42, 32A, are there procedures to recover breast tissue firmness after explant over the muscle?

Hi @BAquestions23, thank you for your question. Performing just a breast fat transfer may help however I think there are other options you can consider. You could benefit from cosmetic reconstruction with the BRALAN (Breast Reconstruction Anatomical Lift Augmentation) technique and breast lift. This technique involves using your own tissue to reconstruct the breast and lift it to provide a natural, lifted appearance. Subsequently, after 4 to 6 months it can be complemented with a fat transfer to improve the volume. I link a video to shed more light. 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).

Hello, thank you for your question. After explanting your breast implants, it is common for breast tissue to take time to settle and potentially fluff out as your body adjusts. However, the degree of change can vary based on several factors, including how long you had your implants, your skin elasticity, and individual healing. It will take time for your breasts to adjust post-explant, so patience is key. Please see the attached video to explain your question specifically in detail. Hope this helps!

Dear BAquestions23,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. Generally speaking, breasts can restore it shape and size after implant removal but sometimes it will remain stretched and droppy. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Following implant removal, it will take up to 12 months for breasts to complete settle. Given the concerns that you describe, you may benefit from a breast uplift (mastopexy) or an uplift and auto augmentation procedure (using the tissue from the lower pole of your breast which would be removed as part of a lift, to enhance the fullness of the breast). You may also benefit from fat transfer, which can have the additional benefit of improving contour in other areas.

Good question! Typically, the breast tissue will decompress, commonly referred to as fluffing postoperatively, and the skin tightens to some degree for many patients. This can occur for months to even one year after breast implant removal surgery. The degree of fluffing and skin retraction is highly variable from patient to patient due to several factors such as patient age, the thickness of one's subcutaneous breast tissue, and skin elasticity. Procedures considered for improving the appearance of the breasts after breast explant surgery include the addition of volume with fat transfer and/or skin tightening by a breast lift, referred to as a mastopexy. I wish you the best of luck!

Hello. In general, at nine months post explantation of implants, the breast tissue and skin will remain close to what it is at this point without additional surgical intervention. Non-surgical options, such as massage, that show demonstrable improvement do not exist. Although it is difficult to advise without photos and examination, surgical options that exist to help restore some firmness and help fill the skin envelope include fat grafting. Additionally, if you have ptosis (droopy breast and nipples), a breast lift (mastipexy) may improve appearance at the expense of scars. I hope this helps answer your question. Wishing you the best!

Thank you for sharing your experience – what you’re going through is common for women post-explant, especially with small natural breast volume, thin issue, and over-the-muscle implants. Here’s a breakdown of what you can expect and options that may help improve firmness, skin tone, and nipple appearance after explant:
1. Will Breast Tissue “Fluff Out” After Explant?
The term “fluffing” often refers to the gradual softening and settling of breast tissue post-surgery. With over-the-muscle implants, natural tissue doesn’t get stretched or separated as much as submuscular implants, so the “fluffing” effect is usually less dramatic.
• 9 months post-explant: Most of the natural settling and tissue reshaping has already occurred by now. You may continue to see minor improvements up to 12-18 months, but dramatic changes are unlikely without intervention.
• Tissue thickness and lack of structure at 10 months suggests you breast skin and glandular tissue were significantly affected by the implant or stretch.
2. Causes of Your Current Symptoms
• Stretched skin: Caused by implants enlarging a small breast pocket
• Thinned breast tissue: Due to pressure from the implant over time (even at 9 months)
• Crinkled nipple or areola: Often related to lack of underlying support and stretched skin not fully rebounding
3. Procedures to Improve Firmness and Appearance
Here are potential non-surgical and surgical options:
Non-Surgical Approaches
These may offer mild to moderate improvements, but not structural change:
• Radiofrequency or laser skin tightening (e.g., Morpheus8): Stimulates collagen production and may help skin texture and firmness
• Microneedling with PRP: Can improve skin quality and texture around the breast and areola
• Breast massage: While massage won’t rebuild volume, gently lymphatic massage and skin rolling may increase circulation and improve superficial skin health
• Topical retinoids or firming creams: Mild benefit to elasticity, but limited penetration into deeper tissues
Surgical or Minimally Invasive Options
• Fat grafting (fat transfer): Fat is harvested (usually from abdomen/thighs) and transferred to the breast. It improves volume, structure, and even skin quality thanks to stem cells in the fat
• Mastopexy (Breast Lift): If excess skin and nipple placement are concerns, a lift can remove excess tissue and reposition the nipple for a firmer, more youthful appearance
• Internal bra techniques (e.g., mesh or biocompatible support): Occasionally used in reconstruction when tissue is too weak
4. Nipple/Areola Appearance
Crinkled or “sunken” nipples may improve slightly with skin tightening or fat grafting. In persistent cases:
• Areolar tattooing: Cosmetic tattooing can improve aesthetic appearance
• Areola reconstruction (minor surgical correction): May be used in conjunction with fat grafting or lifting procedures if the areola is significantly distorted
5. Lifestyle and Supportive Measures
• Supportive bras: Wearing a properly fitted soft support bra (not compressive) can help with skin support as tissue settles
• Nutrition and hydration: Collagen-rich diet (bone broth, vitamin C, amino acids) may support skin repair
• Patience: It’s tough, but changes often continue subtly for over a year after explant
At 10 months post-explant, you’re still in the healing phase, but most natural recovery has occurred. Full restoration of firmness and structure is unlikely without fat grafting or a lift. Non-surgical treatments can support improvement in texture and tightness, but won’t significantly rebuild volume or structural integrity.
Make sure you are following up with your surgeon. A consultation with a board-certified plastic surgeon experienced in explant and fat grafting can provide tailored options and realistic outcomes should you wish to look into surgical options.

At ten months post op there is not much further change that would be expected. Massage is unlikely to be of significant benefit at this point. You may want to consider a lift with or without a smaller implant to help with shape.

No, there is no "fluffing" of breast tissue. Your implants have stretched and thinned out your own tissue and this change remains with the implants removed. Should you gain weight or become pregnant, your breasts might enlarge. If you have donor fat, this could be added. However, with little breast tissue, not much fat can be transferred.

Hello, after 9 months maybe it is not going to change as much as you want, send me some pictures, but maybe its possible that you need to take out more skin and fat transferCB