Transgender breast implant removal. How can I do this with minimal additional scarring? (Photo)

Good afternoon!
Here's what I would do:1) use your old scar
2) en bloc capsulectomy/explant
3) drain for five days
4) tight compression bra for 12 weeks
That should restore you to your previous look!

In general, the smaller the implant and the less the amount of time it has been since placement, the greater the chance the breasts will return to their preoperative state. Breast implants over time tend to thin tissues, cause a decrease in size, and create more droop. No one can truly predict this as each soft tissue envelope will respond differently, but you may do well with just removal. If there is any doubt, explant using the original incision, followed by a period of several months of observation.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Thanks for your question! It does appear that your implants have migrated (not uncommon). I usually recommend removal for patients, and then waiting to see how much their skin envelope returns to it's previous size. Given the amount of stretch needed for larger implants, it's likely that you will need to have some skin excised. However, to minimize scars, allowing to tissue to heal as much as possible first can be helpful. I'll often help some of the tissue 'sag' with some internal lifting stitches and then see where the skin contracts to post-op. However, the approach of immediate mitigation varies surgeon by surgeon.Best of luck! 

One option is for you to have the implants removed and allow the breasts to completely heal.  As you have only had them in for one year and you are young you may get good retraction of the skin.  If after you heal you are unhappy with the result you can return at a later time for a lifting procedure.

You can first try removal with skin tightening like ThermiTight which uses radiofrequency or heat to tighten skin. The tissue will gradually tighten up to one year. Scarring is very minimal. If after a year you have excess skin, you might need a lift. Also, you could consider removing the implants and fat grafting for some fullness. Your third option is to consider going smaller, and have your lower pocket tightened internally. I would suggest meeting with a board certified plastic surgeon who does transgender surgery and discuss all your options.

I am sorry to hear about your concerns after breast augmentation surgery. Based on your photographs and description, you are experiencing bottoming out (inferior breast implant displacement) of both breast implants. Through the years I have come to favor the infra mammary incision for breast implant removal surgery, for several reasons.   In your case, some internal reconstruction of the inframammary fold area may help improve the final aesthetic outcome achieved after removal of breast implants.   In regards to the final aesthetic outcome achieved with present a removal surgery, patience will certainly be indicated; it will take many months for you to see the final outcome achieved after the breast tissue and skin "redraping" that occurs with time.
 
  Best wishes.