your own tissue rather than adding volume) can be considered &mdash; either at the same time or as a later, optional step.Will shape continue to change after surgery?Yes. This is important to know:Early results (first 6–8 weeks) are not finalSkin and tissue remodeling continues for 3–6 monthsFinal shape is usually softer, more natural, and more stable than the early phase

Chet Mays, MD · Answer

Thank you for your inquiry!  Typically this depends on how much breast tissue you currently have. We would love to meet with you and discuss your concerns.  Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Erman Ak, MD · Answer

After 11 years with 150cc and 250cc saline implants, you can generally expect a moderate change in breast volume and shape after removal but the outcome depends on a few key factors:
Deflation or Flattening: Since the implants are relatively small, dramatic deflation is less likely than with larger implants. You’ll lose upper pole fullness but most women retain some natural shape.
Skin Retraction & Elasticity: At 22–23 years old, your skin likely had good elasticity. If you’ve maintained a stable weight, your skin may retract reasonably well after removal.
Asymmetry & Contracture Effects: Mild capsular contracture could slightly distort the shape, but once removed, the tissue typically softens over time. Asymmetry may remain unless corrected with a lift or fat transfer.
After healing (usually over 3–6 months), your breasts will settle into a more natural shape. They may appear a bit deflated at first, but this can improve as swelling resolves and tissue adjusts. If desired, many patients consider:
Fat transfer for subtle volume and shape restoration or Breast lift if there’s sagging or stretched skin
But of course, a consultation will help tailor and give you a more precise idea of your likely results and if you’d benefit from a Lift or Contouring at the time of explant.
Warm wishes for your next steps, Dr. Erman AK!

Larry C. Leverett, MD, FACS · Answer

In general, silicone implants are superior to saline implants. However, there are three scenarios in which saline implants are preferable. The first scenario is in the patient who has a narrow budget and nice soft tissue coverage. Saline costs less than silicone implants. We, as plastic surgeons, achieved great results when silicone implants were routinely off the market in the 90s. The second scenario is in patients such as yourself in which you'd want to "see" before committing to what you might  look like with no implants. You may love it. You may hate it. But at least you would be able to make an informed, visual decision before opting to a larger procedure. and your decision is reversable.  The third is the patient who has gained weight over many years and the breast are now too large. She doesn't know if she wants smaller implants or, if they are still too large when the implants are deflated, she may choose to have NO implants at all.  Best advice is to deflate them in the office using local anesthesia. It will be obvious in a very few weeks if you love the new look (and simply want them removed) or whether you still want "a little somethin" in which case you may opt for a smaller size.

Kevin Brenner, MD, FACS · Answer

Hi Phoebe. It sounds like you originally had a decent amount of breast tissue. Further, your implants are not crazy big. You probably will have a decent shape following explant, though I have still had patients in your situation who benefitted from breast lift at the same time.

Daniel Barrett, MD · Answer

Dear Phoebe McGee,
it is hard to tell for sure without an examination. 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

Shaher W. Khan, MD · Answer

Hello, thank you for your question. Explanting (removal of breast implants) will likely cause some noticeable changes to your breasts, but how dramatic the changes are will depend on several factors. Based on your description of having saline implants with mild capsular contracture, I have discussed possibilities in the attached video. Please view this. If you’re concerned about the potential outcomes (such as sagging or a significant reduction in volume), options like a breast lift or fat transfer after explanting might be worth discussing with your surgeon to help restore shape or volume. A consultation with a board-certified plastic surgeon who can assess your breast tissue, current breast shape, and desired outcome is crucial to determine the best plan for you.
Lastly, be patient with the process of recovery as the tissue and skin may need time to adjust to the new, post-explant shape.

Jonathan Heistein, MD · Answer

It's impossible to answer your question without an in-person exam.  There are so many factors that change the outcome of explantation like how much natural breast volume you have, how big the implants are, if there is any capsular contracture, how much sagging you have, and your overall body frame/shape.  In general, people with explantation are smaller, have less roundness, less firmness, more sagging, and more flat or sloped shape at the top of the breast.  Go for an in-person consultation to get a more specific answer for your situation.  Best of luck!

Matthew S. Kilgo, MD · Answer

Hello and thank you for your question.It can be very difficult to predict how the breasts will look after implant removal, particularly if the implants have been in for an extended period of time. One of the advantages of a saline implant is that it can be deflated prior to removal. It is a simple procedure that can be performed awake in the office by simply placing a needle in the implant percutaneously and removing the saline. This will allow the skin to retract and after some you should have a fairly good idea of how your breast will look once the implants are removed. I would recommend seeing a surgeon certified by the American Board of Plastic Surgery. I hope this helps. Good luck.