I'm 48 with silicone implants for over 15 years having them removed by the NHS, how are my breasts going to look?

Your look after implant removal will be influenced by a few factors.  Some include the quality of your skin, the size of your implants, the length of time the implants have been in place, and the amount of natural breast tissue you currently have.  You can expect that the volume provided by the implants will be lost.  After 15 years the skin has probably loosened especially if you had larger implants, and you can expect some sagging.  You can consider having a lift at the time of the implant removal if you are concerned.

Thank you for your question. It would be difficult to give an absolute answer of how they will turn out.  It will take several months to see the final result. The answers to your questions depend on a variety of factors.  How large are your implants?  What is your skin like?  Do you have ptosis?  How long have the implants been in?  This will help determine if you need a lift or not.  There are options for the different types of incision lines as well.  Please tell your Board Certified Plastic Surgeon your concerns.Jeffrey J. Roth, M.D., F.A.C.S.Board Certified Plastic Surgeon Las Vegas Plastic Surgery

Thank you for the question. Short answer: much will depend on your physical examination ( factors such as degree of breast ptosis, current position of breast implants,  assessment of breast skin quality/elasticity…).
Generally speaking what breasts look like after explantation depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back), the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation).
Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will potentially influence the factors discussed above. If you take these factors into consideration and apply them to your specific circumstances you may get a good idea of what to expect after the implants are removed.
In my practice, if a patient presents with "breasts in borderline position" or has doubts about breast lifting surgery, I suggest that they undergo breast implant removal only; breast lifting can always be done at a second stage, if necessary.
I hope this, and the attached link (dedicated to breast implant removal surgery concerns) helps. Best wishes with your decision-making and for an outcome that you will be pleased with long-term.