How will breasts look post explant? Any indications for prediction of fullness? (photos)

Question

I was a saggy stretched out 36 B on left and C on right breast. Had lift with implants 1.5 years ago. Implant displacement occurred and after one revision and reoccurrence of displacement I just want them gone. They are 400 cc saline unders. Currently I am a 36 Moderate C/full D with my implants. My surgeon already preformed the lift and since I haven’t had them long I’m wondering if I can get away with no lift at time of explant. Sorry my before pics aren’t great!Thank you for your time!!

Alan Gonzalez, MD, FACS · Answer

Hello @Graceful05, thank you for your question. How breasts look after an explant depends on the surgical technique of the specialist who performs the surgery. If breast implant removal is performed with breast reconstruction, you will not have deflated breasts. As a matter of fact, after having removed the implant and the capsules, this procedure is beneficial to the patient's health. This procedure is done definitively. That means no more implants. The reconstruction of the breast ensures the repositioning of the mammary tissues and improves the overall appearance of the breast. The fullness of the breast will depend on the amount of mammary tissue that a patient has, and this can be improved through lipo injections later on. If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS.

Chet Mays, MD · Answer

Thank you for your inquiry!  There will be volume loss and some skin laxity after removal.   Discuss how much of your breast is tissue versus implant.  We would love to meet with you to discuss your concerns.  Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Robert M. Wald, Jr., MD · Answer

Presently, you still have some breast ptosis or droopiness. If you remove your implants, you may have more loose skin requiring a breast lift. If you're OK with this sagginess, you don't have to do lift. Most surgeons would probably recommend redoing your lift.

Ellen A. Mahony, MD · Answer

Hello Graceful,

Am I correct that your far right photo represents your breast appearance 1.5 years after combination breast augmenation and mastopexy?

Removing the implants will reduce your breast volume and contribute to some immediate skin excess.  Over the course of about 3 months from surgery, your skin will contract/tighten up a bit and your shape will improve.

In my practice, I perform a partial capsulectomy tat the time of explant to facilitate healing and collapse of the space that previously housed the implant.  I also encourage active massage of the tissue to enhance overall shape and contour of the breasts.

You may find that with patience and time, you have no interest in any additional lift surgery.  Keep in mind, your nipple and areola appear in good postion- not low.  That position is the key factor  on which lift surgery is predicated.

My suggeestion:  take it one step at a time.

In good health,
Ellen Mahony, MD

Gary M. Horndeski, MD · Answer

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.

Wess Cohen, MD · Answer

Thank you for your question. You will lack significant upper pole volume after the explantation. Additionally you will have lots of excess skin that will sag. You would benefit from an additional lift at the time of explantation. You should consider some fat grafting to the breast in order to maintain some volume, however you will not be as large as you are currently. Good luck.

Daniel Barrett, MD · Answer

Dear Graceful05,
based on your photos, it looks like you would need breast lift. My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. 
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

With the size of implants you now have, you have thinned and stretched your tissue and will probably need a lift. You might consider going down in size since you were not happy with your breasts prior to implants and may not be happy once removed.

Camille Cash, MD · Answer

An in person examination is always best, but it appears when the implants are removed you would benefit from a revision to your breast lift.  You may want to consider a smaller implant to enhance breast shape.

How will breasts look post explant? Any indications for prediction of fullness? (photos)

Answers (9)

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