Explant of implants - is it possible to deflate implants to decide if they should be replaced?

Question

I have had saline implants for 24 yrs (and silicone for 18 yrs before that. I want to either get much smaller implants with a lift, or possibly just a lift with no implants. I feel like I’m going to need to see what my breasts look like without implants before deciding but don’t really want 2 surgeries. Is it possible to just deflate them, let things settle and then decide? I will need a lift either way. Thank you

Maryam Zamani (Saheb-Al-Zamani), MD · Answer

Hi,
Deflating saline implants prior to implant removal or exchange is a great procedure which I offer to many of my patients undergoing explant of breast implants or implant revision. This procedure is done comfortably in the office and allows patients to preview their breasts after the implants are removed. Deflation can also help with planned revision surgeries by tightening the implant pocket, allow new implant sizing, and make decisions regarding lift when the breast tissues have rehydrated and lifted (typically after 2-3 weeks).  I recommend a consultation for full assessment and individualized treatment planning. 
Dr. Maryam Zamani MD FRCSC 
Double-Board Certified Plastic Surgeon

Emre Guvercin, MD, FEBOPRAS · Answer

Yes &mdash; with saline implants, deflation is technically possible, and in some situations it can help patients visualize life without implants. But there are important caveats you should understand before choosing this route.Can saline implants be deflated without full surgery?Yes.Saline implants can be partially or fully deflated in the office by accessing the fill port (or via a small needle puncture), without removing the implant.This can:Immediately reduce volumeGive you a sense of weight reliefShow how your skin and tissue behave without implant supportThe important limitations (this is key)Deflation is not the same as true explant or a final result.After deflation:The empty shell remains insideThe capsule is still presentThe breast often looks more distorted or deflated than it would after proper explant + reshapingSkin may look worse temporarily because nothing is supporting itSo deflation can feel emotionally jarring and may underestimate how good a proper surgical result could be.Will deflation help you decide?It can help you answer one question only:“Do I feel better without the weight and volume of implants?”If the answer is yes, that’s useful information.But it will not reliably show:What your breasts will look like after a liftHow much volume you’ll truly have after reshapingWhether smaller implants would be idealAbout avoiding two surgeriesYou’re right that you’ll need a lift either way &mdash; and that’s the most important point.Many patients in your situation choose one definitive surgery:Either explant + Push-Up Lift (no implants)Or implant exchange to much smaller implants + Push-Up LiftA Push-Up Lift (supportive mastopexy) reshapes and lifts your own tissue, so you’re not relying on implants to define shape. That’s why many patients are pleasantly surprised by how good they look without implants once this is done properly.When deflation can make senseDeflation can be reasonable if:You are very unsure emotionallyYou want to feel the physical difference firstYou understand it’s a temporary, imperfect previewBut it should be seen as a decision aid, not a cosmetic solution.

Christine Fisher, MD, FACS · Answer

Hi Suzhutch!  Great question!  We commonly perform saline implant deflation prior to an implant exchange or removal.  Deflation can give you a good idea of how much breast tissue you have to determine whether or not you will need extra volume from an implant to reach your size goals.  Deflation is something we easily do with you awake in the office with little to no discomfort.  Revision breast surgeries can be technically challenging, so I highly recommend seeking out a board certified plastic surgeon specializing in surgery of the breasts to help you acheive your aesthetic goals.  Best of luck!

Danielle Dumestre, MD · Answer

Hello! 
Yes! So some surgeons will offer and in office procedure where we can deflate the saline implant and remove the shell in the office without general anesthesia only using local, like lidocaine. Little downtime as well. We close the incisions and see how the breasts heal and in a few months you can decide if you want implants with a lift or just a lift. Hope this helps!

Daniel Barrett, MD · Answer

Dear suzhutch1,

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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

I frequently do explant with breast lift simultaneously. I do this because most times the excess skin requires a lift. The question is whether you want volume. Since you have saline implants, they can be ruptured and will determine the final volume. However, 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. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Matthew S. Kilgo, MD · Answer

Hello and thank you for your question.
It is absolutely possible to deflate your implants before undergoing additional surgery. It can be easily done in the office and something I routinely encourage . Deflating the implants will give you a better idea of how your breasts will look after explanation and allow you to make a more informed decision about whether you would require replacement of the implants, a breast lift or a combination of the two. I've had patients who after deflation and skin retraction were pleased with the appearance of their breasts and decided on implant removal only. Good luck. I hope this helps.

Brian K. Reedy, MD · Answer

Thanks for your question! Absolutely you can deflate your implants and then see how you feel prior to making any decisions. We do this all the time. Good luck!

Sean Fisher, MD · Answer

Yes, it is absolutely possible to deflate saline implants prior to surgery. This can be done simply by aspirating the fluid out using a large syringe. This will not give a complete picture of what a lift without implant replacement will look like, as you are going to have a more deflated appearance than what would be achieved once a lift is performed. However, purely from a volume-standpoint this may help you make you decision. 
Sean Fisher, MDAesthetic Plastic SurgeonSeattle, WA

James Knoetgen, III, MD · Answer

Great question! Here’s how this usually works:
Deflating saline implants temporarily to see how your breasts look without volume can be done, but it’s not typically the best or most common approach for a few reasons:
1.	Temporary deflation is possible — your surgeon can remove saline from the implant through the valve. This reduces volume and lets you get a sense of your breast shape with less fullness.
2.	But implants are still physically there — even deflated, the implant shell remains, so your breast shape won’t be exactly the same as it would be without implants at all.
3.	Tissue changes take time — after deflation, your skin and breast tissue need weeks to settle to get a clearer picture. This means multiple visits, and sometimes discomfort or unevenness while the tissue adjusts.
4.	Two surgeries often still needed — if you decide to remove the implants entirely, you’ll usually need a second surgery for removal plus the lift (mastopexy). If you want smaller implants, that’s typically done at the time of implant exchange with lift.
What’s usually recommended?
•	Consult with your plastic surgeon to discuss your goals and options.
•	Often, surgeons will do a single surgery where implants are removed and a lift is done — if you want to see your natural breast shape beforehand, they might show you simulations or photos of similar cases.
•	If you want to downsize implants with a lift, it’s often done in one operation: remove old implants, place smaller ones, and do the lift all together.
•	Temporary deflation can be an option but it’s less common and might not give the full picture of post-removal breast shape.
Bottom line:
You can deflate saline implants to get a sense of volume reduction temporarily, but it won’t perfectly replicate implant removal. Usually, the best route is a careful surgical plan with your plastic surgeon to achieve your desired size and lift in one surgery.

Explant of implants - is it possible to deflate implants to decide if they should be replaced?

Answers (15)

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