Can I get needle deflation before deciding whether to remove or replace my implants?

Question

I have saline implants placed 3 years ago that are too big. The issue is I am not sure if I want to remove the implants, replace with smaller, or remove an then do a lift. I am looking to do a needle deflation and give myself some time to decide on next steps, however my Doctor is saying I need to replace right away.I feel strongly about giving my body time to adjust before deciding next steps. Where can I find a dr that will support this?

Daniel Barrett, MD · Answer

Dear Nice55596,
in the case of saline implants, it is possible to remove some of its volume prior to removal. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Alan Gonzalez, MD, FACS · Answer

Hello @Nice55596, thank you for your question. It's technically possible to deflate saline implants and see what the breast would look like without them. This could help you decide whether to replace the implants with smaller ones, remove them entirely, or pursue a breast lift.
However, it's important to know that needle deflation is not typically recommended. There are several reasons for this. Once an implant is deflated, the breast tissue and skin that have stretched to accommodate the implant can sag, and this may not give an accurate representation of what your breasts will look like after a formal explantation procedure. Your surgeon's recommendation to replace the implants immediately is likely based on their professional judgement and concern for your overall wellbeing and aesthetic outcome. If you feel strongly about exploring other options, it may be beneficial to seek a second opinion from another board-certified plastic surgeon. They can provide additional perspective and may be more aligned with your wishes. It's important to remember that each patient's situation is unique and a direct consultation with a board-certified plastic surgeon is crucial to determine the most appropriate plan for your specific case.   Best wishes! Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science”  Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Shaher W. Khan, MD · Answer

Hello, thank you for your question! It is not advised to deflate the saline implants, at all, never: This is a serious mistake. You are correct to worry about contamination within the chest wall if fluids travel elsewhere during the procedure. The entire implant, capsule, and all inflamed tissue must be removed as one system in EN BLOC fashion or 100% total capsulectomy. This will allow for optimal recovery. This is the gist of explant surgery. Not everyone can perform explant surgery.

Shana Kalaria, MD · Answer

Good question! The risk of needle deflation is that the capsule will shrink and scar down. This means that in the event you chose to replace your implants, you may need a capsulotomy (opening back up of the capsule) to make more room for the implant. This has higher risks of bleeding and capsular contracture than replacing the implants right away. If you decide to remove the implants and do a lift, this will make little difference. Please visit with a board-certified plastic surgeon. Good luck!

Frank Lalezar, MD · Answer

The benefit of saline implants is that you can deflate them and remove the fluid. There is no danger in this. However, once you decide to deflate them, all the fluid will be gone. You cannot just remove some of the fluid. Whenever patients want to remove saline implants and go to smaller implants, I typically will deflate them ahead of time in order to allow the implant pocket to downsize, and then go in and replace the implants 1-2 months later. Patients have excellent results with this. Please make sure to see a board certified plastic surgeon about your decisions.

Connie Hiers, MD, FACS · Answer

Yes, your implants can be deflated so you can determine what to do next. However, I would suggest at least getting them out within a few months or they may wad up and be harder to locate to remove. with the empty implant and it wadding up, you may feel more discomfort from the bag and its corners.  It is easiest to remove and replace, then deflate and later remove and replace in many women.

Camille Cash, MD · Answer

Yes, you can have your saline implants deflated in the office.  As you stated this will give you some time to see how much the skin retracts on its own as how you feel about the size without the volume from your implants.  You will want to eventually get the capsules out even if you decide not to do any further surgery.

Can I get needle deflation before deciding whether to remove or replace my implants?

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