If your skin is very elastic, it will usually look pretty good. One approach is to remove the implant, no lift, and see how you look. Remember to have your surgeon ALWAYS repair the muscle after the breast implant is removed or you will get a pec motion deformity. Also, there a few tricks to pop up the breast after removal. Mostly it's about stitching the capsule upwards to close down the imaplnt space which provides and internal lift.
It's hard to say without examining you in person or, at the very least, seeing a photo. The "need" for a lift depends on many factors, including those you listed.
In general, though, 400cc implants that were in for two years suggest that a lift may be necessary. Smaller implants are less likely to stretch the skin out to the degree that 400's would.
But if there is a question as to whether or not it is needed (ie, after talking to your PS) you can always stage the procedure, which has some advantages. You can have the implants removed and then wait a few months (like 3-6) to see how well your body heals on its own. If you already have some sagging now, though, then it is unlikely you'll be happy with the appearance of your breasts without a lift (though a lift is associated with scars).
Discuss this with your PS and you should be able to come up with a plan you'll be comfortable with.
I hope that this helps and good luck,
Dr. Alan EnglerMember of #RealSelf500
The best way to understand breast implants and their effect when removed (or when put in) is as a pillow of volume. When the pillow is removed, the breast returns to what it would have been without the implant present (assuming the tissues weren't distorted or altered when it was put in). Breast implants do not lift the breast when put in and don't make the breast sag when taken out. They can give the illusion of the breast being lifted or sagging but they don't actually lift or sag the breast. They fill it out with volume in a forward direction. In your situation, the best option would be to do a simple removal of the implants and then see what, if anything, you think you still need. You also haven't burned any bridges because you could still have the augmentation redone, perhaps with different implants.
Thank you for your question. No online reviewer can make a diagnosis or provide treatment recommendations without an examination and full medical history. In my opinion after removal of 400 cc implants one would most likely have significant tissue sagging. I doubt that a person can have enough elasticity to look acceptable with removal alone. However, the patient needs to make the decision and this is best accomplished with a team approach of educated patient and surgeon. I would recommend starting with a with a face to face consult with a Board Certified Plastic Surgeon who has experience in breast surgery. During your visit your surgeon should be evaluating your health to determine if you are a good surgical candidate and examining your tissues to get a sense of what type of procedure your tissues will allow. Only with a hands on exam can this be determined. During the consult you and the surgeon should be understanding of the goals and realistic outcomes of your choices. Be sure to see plenty of before and after photos to get an idea of the range of patient experience of your surgeon. Once an exam and opinion is rendered then you can decide if surgery is right for you. Good luck.
Unfortunately without photos of you there is no we we can commenton your specifics. In general I discourage doing a lift at the time of the explantation. The tissues adjust to some degree, usually more than you expect, over the following 6 weeks and I feel we have a better idea of how best to reshape the breast (or not) after a few weeks.
Good morning! This concern of yours is something that can't 100% be predicted. And what the surgeon might think is acceptable the patient might not. This depends on the breast size prior to implant placement, the size of the implant, how long they've been in place and the current condition of the breast tissue. Has there been any major weight loss or gain since implant placement? All of this is best discussed during a consultation where you can be fully examined to discuss your best option. Best of luck to you!
Need photographs to determine if you will need a lift. Should you have a significant skin stretching then most likely you will require a skin tightening surgery as well
Thank you for the excellent question. Short answer: much will depend on your physical examination ( factors such as degree of breast ptosis, current position of breast implants, number of previous operations, assessment of breast skin quality/elasticity…) and your plastic surgeons' clinical judgment.
Longer answer: in person consultation will be necessary to provide you with precise advice. The main issue of concern is adequacy of blood flow given the extensive breast surgery planned. In my opinion, if the degree of breast lifting ( distance of movement of the nipple/areola complexes) is significant, then you may be better off having the procedure performed in 2 stages. If the degree of breast lifting is relatively small ( shorter distance of movement of the nipple/areola complexes) then it is likely that the procedure can be performed in one stage. If in doubt, in my opinion, the two stage approach is safer.
In "borderline" cases where there is doubt whether breast lifting is necessary or not, I advise patients to undergo explantation only and to give their breasts the benefit of the doubt (allow for about six months to pass after breast implant removal) before deciding whether breast lifting would be beneficial.
I hope this, and the attached link (dedicated to breast implant removal surgery concerns) helps. Best wishes.