Since I have stretch marks, will my breasts look bad after explant?

Question

I had a breast augmentation about 5 months ago, and since about 2 months ago I have had chronic back pain. The pain moves, and when it hurts, is much worse when I lay down or sit. I go to the chiropractor every week with no help, xrays look fine. At this point I dont know what else it could be, and am considering explant. I know the skin will retract differently for every person, but I did develop stretch Mark's after surgery, and am wondering if that means my skin will not retract as much?

Kenneth Hughes, MD · Answer

The smaller the implant and the less the amount of time it has been since placement, the greater the chance the breasts will return to their preoperative state. It is very difficult to predict breast size following explant b/c breast implants and weight fluctuations over time tend to thin tissues, cause a decrease in size, and create more droop.  
It is not unreasonable to remove the implants and then observe a waiting period of six months before the determination for breast lift or breast fat transfer is made. This will give your breasts time to bounce back and your PS time to determine what type of lift, if any, is needed.  If you had stretch marks before the breast augmentation, they may be more pronounced when the implant is removed.

Daniel Barrett, MD · Answer

Dear Brianna0004,
it is hard to guess how will your breasts look once you remove your implants. But if you have stretch marks now, there is a big chance that they will be more visible once you remove your implants. You always have an option to wait to see how will they look after implants removal and then decide whether to have another surgery to improve your results. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Roger Tsai, MD · Answer

Great question!  There are many factors to consider when it comes to the quality of breast retraction, mostly skin quality.  Age, ethnicity, and genetics obviously affect the quality of skin and are factors as well.  Since you've only had them in for 2 months, the skin hasn't really stretched out as much the typical patients with breast augmentation, so the retraction could still be good, again depending on the other factors of skin quality.  However, everyone heals and reacts differently so what may happen with one patient may not happen with another.Best of luck and hope this information helps!
- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

Gary M. Horndeski, MD · Answer

After explant alone patients are usually dissatisfied because of the empty appearance and excess hanging skin.  Patients frequently require a lift and I recommend performing both at the same time.  The technique I recommend is explantation and lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained, if not injured during your previous surgery.  Stretch marks are tears in the dermis from stretching skin beyond its elastic modules.  At the same time or later, fat transfers can be performed if additional volume is desired.  Best Wishes,Gary Horndeski, M.D.

Nelson Castillo, MD · Answer

Thank you for sharing your question. Unfortunately without being able to assess your skin quality it is difficult to know exactly what your skin will be able to do.  That said you have not had your implants in for long so the likelihood of appropriate retraction is high.  I would either continue to work to identify the source of your back pain, or have the implants removed if you feel they are the cause.

Donovan Rosas, MD · Answer

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.
With regards to your specific question, without an in-person exam it is difficult to make a prediction. Much will depend how long they have been in place and how much you have changed over time. That being said, stretch marks are the hallmark of skin which has lost some of its inherent ability to retract or snap back. 
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
RealSelf Top 100
RealSelf Hall of Fame

Connie Hiers, MD, FACS · Answer

If you have large implants, you might want to consider exchanging them for something smaller that is less heavy on your neck and shoulders. You may or may not need a lift. If you choose to just remove your implants, you will have some excess skin. You may need a lift. skin tightening with radiofrequency like ThermTight might also be helpful.

Tom J. Pousti, MD · Answer

I am sorry to hear about the problems you are experiencing. Generally, given that you are only five months out of surgery, I would expect that your breasts will "bounce back" better than what is seen for patients who have had breast implants in place longer periods of time. The presence of stretch marks does not necessarily mean that your breasts will not retract as much. Your plastic surgeon, knowing your situation, will be your best resource when it comes to predicting what your breasts will look like after implant removal surgery. Best wishes.

Matthew A. DelMauro, MD, FACS · Answer

Hello, and thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) Since you did not provide photos and were not examined in person, it is difficult to give you any advice. Your outcome will depend on your anatomy (e.g., the location of the stretch marks, amount of breast tissue, presence of breast sagging). If you decide to pursue surgery it’s very important that you find a surgeon whom you are comfortable with and trust and who evaluates you in-person and tailors an individualized treatment plan for you and your aesthetic goals. Best of luck!
Matthew A. DelMauro, M.D.

Camille Cash, MD · Answer

I'm sorry you are unhappy with your breast augmentation.  As you've only had your implants in for 5 months, upon healing from removal you should return to a look similar to what you had prior to surgery.  There may be some looseness of the skin and the stretch marks will not go away, but the skin should have decent retraction since the implants were in for only a short time.

Since I have stretch marks, will my breasts look bad after explant?

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