Lift with my total capsulectomy explant? (photos)

The removal with an enbloc capsulectomy can be performed and that is the easy part.  To tell you if you need a lift or simply reduce the areola again is difficult to say without an exam.  You may benefit from a lift, perhaps a full lift with fat transfer to the upper pole of the breast to help replace some of the upper pole volume that will be lost with the implant removal.I would recommend you see a board certified plastic surgeon to discuss your options.Hope that helps.

It is difficult to make 100% accurate predictions following explant. There are a number of factors to consider including age (the breast changes over time irregardless of augmentation), weight change, skin stretch and residual elasticity.
Following removal, one can expect:
-Loss of volume- Not an exact correlation between pre- and post augmentation due to the changes over time. You may be bigger or smaller than you remember.
-Ptosis/sagging-Ptosis develops over time and may be worsened by the presence of an implant. If a patient has pre-explant sagging, removal is likely to worsen this to a certain extent. If there is no ptosis, it does not necessarily mean there will be no ptosis after removal.
-Skin laxity/stretch- There is inherent skin elasticity which will allow for some measure of snap back. However, the greater the volume differential pre- and post- the more likely there will be excess skin.
In my experience, it is usually a safe assumption that there will be some changes post removal which oftentimes may necessitate further operative intervention (i.e. lift), however this is often a function of size and length of time post op. Small implants which have only been in place for a short period will lead to an improved response/recoil post removal. Whereas larger implants which have been in for several years will often necessitate a lift.
With regards to your specific question, removal and capsulectomy may be done in concert with a lift. However, having had multiple lifts in the past, staging may be an option (considering concerns for bloodflow to the areola has been altered repeatedly).
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
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