The first surgeon I consulted wanted to remove the implants and replace them with new ones, which would have cost about $11,000. He also said there apparently was at least 200cc of silicone still in the right one, and he was going to order new implants accordingly (so that I'd end up about a cup size less than my previous, implanted size, as I wanted to go smaller). I wanted breasts in more in keeping with my body size, and was tired of having tactless people ask me if I had implants.
Although this doctor obviously was highly skilled and had a great reputation, I didn't feel good about his approach. My instincts told me to have a consultation with Dr. Lisa Sowder, and that was the best decision I could possibly have made! Rather than suggesting a "cookie-cutter" implant removal and replacement surgery, she offered several options, and I appreciated her innovative approach. Knowing that it is now recommended that breast implants be replaced about every 10 years, I didn't think I wanted new ones, but I did want a cosmetically acceptable result. Due to the initial asymmetry and having one side deflated, we agreed that the best approach was to first remove the implants and scar-tissue capsules, let me heal for a few months, and then decide how to proceed.
Dr. Sowder succeeded in removing the implants and scar capsules completely, while preserving all my natural breast tissue – no small feat, with implants that had been in place for over 23 years! The big surprise was that the implants had been totally saline, not double-lumen. The other doctor I had consulted had been wrong about there being 200cc of silicone on the right side: I had more breast tissue than anyone had thought. I was so glad I had not opted for the removal-and-replacement surgery suggested by the first doctor! And the implants they would have ordered would have been too large.
Having my implants out took some getting used to, especially for the first month when I had to wear a sports bra all the time. At first it felt like I'd gone "from baseballs to board"! Once I could wear a regular bra, I felt better psychologically. I found a 34B bra that has unpadded foam cups and no wires, and I mostly fill out the left side. The right side is a bit caved in, which is how things were before the augmentation surgery.
Now, almost three months post-surgery, I am more pleased with the result than I had imagined I would be. I'm still asymmetrical and my breasts don’t look ideal, but I'm very glad I didn't get new implants. I'm going back to Dr. Sowder and plan to have a fat-graft procedure next year, to even out the size difference, fill in some uneven spots, and add more fullness (fat grafting won't achieve large size increases). Interestingly, I have fullness at the top and insides of the breasts and didn't end up with saggy envelopes, as I had feared. And my boyfriend much prefers me with natural breasts than with implants. (He has spontaneously commented on this numerous times: that I look so much better with breasts more in harmony with my body size, and that look and feel natural.)
For women considering implant removal, I suggest exploring all options, including not having the implants replaced. Other options are fat grafting (which can achieve up to a cup size increase) or a breast lift. Or, you may look okay just having the implants taken out! My skin has tightened up more than I expected, and I'm in mid-life.
Dr. Sowder and the operating-room staff also ensured that I did not get nausea from the anesthesia and medication, which I did with the augmentation surgery. The pain was considerably less with the removal as well; I took pain meds for only about 24 hours.