Nipple and Areola Caved in After Explant Surgery. Permanent?

I am three weeks post explant. I had silicone implants for 30 years and had them removed due to rupture. I am devastated with the outcome. I am 56 years old and my breasts now look deformed. The nipple and areola are caved in. I have just today stopped wearing the tight sports bra that I was told to wear for two weeks after surgery. Is there any hope that the look of the breast is temporary, the breast is still healing, etc.; or is this pretty much what I can expect to look like from now on?

Doctor Answers 14

Breast implant removal after 30 years

Your result is most likely permanent. This happens when a woman has had her implants in over a long period of time and she is older. At the time of your initial surgery, you were young with a small amount of breast tissue. Implants were inserted into a tight space and created pressure against the surrounding breast tissue, causing it to atrophy (thin out) and you most likely had children that caused your breasts to enlarge and cause more pressure against the real breast tissue. You may improve slightly over the next 6 months, but I doubt it. You state that your implant ruptured. This is not a tragedy and you could have another implant inserted in the same space. A smaller one should be able to fix everything.

San Diego Plastic Surgeon
5.0 out of 5 stars 1 review

Breast appearance after removal of 30 year old ruptured implants.

This is one of the downsides of gel implants.  When they rupture, they can cause inflammation and scarring and when they are removed, there can be areas that are thinned out or scarred down.  In many, many cases, the appearance of the breast can be improved with either some fat grafting and some reshaping of the breast using breast lift techniques or even new implants.  I highly recommend you let everything heal and soften up and then explore your options.  I have yet to see a patient in your situation that I have not been able to improved considerably. 

You are WAY too young to have to live with deformed breasts.  I wish you the best of luck. 

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 73 reviews

Deformity after explantation

There may be some improvement in this deformity for about 3 months, but in general, I recommend an internal lift in order to prevent this complication as the breast tissue can be projected out with dissolvable sutures at the time of explantation and capsule removal. 

Susan Kolb, MD
Atlanta Plastic Surgeon
4.2 out of 5 stars 28 reviews

Distortion Following Implant Removal

                  It’s not unusual for patients to experience breast distortion following removal of ruptured silicone implants, especially when calcified capsular contractures are present.  Under these circumstances patients are often emotionally devastated by breast distortion and associated loss of breast volume.

When this situation arises in the immediate post-operative period, it can be difficult to know if this distortion is permanent.  In some cases swelling resolves and tissue remodels over the course of 3-6 months with significant improvement in the aesthetic result.  In other cases, the deformity may be permanent and secondary surgery may be indicated.  This may include implant replacement, breast lift and possibly fat grafting procedures.

If you’re concerned about the appearance of your breasts following implant removal, consultation with a board certified plastic surgeon is appropriate.  This surgeon should be able to formulate an appropriate treatment plan.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Are nipple irregularities permanent after breast implant removal?

Following breast implant removal, you will have swelling that can cause irregularities of your nipples.  Most of the time this will improve when the swelling resolves after several weeks to months depending on individual variation.

Some of these irregularities may not improve after the swelling has resolved and may require surgery for improvement.

See a board certified plastic surgeon to be evaluated and to discuss your treatment options,

Fredrick A. Valauri, MD
New York Plastic Surgeon

Caved in Nipples afer old implant removal

The problem you are describing is usually more common when the nipple approach was used for implant placement. Nevertheless it is too soon to plan any more surgery yet. After discussing the problem with your plastic surgeon you may decide to leave it alone or place a new implant. Another approach, which no one has mentioned yet, is fat transfer to reconstruct the area. Fat transfers to the breast have been controversial but are now being utilized for some problems such as yours. Your doctor can refer you to a doctor who is skilled in fat transfers to fill in deficient areas such as you are describing.

James Apesos, MD
Dayton Plastic Surgeon
4.2 out of 5 stars 14 reviews

Breast appearance after implant removal (30 years later)

Your breast shape may or may not improve over time. You are certainly going to do no harm by waiting, massaging, and giving the scars (both internal and external) time to soften and mature.  The nipple depression you describe may be partially due to internal scarring which may soften over time, and it may be due partially to lack of support for the nipple complex, which can be fixed by adding a new implant or maybe doing a breast lift.  Talk to your surgeon about your goals--I'm sure your surgeon wants you to be happy with your final results.

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 43 reviews

Depression deformity after breast implant removal

Your breast implants had stretched out the overlying tissue over 30 years. When these implants were removed, a portion of the breast caved in. It is possible that this depression around your areola will be permanent. However, there are options to correct this defect. You may elect to receive another breast implant to fill this volume or a small breast lift may address this issue as well.

Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 108 reviews

All you can do is work with your doctor on this

It is very possible that you will maintain a deformed looking breast if they look bad now.  I do doubt that they will start to look better with time unfortunately.  All you can do though is wait, massage, and follow your doctor's advice and see where it goes.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

It is possible

The fact that your implants were 30 years old makes me think they were above the muscle and the tisse over the most prominent portion of the implant which can often times be the areola gets more thinned. In women whose natural breasts have increased in size over the years this is sometimes less prominent. Give it time to heal and follow your plastic surgeon's instructions.

Dr Edwards

Michael C. Edwards, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 35 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.