Surgeon gave one option: explant. Second opinions?

The best second opinion requires an in-person evaluation, but here are a few things to know: First, you may have misheard something about grading contractures. Baker 1 is soft and normal, Baker 4 is hard and painful. If your implants are actually Baker 1, then just do a lift for waterfall ptosis. If there is a contracture (Baker 2-4), then a capsulectomy and implant replacement would be done. It could be risky to combine this with a lift because of blood supply to the nipple. Not sure you would need to wait a full year but without seeing you, I wouldn't second-guess your own surgeon.

Thank you for your question. I recommend getting a few opinions before making your final decision. We regularly do enblock capsulectomies with breast lift & fat transfer at the same time. Less downtime and cost to the patient. That being said there are times we recommend waiting in between procedures if the patient is unsure. Your expectations and health will dictate the best procedure(s) for you. I suggest a consultation with a board certified plastic surgeon to go over the options that best address your goals. Best of luck!

Dhaval Patel MD
Double Board Certified Plastic Surgeon
Chicago
South Barrington
Oakbrook
Orland Park

Without the benefit of physical exam, posted pre+post-op photos, reading op-report- it's difficult to comment accurately. If you are seeking second opinions - I suggest that you schedule in person consultations with experienced Board Certified PS to review your options.

Thank you for you questions regarding breast explant and lift. In my experience, patients do not always needs another surgical procedure for a grade 1 capsular contracture. I have also performed breast implant exchange with mastopexy (breast lift) simultaneously with great results.

To be sure, see two or more experienced, board-certified plastic surgeons in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have breast implant exchange, capsulectomy, and mastopexy. I hope this helps.

Unfortunately, you have not provided photographs or told us your bra size or implant size. However, if you have capsular contracture and waterfall effect then the implants need to be replaced at a different location and you need to have a lift. More information is needed to give a accurate answer.

Best Wishes,

Gary Horndeski, M.D.

Hello @Tammyof4 thank you for your question. It is vital to develop a customized surgical plan that takes into account several factors in order to perform a procedure that fits reality and the patient's expectations. We have our own surgical techniques that allow us to remove the capsule and improve the aesthetic aspect of the breast without prosthesis. I would encourage you to schedule a consultation with a board-certified plastic surgeon. During your consultation, your surgeon will be able to assess your unique needs and develop a treatment plan that is right for you. Best wishes! Alan Gonzalez MD, FACS.

Dear Tammyof4,
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

You posted no photos, but typically with the waterfall problem, your tissue is sagging away from the implants and you need a lift. Your implants also may be too large for your frame and tissue. Not all women, however, can have a lift if they had very little breast tissue prior to implants. An examination will tell if you can have a lift and if you need to wait a while after removal to lift, or do it at the same time as the removal. Capsular 1 contracture is no contracture, but a very soft and normal breast. Perhaps you are a 2 or 3?

It's difficult to give you an opinion without an exam or photos. An exam would help determine what options you have. Sometimes medication can improve a capsular contracture. Often times if implants are removed a lift can be performed at the same time. I encourage you to visit with a few board certified plastic surgeons near you to hear opinions and discuss your options. I've included a video about capsular contracture that I hope you find helpful.