How will my breasts look after removing 300/350cc saline implants?

Question

I am 32 years old, 5'6'', 130 pounds, size 32C. I had 300/350 cc saline implants placed under the muscle 10 yrs ago. I had the surgery initially because my left breast was much smaller than the right. Now that I am older, I want to remove the implants but worried about how my breasts will look after surgery (saggy? etc). Should I go to a size B and make the transition slowly? Also which area of incision will make the smallest scar? Thanks...

Elizabeth Slass Lee, MD · Answer

I have learned serendipitously that although breasts look really bad and collapsed initially after implant removal without a lift, over several weeks, the skin contracts and they end up looking like breasts again. I have started offering this procedure, explantation only, to all of my patients who want implant removal, with the understanding that if the breast does not firm up enough to be pretty, we can do a lift then as a secondary procedure. A lift later usually involves smaller incisions than a lift done at the same time as implant removal, so in my opinion, there is benefit in wainting. In fact, in the 12 or so patients I have treated this way over the past 18 months, none of them have needed a lift, and all have been happy with the results. It is a small number to be sure, but there is little risk in this approach and much to gain in terms of avoiding more scars if a lift is not necessary.

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. Result varies between patients and it will largely depend upon 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, pregnancy and other factors. Do not hesitate to contact your surgeon about this and discuss realistic goals and expectations. Best of luck! #RealSelf100

Richard J. Bruneteau, MD · Answer

In any particular case, it’s
virtually impossible to know if a breast lift will be necessary following
explantation without pictures or a physical examination.The presence of a nipple areola complex that
sets below the inframammary fold, poor skin tone and a high ratio of implant
volume to native breast tissue volume often suggests the need for breast lift
surgery. Breast sag following explantation is more likely in
patients who have had multiple pregnancies, have breast fed, have had weight
fluctuations, and have had implants for longer periods of time.When implants are large and are placed on top
of the muscle, the incidence of breast sag following implant removal is higher
as well.If you’re considering removal of your breast implants,
consultation with a board certified plastic surgeon is appropriate.This surgeon should be able to determine the
likelihood of a breast lift following implant removal based on your physical
examination.He should also be able to
formulate a treatment plan that addresses all of your concerns.

Otto Joseph Placik, MD · Answer

USe your existing scar and you may want to consider implant deflation with a needle to determine if you will be happy with the implant out or if you prefer a smaller sized implant replacement

Farbod Esmailian, MD · Answer

This will change the appearance of your breasts.  Your breasts may not just be smaller but they may be lower on your chest with excess undesired skin.  It is difficult to say if you will need a lift, this is something that we would need to do measurements on and an exam.  Gradually decreasing your size will not really help either.  Also when removing the implants after such a long time, you must also know that you may not have much of any breast tissue left.

	I would recommend seeing a plastic surgeon who can approximate the amount of breast tissue you would have after the removal and if you would need a lift.

	Good luck.

Christopher V. Pelletiere, MD · Answer

When you have had implants for ten years, the chances of removing them and having the breast tissue rebound back are small. Some women will undergo a lift afterwards to remove the excess skin, but it can leave you fairly flat chested. Alot of women simply downsize to a smaller implant instead of fully removing them to try and avoid the need for a lift. I hope this helps.

Steven Wallach, MD · Answer

Whenever you remove implants after a long period of time, it is difficult to predict the final shape. If you go smaller you may need a lift.

Peter A. Aldea, MD · Answer

Breast implants progressively and permanently change the overlying breast. They exert pressure on the breast tissue above/below them causing disappearance of some of the tissue and stretch the breast skin causing sagging. This especially seen along the bottom part of the breast and is more pronounced with larger implants.

	Removal of breast implants results in a picture similar to that of a sail ship when the wind disappears - deflated, sagging sails. It is unlikely that long-standing implants will not have an impact on the breast and that their removal would not have an adverse cosmetic appearance. The extent of deformity would vary from patient to patient.

How will my breasts look after removing 300/350cc saline implants?

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