Implant removal and fat transfer done separately? Why?

Question

I recently reached out to the doctor, who did my original breast augmentation and lift because I am ready to have my implants removed. I requested an implant removal with a fat transfer, he’s recommending that I do an implant removal with a lift first, and if I’m happy with that then no fat transfer but if I am not then he’s wantin to do a second surgery that would be a fat transfer. Why 2 surgeries, when I see folks on here get it don’t all at once.

Alan Gonzalez, MD, FACS · Answer

Hello @KAMSeattle, thank you for your question. Everything depends on the surgical technique of the specialist performing surgery. Remember that any kind of explant must be complete, that is, the surgeon must remove the whole capsule out. Complete capsulectomy. Also it would be necessary to carry out a preventive biopsy on each capsule. In any case, I do not perform breast fat transfer during a breast implant removal procedure because for me, the breast explant must be performed with a breast reconstruction in which the mammary tissue is placed adequately in place again. If the fat seeding is done at the same time, it might get infected or die; there is no guarantee that the seeding will stick. 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.

Camille Cash, MD · Answer

These two procedures can often be performed at the same time.  It is important to understand the benefits and risks associated with fat transfer to the breast.  Microcalcifications can form as a result of fat transfer to the breast.  These can sometimes interfere with imaging when screening for cancer.  You may want to consider smaller implants as an alternative.

Raffy Karamanoukian, MD, FACS · Answer

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Shaher W. Khan, MD · Answer

Fat transfer is not recommended at all. At least 30-50% of the fat will inevitably die, and clumps of that fat may remain. This will certainly lead to change/loss of sensation, along with self monthly breast exam that may pick up on these hard masses that may result in unnecessary images, biopsies, and worry to rule out breast cancer. Your explantation surgery must completely remove not only the implant, but the capsule and all inflamed tissue which will take approximately four hours. This does not include time for lift, which should take at least two-four hours to complete depending on your exam.

Daniel Barrett, MD · Answer

Dear KAMSeattle,
I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Implant removal and fat transfer done separately? Why?

Answers (9)

Answer: Why is fat transfer not recommended?

Answer: Why is fat transfer not recommended?

Answer: Combination of procedures

Answer: Combination of procedures

Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.

Implant removal and fat transfer done separately? Why?

Answers (9)

Answer: Why is fat transfer not recommended?

Answer: Why is fat transfer not recommended?

Answer: Combination of procedures

Answer: Combination of procedures

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.