Considering breast implant removal with a lift and fat transfer to replace the implants? (Photo)

Question

Hi there. Just over 2 years ago i had breast implants about 330 cc i believe? I am a 34 c now before i had minimal breast tissue due to constricted breasts, nipples pointed down with tight lower pole. Shape is fine now but the implants are causing issues and i want them out. I want a nipple lift plus capsulectomy/explant and fat transfer. Not concerned about them being big just want a decent outcome. Is this possible? I will include pics of how they look now. Thx def want them out for sure.

Joel Patrick Maier, MD · Answer

I can see some slight constriction on the right side below the nipple which you referred to. But yes, fat transfer is a great option. First, I would recommend removal of the implants so allow your breasts to recover to their native shape and architecture and allow the capsule to retract. I would not perform capsulectomy if you do not have thick capsules as this is a bloody operation with complications and unnecessary. If you have saline implants, they could be percutaneously drained in the clinic with local as an initial step; silicone would require operative removal first. Then you can proceed with fat transfer with a predictable, durable result. Thank you.

Gary M. Horndeski, MD · Answer

You have not told us if the implants are in front of the muscle or behind. 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. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear tja1234,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Daniel Del Vecchio, MD · Answer

Thank you for your question. The best course of action in your case would be to do an SIEF operation. You could have the implants removed and Fat replaced. Once everything settled down, you could consider adjusting the position of the nipples.

If you take the capsule out at the time of the implant removal, it is not possible to safely fat graft,  because the fat will migrate into the pocket and you will have fat necrosis. in other words, when a SIEF is done, the capsule must be left intact. Hope this helps!

Libby Copeland-Halperin, MD · Answer

Thank you for sharing your photos and for your question. I would need to examine you in-person to best answer your question. In general, however, it is possible to remove your implants and perform a capsulectomy, fat transfer, and lift at the same time. However, it may not be possible to achieve the same size you are now with fat alone. There is a limit to how much fat can be safely transferred in one operation, especially if done at the same time as an implant removal/capsulectomy, and you may need to have more than one fat transfer procedure. From your photos, you appear to have some asymmetry of your nipples and this could be improved with the lift, as well. This can be performed as an outpatient surgery. I recommend you meet with a fully-trained plastic surgeon to fully discuss your goals and the best treatment approach. Good luck!

Connie Hiers, MD, FACS · Answer

Since you used the implants to reshape your constricted breasts, once removed, you should be able to keep your shape. Fat can then be added, but not at the same time as the lift.  You may not be able to obtain the same volume as you have now with just one transfer.

Mats Hagstrom, MD (license on probation) · Answer

I do not recommend explantation, capsulectomy and fat transfer in the same procedure. There are servers advantages to staging the procedure. One major issue is that you will not know the impact of fat transfer without first knowing what your breasts look like after explantation. 
Each plastic surgeon will have their own view which may be different than mine. 
I suggest having multiple in person consultations with local plastic surgeons who have a proven track record with breast fat transfer.
Fat transfer gives subtle improvements. The procedure can not accomplish the shape improvements possible with implants especially on individuals with tubular breast deformities.
Consideration to keeping your implants should be included in the decision process.
Best,
Mats Hagstrom, MD

Considering breast implant removal with a lift and fat transfer to replace the implants? (Photo)

Answers (7)

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