Explant of 15 year old silicones with fat graph replacement? (photo)

I am hoping to find out details from women that have had this procedure done and from Doctors that have performed this type of procedure. Can both be done at once? What was the final outcome, average cost, and would you suggest this for me? I am 36, no kids, 115lbs, had the Mentor silicones since 2002 and ready to look and feel natural again. There is a little fat on my thighs and belly but don't want my belly to look like mashed potatoes after... THANK YOU FOR ANY FEEDBACK!!

Doctor Answers 5

Explant and fat graft

I think it's a great idea. You need to know the limitations of the procedure, however. For implants, they are a set size. For fat graft, you can't just put in any size you want, you are limited by both the amount of fat available, and the amount of breast tissue you have. A good rule of thumb is that you can double your breast size with fat. So if your natural breast is super small, and you remove a big implant, you would have to have more than one surgery to get up to the size of the implant. The good news is that if you don't mind being a little smaller, and you want to be natural, fat grafting really does help to make up the lost bulk of the implant and prevents you from being droopy or hollowed out, even in one surgery. 


Beverly Hills Plastic Surgeon
4.7 out of 5 stars 16 reviews

Implant removal and fat grafting

If you are going to remove your implants, then I would wait to have fat grafting until the tissues have settled down and the pocket space has collapsed. You are likely to get a more reliable results with implant exchange if your implants are causing problems.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

You can remove implants and have fat transfer, but you will be a bit smaller

I don't know your implant size, but it's probably not possible to be the same size. Looking at your photos, you have enough fat for modest augmentation of your breasts in 1-2 sessions. Some fat can be placed at the time of implant removal, but fat transfer for breast augmentation is typically done in several sessions. It is limited by how much fat you have to donate and how much your breasts can hold at one time. Again, I don't know how large your implants are, but you may look a bit deflated after implant removal. Best wishes to you!

Nicholas A. Flugstad, MD
Bellevue Plastic Surgeon
5.0 out of 5 stars 10 reviews

Explant of 15 year old silicones with fat graph replacement?

Thank you for your pictures and questions. Sorry to hear that you are no longer happy with your implant surgery. I will say that you really have a wonderful result that has stood the test of time. 

In regards to removing the implants and replacing it with fat graft, this option is is not going to provide you with anything near the result you have now. If you were fairly small before augmentation and had (as a complete guess) a 350-400 cc implant placed at the time of your surgery, then the major component of your breast now is implant. If you remove that implant, you cannot simply replace that space with fat graft as fat graft has to be placed into the living breast tissue to have any chance of surviving. In addition, the amount of fat that can be placed at one time that could survive in likely much smaller than would be your ultimate goal. To get any kind of meaningful result, I think you would require several sessions of fat grafting which can turn out to be rather expensive. 

Sorry to say what you probably did not want to hear, but with where you are now (what I consider an excellent long term result), there are very few options available to you that are going to replicate your current look without implants. 

Hope this helps!

Dallas Buchanan, MD
Spokane Plastic Surgeon
5.0 out of 5 stars 30 reviews

Implant removal

After removal of implants fat can be grafted but it will not give same look as implants.  Fat can be removed from where there is extra that you wish to remove. I recommend consulting with a board certified plastic surgeon to assess if there is enough extra fat to give you the outcome you wish. In some patients a combination of fat and smaller implant can also be performed. Best of luck

Helena Guarda, MD
Suffolk Plastic Surgeon
5.0 out of 5 stars 2 reviews

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.