Why does the upper pole seem less full on a lot of people who explant?

It has to do with the volume of the breast, the support of the skin and breast, the elasticity of the skin.  A minimal lift wilt fix this problem.

Hi,

Thanks for posting your question. I am happy to try and help you. It is
important to remember that a board certified plastic surgeon will be your best
resource when it comes to an accurate assessment of your situation, and
concerns.

Having said that, time will allow your tissues to remodel. It may not be enough
to satisfy your aesthetic goals and another enhancement procedure may be
beneficial. The scar may have to be revised and the breast reshaped. If you
have some body fat, then placing some of your body fat into your breasts may
fill up some of the void left by the implants. Or you may select to have
smaller implants replaced.

Below is a link to learn more about implant removal.

Best wishes,

Dr. Michael J. Brown
Northern Virginia Plastic Surgeon

The natural breast tissue typically has a tear drop shape and not much upper pole fullness. After removing a breast implant, the upper pole fullness returns to its natural appearance. Every patient is different and I would recommend having a consultation with an experienced board certified plastic surgeon.

Unfortunately only an implant  or fat grafting can give long lasting fullness to the upper pole . A lift may appear to until the swelling goes down . After explantation a women is left with whatever upper pole tissue she started  with , or less  ,since the tissues have dropped and thinned  . You are correct that skin tone and elasticity are also part of the equation. 

Thank you for the question. I think that what the upper breast pole volume will look like after breast implant removal will depend on how much native breast/soft tissue specific patient  has.  As you can imagine, this will vary from one patient to another. Whether or not a breast lift is necessary or helpful will depend on the specific patient's physical examination.
Generally speaking what breasts look like after explantation depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back), the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation).
Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will potentially influence the factors discussed above. If you take these factors into consideration and apply them to your specific circumstances you may get a good idea of what to expect after the implants are removed. I would suggest that you select your plastic surgeon carefully; it is likely, that working together you will come up with the best plan of action. You may find the attached link, dedicated to breast implant removal surgery concerns, helpful to you as you learn more. Best wishes with your decision-making and an outcome that you will be pleased with long-term.

Basically because breasts are different - they vary from individual to individual and even from one side to the other.  The way a breast looks after an explant is dependent on many factors.  These include what the patient's own breast tissue looks like (and possibly looked like before the surgery), the size of the implants, how long they were in place, changes the patient's body went through over the years (pregnancies, weight gains and losses), whether or not capsules were present (and removed) and so on.The specifics of each case need to be discussed in person with a board-certified plastic surgeon, although it is not always possible to predict precisely what any person will look like after the surgery.Increasing the volume of the upper pole is best accomplished with implants or fat grafting.I hope that this helps and good luck,Dr. Alan EnglerMember of #RealSelf100@RealSelf

Implants can thin out the upper pole with time and pressure and natural breast tissue can droop with time as well.  Upper pole tissue deficiency is best corrected with fat grafting.