Can I achieve nice aesthetics after explant due to hardening?

Question

I am a 71 y.o. female with 9 year old Mentor smooth memory gel implants. My right breast became swollen and hard this week and ultrasound shows fluid around the implant. MRI is scheduled. The supposition is that the implant has ruptured and will need to be removed (the left will also be removed). I established my profile here, pre-augmentation/lift, 9 years ago, showing my original small, narrow-based, assymetric breasts that needed correction. My question now is, after the explant procedure, can the tissues and skin that remain be worked with (NO implants) to achieve a nicer shape than my small, droopy, narrow-based, assymetrical breasts had pre-augmentation/lift? I am not concerned with the size, just the shape. Thanks for any and all information I can get. This is not a simple situation to research! (Dr. Steven Vath of Golden, CO gave me new, pretty breasts all those 9 years ago, and I highly recommend his artistry in breast augmentation.)

Mert Demirel, MD · Answer

Yes, it may be possible to achieve a nicer shape after explant without replacing the implants, but the result will depend on how much natural breast tissue, skin elasticity, scar tissue, and capsule changes are present after removal.
Because you now have sudden swelling, hardness, and fluid around the implant, the medical evaluation comes first. MRI is appropriate, and your surgeon may also consider fluid aspiration or testing depending on the findings. With late swelling around an implant, it is important to rule out rupture, infection, seroma, capsular contracture, and rare implant-associated problems.
After explant, the breasts will almost certainly be smaller and may look deflated at first. However, a lift or reshaping procedure can often improve nipple position, tighten loose skin, and rearrange remaining tissue to create a cleaner, more aesthetic breast shape.
If there is very little natural tissue, the breast may still be small and narrow-based, but it can often be made neater and more lifted than before. Fat grafting may be an option later if you want subtle contour improvement, but it depends on donor fat and whether the breast tissues are healthy after explant.
Capsule management is important. If there is rupture, thick contracture, abnormal fluid, or inflammation, your surgeon may recommend partial or total capsulectomy and appropriate pathology testing. The plan may need to be adjusted based on MRI and intraoperative findings.
My advice would be to focus first on diagnosis and safe implant removal. Then discuss explant with lift/reshaping, possible capsule removal, pathology/fluid testing, and whether fat grafting should be staged. Even without implants, improvement in shape is often possible, but expectations should be based on your remaining tissue and skin quality.

Can I achieve nice aesthetics after explant due to hardening?

Answers (1)

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