Explant: with or without a lift?
Doctor Answers 6
Deflation first( aspiration of the saline) then possible lift
Your surgeon is correct with his plan and the deflation would give time to make better decision about the lift and possible size of the implant. The deflation and aspiration can be done safely under local.
Breast implant removal
If you are confident that you will need a lift, it is ok to do it at the same time as the removal. However you must be aware that your surgeon may not be able to accurately predict how you will look after surgery as the breast tissues will have changed over the 17 years. If you choose to have the implants drained first you will have a better feel for the amount and quality of breast tissue that is present.
Draining of saline implants
I would recommend against this as I have seen significant chest wall infections if there is contaminated saline (bacteria or mold) in the saline implants. It is safer to remove them intact along with the entire capsules. We use drains for about a week, along with antifungals if needed. An internal lift is usually needed and sometimes skin excision from the lower pole or around the NA complex if it is present. If you have small implants that are not laterally displaces, sometimes a llift is not needed.
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If they are saline, then it might be reasonable to do so especially if they were asymmetric to begin with, and you did not start off with a lot of breast tissue.
Draining saline implants
The decision on whether or not to get a lift can have financial repercussions that must be taken into consideration prior to surgery. Draining the implants will give you a preview of what to expect if you don't get a lift. That way you can make a more informed decision. Hope this helps, good luck!
To lift or not to lift
Thank you for your question. Without pictures, measurements and other important information it is almost impossible to give any recommendations. However, if you have saline implants, the option the surgeon has given you is a very reasonable thing to do. Usually after evaluating a patient one should be able to tell if a lift is needed after explant, but sometimes its not so cut n dry. In that case I think draining the implant and seeing how you feel about your breasts and determining later on that a lift is or isn't needed is not a bad option. Draining the implant should be a VERY quick procedure with very minimal discomfort. Of note, if your breasts are at a point where you think they need to be lifted then after explant they almost surely will need to be lifted. I hope this helps...sorry cant be more helpful without more information. Hopefully you are being evaluated by a board certified plastic surgeon!
Ankur Mehta MD