Removal of 20 year old textured implants required: what are the risks?

If you are not having issues with your implants and you still like them there is no need to remove them.  If you elect to have them removed you will likely have loose skin.  Your skin will contract to some degree during healing, but without an examination it is difficult to say how much to expect.  

It is likely that your breasts are low on the chest wall.  If you simply undergo explant alone you will have hanging skin and an empty appearance.  You will need a lift as a secondary procedure.  You are better off doing them both at the same time.  The technique I recommend is explantation and lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery.  Best Wishes,Gary Horndeski, M.D.

Thank you for sharing your excellent question.  There is a significant amount of misinformation currently taking place with implants but current consensus is that if you are not having and difficulties, or changes, with your implants, you need not have them removed or replaced.  Hope this helps.

Dear Miles33,
it is hard to predict how will your breasts look if you remove your implants. There are no recommendations for removal of textured implants in asymptomatic patients. In case of textured implants, they are harder to remove than smooth implants. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Breast implants do not need to be removed if there are no problems with your breasts or your breast implants. The FDA has not recommended removal or replacement of textured breast
implants or tissue expanders in asymptomatic patients.  Textured
implants could be more difficult to remove because of the friction
caused between the implant and the muscle surface.  Leaving
a capsule behind is preferred if it is thin and pliable. If there are
calcific components, or silicone granulomatous material, or if the
capsule is deforming the breast tissue, then removal of the capsule may
be warranted.  If the capsule is left behind, the body will break down
and remodel the scar tissue on its own.
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.
It is very difficult to predict breast size following explant b/c
breast implants and weight fluctuations over time tend to thin tissues,
cause a decrease in size, and create more droop.  
It is not unreasonable to remove the implants and then observe a
waiting period of six months before the determination for breast lift is
made. This will give your breasts time to bounce back and your PS time
to determine what type of lift, if any, is needed.