Need to replace implants due to ALCA concern. Would like a lift. Do I need to downsize for lift? Size? (photos)

Saggy uneven 36B- First BA 1997- Saline Round Under Muscle 325cc L 375cc R. 2003-Replaced with Anatomical 410FX FullHeight Extra Full Projection 690 grams Over Muscle. July 2016 severe swelling & rash. Emergency MRI ruled out rupture but showed fluid filled mass within capsule-concern of ALCL, both implants folded, L below muscle, R above muscle. Surgery ASAP. Should I wait between explant & implant? Good candidate for lift?OV/UN? Round or Anatomical?In process of losing 30lbs- affect results?

Doctor Answers 2

Implant exchange and replacement

It is possible to have your implants removed and exchanged at the same time.  Going small will likely mean that you will have some loose skin that could benefit from a lift.  

This is not a simple decision process, it is best to be seen in person by a board certified plastic surgeon for an in-person assessment.

Toronto Plastic Surgeon
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Implant replacement and lift with concern about ALCL

Thank you for all the details you provided - I wish that more of my patients requesting breast augmentation revision knew as much about their history!  Your situation is very complicated and I don't think can be answered accurately in an online setting, so the best advice you'll receive is from your surgeon but I'll give you my thoughts.  First, removing your current implants and testing for ALCL seems appropriate based on your symptoms and MRI findings.  Whether you should replace your implants with new ones at that time, in my opinion, would depend on the degree of suspicion that this is ALCL.  If it is, the recommended treatment may compromise your aesthetic result and it may not make sense to do complicated and expensive surgery (new implants and a lift) before knowing the pathology results.  Assuming it is not ALCL, a lift would help re-position your nipples and your goal photos may be better achieved with anatomical implants than round.  Over or under the muscle would depend on your anatomy after having had 3 surgical procedures, so I'd just leave that to your surgeon's judgment.  Finally, significant weight loss after surgery can affect the results of the surgery, as your breasts may sag or your proportions may change.  Obviously you shouldn't wait to address the ALCL issue until you've achieved your goal weight, but you may want to consider just replacing your implants now and waiting until after you've achieved your goal weight to do the lift.

I want to emphasize again that these are all issues you should discuss with your surgeon and the online opinions you get should be used as talking points for your conversation with him or her.  Best wishes.

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.