Breast Implant Removal. What to Do?

4 yrs ago I've had a breast augmentation . Used to be 34B with right breast OK but left was bigger and flatter. Silicone ( cohesive) on top of breast muscle . 325 cc . Then I had a revision surgery on my right breast because of capsular contracture . It keeps coming back with more discomfort . I've decided to get them out ! Guess , I'll require a breast lift :((( Want less scaring! Better result! And, should I wait 6 mhs ?

Doctor Answers 11

Removing Implant Concerns

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I'm a little unclear, did you have implants placed in both breasts or just one? Are you happy with your overall results and size and it's because you have encapsulated that you want to remove them?  If that is the case, there are several options to treat capsular contracture such as changing planes (going under the muscle), using an acellular dermal matrix, etc.  Consult with your surgeon to go over all of your concerns and learn about all of your options so you can make an informed decision.  Best of luck!



Removing breast implants

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Without an exam or at least a photo, its difficult to give you specific advice. You wont necessarily need a lift but its certainly a possibility. Because your implants were over the muscle, there is some additional risk of decreased blood flow to your nipple if you do have a lift. Please discuss this with your surgeon.

Paul Wigoda, MD
Fort Lauderdale Plastic Surgeon
4.8 out of 5 stars 30 reviews

Breast implant removal options

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I would add some general principles to the reasonable responses and options here. 

Evidence is accumulating that capsule contracture is more common with implants above the pectoralis muscle and particularly with a periareolar incision. A revision could be done with an inframammary incision and subpectoral placement of a new implant (which would require the same for the other side and would be equivalent to a redo augmentation). 

Breasts are not actually lifted by implants and they do not sag because they are taken out. Implants are pillow volume. The two things that could have stretched or sagged your breasts in the four years since they were placed are too big implants placed originally and the passage of time (aging, pregnancy effects, weight changes etc.). 

In general I would advise keeping it simple and take the implants out with a simple removal and then see if you still want or need something to adjust, including re-augmentation in the subpectoral position. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Concerns about Breast Implant Removal?

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Thank you for the question, but  (as you can imagine)  it is not possible to give you precise advice without direct examination or at least viewing pictures.

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.
Consulting with a well experienced board-certified plastic surgeons in person will be helpful.  Ask to see lots of examples of their work helping patients in your situation.

I hope this helps.

Breast Implant Removal

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   Although you can remove the implants, I would recommend a replaning procedure to under the muscle to help prevent future capsular contracture.  I have seen very few patients who are happy after implant removal.  If you are determined to get them out, you may want to consider fat grafting to the breast.  Find a board certified plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and revisions each year.  Kenneth Hughes, MD Los Angeles, CA

Implant removal and a lift

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Sometimes delaying the lift after implant removal is the best thing especially in small breasted patients.

Wait after removal prior to having a breast lift.

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i agree with Dr. Gottlieb. There are many options to treat recureent capsular contracture and I am not sure you have exhausted all of them.   Often when implants are removed, and the patient was not drooping prior to the augmentation, the breasts will tighten up enought not to need a lift.   That may be the good news in your case.  I would definitely wait at least 6 months after removal prior to having a lift, just to see how the breasts will react and tighten.

Best regards, 

Dr. Lane Smith

Breast Implant Removal. What to Do?

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Sorry to hear about the issues you have had. 

Although I concur with your decision to have these removed, hopefully your surgeon has gone through the options which include transferring the implants to the subpectoral position, and possibly using Strattice to minimize the chance of recurrence of contracture. 

I wouldn't want to guess about the lift without the benefit of photos. If there is any uncertainty about the need for one, just having the implants out and delaying the decision to see how much breast shrinkage occurs my result in a better outcome than doing a lift would. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Removal of breast implants do not necessarily result in a condition that benefits from breast lift.

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Depending on a number of variables removal of implants without replacement does not necessarily mean the shape of the breast will be unattractive. Usually this can be decided preoperatively.

Capsular contracture after breast augmentation

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Hello 'Sadkitten', thanks for your question.  I'm sorry to hear you have had recurrent problems with capsular contracture after your breast augmentation surgery.  Although noone knows for sure what causes capsular contracture, some theories are subacute infection leading to a biofilm entity around the breast implants, implant rupture, or fluid/ hematoma collection after surgery leading to prolonged inflammation and swelling of the breast pocket. Several risk factors have been described including smoking and implant pocket position.  Of the latter, there is a documented significant 20:1 increased risk of capsular contracture with implant placement in a subglandular pocket (on top of the muscle) versus in a subpectoral pocket (under the muscle).  This is one of the main reasons I always recommend placement of implants in the subpectoral pocket.  If you have recurrent problems using the same pocket, one option if you still want to be augmented is to switch pockets into a submuscular plane, which minimizes risk of capsular contracture with the massaging action of the pectoralis major muscles.  If you do not wish to pursue further augmentation revisions, then explantation, with or without a mastopexy (breast lift) would be warranted.  Without a photo, I cannot comment on which option would be best for you.  Either way, I would recommend waiting at least 6 months to let things 'settle' before pursuing further surgery.  Be sure to go to a board-certified plastic surgeon who can perform a thorough examination and go over the options with you in more detail. Good luck! -Dr.92660

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