Hi @janey.jess, thanks for your question! Whether or not you need a lift after removing your 420cc, under muscle saline implants depends on your specific goals and aesthetic concerns. However, is important that you have total capsulectomy. It is important to note that after the removal of implants, the skin and tissues of the breast may be stretched or sagging, which can lead to a less-than-ideal appearance. If you do decide to have a lift, the most optimal and aesthetically adequate option would be immediate reconstruction with the BRALAN technique (Breast Reconstruction Anatomical Lift Augmentation) combine with a breast lift to provide a natural and lifted appearance. I link a video that sheds more light on the matter. If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science" Member (IFATS), Colombian Society of Plastic Surgery member (SCCP).