Options after Breast Implant Removal
Breast implant surgery involves the placement of a medical prosthesis into the breast to increase the shape, size and projection. But what about breast explant surgery? Will it do the opposite? If you’ve undergone breast augmentation surgery and are now at a crossroads deciding what to do, you’re in the right place. This blog will discuss all the possibilities and options after breast implant removal surgery that can help you retain your shapely bust. Options include replacement of breast implants, fat transfer after breast implant removal, breast reduction after breast implant removal and breast lift after breast implant removal.
Breast Implant Revision Surgery
When consulting for breast augmentation surgery, you were likely told about the need for future revisional surgery once your breast implants run their course (10-25 years). All women who have breast implants will ultimately need another revision procedure sometime throughout their lives. This may include:
- Removing the implants and replacing them with new implants,
- Repositioning the existing implants, or
- Removing the breast implants without replacement.
What you probably weren’t told is that when your implants come out, your breasts may look deflated, ‘empty’ or saggy… Fortunately, there are solutions to correct this unwanted outcome.
If you choose to remove your breast implants and not replace them, your options after breast implant removal surgery include breast lift, breast reduction, or fat transfer to breasts. Specialist Plastic Surgeon Dr Doyle frequently performs breast implant removal surgery on its own as well as in conjunction with the above procedures. As everyone is different, surgery is always adapted to suit your unique anatomy, lifestyle and aesthetic goals.
Reasons For Removal
You may decide to remove your breast implants for a number of reasons including the age of your implants, the appearance of them, or the functionality of them. As breast implants aren’t designed to last forever, complications do occur. This can make them fairly uncomfortable.
Common reasons that women choose to remove their implants include:
1. Personal Preference
After having breast implants for 20 or so years, many women just decide that the size of their implants no longer suit them. Over time, their aesthetic goals or lifestyle may have changed. This reason is enough to consider removing them completely or replacing them with a smaller size implant.
2. Capsular Contracture
Capsular contracture is one of the most common reasons for removal, according to Dr Doyle. Capsular contracture is defined as when implants become hard due to a thick wall of scar tissue developing around the soft breast implant. It’s the body’s natural response to the foreign object and is usually harmless.
However, the capsule that forms around the implant can harden, distort the implant and sometimes cause pain. Roughly 1 in 6 breast augmentation patients experience some degree of capsular contracture. If this complication starts to cause you discomfort or aesthetic disturbances, Dr Doyle will suggest removing the implant and capsule as a whole using an En Bloc technique.
3. Changes in Appearance
Unfortunately, breast implants won’t always look as they once did and can actually distort over time. You may require revisional surgery if your breast implant begins to ‘ripple’ or ‘wrinkle’ which may either be seen or felt through the breast skin.
Your breast implant may move out of position or rotate in such a way that the back surface of the implant faces forward. This rotation of the implant in the pockets causes the breast shape to appear distorted. And while it’s not uncommon for women with this problem to be able to flip their implants back into position themselves, constant flipping, rotation or malposition often provides a good cause for removal.
4. Breast Implant Illness
Some women may also choose to remove their implants if they believe they are suffering from a condition known as Breast Implant Illness. This refers to a group of autoimmune symptoms such as fatigue, chronic pain, hair loss, headaches, photosensitivity, sleep disturbance, and depression (to name a few). Although this condition is poorly researched and even denied by the manufacturers of breast implants, many of Dr Doyle’s patients report an increased sense of wellbeing following the removal of their silicone implants.
If you are suffering from an unexplained autoimmune disease and believe your symptoms can be attributed to your breast implants, Dr Doyle recommends that you remove and NOT replace them. This is where options after breast implant removal other than replacement present as a good option.
Other common reasons for seeking removal surgery include:
- Change of lifestyle
- Change of breast size preferences
- Having chosen a breast implant size that was too large or heavy for the skin
- Feeling restricted in swimwear, bras or gym gear and exercise classes due to having large breasts
- Having neck or shoulder pain due to the weight of heavy or large breast implants
- Wanting to switch from an older implant to a more modern implant, such as Motiva
- Wanting to replace existing implants with a different sized breast implant (smaller or larger)
- Wanting naturally smaller breasts later in life
- Weight changes which have impacted the proportions of the breast area or upper body
The Breast Implant Removal Process
You can expect your implant removal procedure to be tailored towards your current situation and your aesthetic goals. If dealing with conditions like capsular contraction, deflation, or rupture, the removal surgery becomes more complex. To ensure your desired results can be achieved, it is always recommended that you consult with a specialist plastic surgeon.
Similar to how breast implants are placed, breast implant removal surgery requires an incision to be made along the lower fold of the breast (i.e. the inframammary fold). From here, Dr Doyle will perform an en bloc capsulectomy to remove the implant and the breast capsule in one piece. By removing the scar tissue and the implant together, the body is protected from any leaking silicone that could enter the body.
The incision is normally placed in the same position as the original breast augmentation scar but will be longer than the original scars. This is because the En Bloc technique doesn’t allow the implants to be compressed the same way as when they were inserted.
How The Breasts Look After Implant Removal
The shape and condition of the breasts after implants are removed depends on three factors:
- The size of your breasts before implants
- The size of the implants placed
- Body changes while having implants (think: weight loss or gain, pregnancy, menopause)
Larger implants will have a larger effect on the natural breast than smaller ones. When removed, it may create the appearance that the breasts are distorted. They may often appear deflated with loose, saggy skin.
Smaller breast implants tend to have a lesser effect on the skin. This is because the breast skin doesn’t have to stretch too much to accommodate the implant. Removing small implants can leave the breast looking natural with only a slight amount of sag or ptosis.
Similarly, women who naturally had smaller breasts before getting implants will see less of an effect after removing implants. If you had small breasts before implants, there is less skin and breast tissue to sag.
However, if you had larger breasts before implants, hormonal and weight changes can often make your breasts saggier, and, without the extra volume of the implant, your breasts will look more deflated and droopy.
Age also plays a role in how the breasts recover from implant removal. Small breasts in young women with good skin elasticity may contract back to close to where they were. Older patients have less elastin and collagen in their skin and are less likely to revert back. This is why the vast majority of older patients opt for a breast lift or fat transfer after implant removal.
Surgical Options After Breast Implant Removal
Your decision about potential future breast surgery will depend on a variety of factors.
Factors to consider in relation to future breast surgery include your suitability and preferences for:
- surgical breast shaping
- nipple re-positioning
- breast projection (cleavage)
These factors, as well as your overall skin health, lifestyle preferences and your willingness to pursue additional plastic surgery, will help you decide if you will benefit most from:
- additional implant insertion
- a breast lift
- cleavage enhancements using liposuction and fat transfer methods
- a breast reduction (such as if you gained a lot of weight in the breasts after having children or due to other factors)
Let’s take a look at these options after breast implant removal in more detail:
Remove and Replace Breast Implants
Some women decide to replace their implants, and others simply to remove them during breast explantation procedures. Removing your implants can be a good option if you’d like to maintain the appearance of full breasts but replace the old implant.
Replacement after removal is a good option if you’re concerned only about the age of your implants, you have some degree of capsular contracture or one or both of your implants have ruptured. Implants used for the replacement always have a smooth surface to prevent the risk of BIA-ALCL.
During this surgery, you’re able to adjust the shape, size and projection of your implants as required but will need to be open to pursuing another revision surgery later on.
Breast Lift After Implant Removal
You may want breast lift surgery immediately after your breast implants are removed, but it varies from person to person.
Following the removal of small breast implants, particularly in younger women, the skin may adjust to the volume changes and return to its original shape. However in some women, due to age-related loss of skin elasticity, this may not happen and the skin around the breast may sag.
Breast lift is a cosmetic surgical procedure to raise and reshape the breast to restore its youthful appearance. It helps get rid of excess saggy skin around the breasts which may be present following implant removal surgery.
These two surgical procedures can be effectively combined for best results related to implant removal especially in women with poor skin elasticity and women requiring removal of large implants. A breast lift can be performed along with breast implant removal surgery in one procedure or 3-12 months after the initial breast implant removal surgery if you want to wait and see if the tissues around the breast naturally return to their original state. Another benefit of undergoing breast lift after removal surgery is that it doesn’t necessitate the need for further revisional surgery.
Fat Transfer to Breast After Implant Removal
Many women explore their “fat transfer to breast” options, although if you have sagging skin, this is unlikely to be a good option for you. Also called lipoaugmentation, fat transfer after implant removal helps to refine the breast contour by using fat extracted from your own body. It involves fat being harvested from your choice of the hips, thighs or abdomen and placed into the breasts. This brings the added benefit of reducing the size of these areas.
This fat replaces lost breast volume after removing your implants. Depending on your aesthetic goals, the fat is typically grafted into the cleavage and upper pole of the breast. This can reduce any sag or deflation that might’ve occurred when removing your implants. It results in a more natural look and feels more natural to the touch when compared to traditional breast augmentation.
For most patients, fat transfer provides up to a 1.5x increase in bra cup size after implant removal, although this varies between patients. Explantation with fat transfer is a great option for patients who no longer wish to have breast implants but still want full, shapely breasts. Many patients find they enjoy the soft, natural look and feel of their breasts, and may feel more at ease that the increased volume came from their own body rather than outside material.
Dr Doyle is highly skilled and is an expert at performing this specialised fat transfer procedure.
Breast Reduction After Implant Removal
If your skin sags excessively due to ageing, pregnancy, weight gain or stretching that occurred when you had your implants in, then you may decide you want a breast reduction. Breast reduction surgery not only reduces the size of the breasts—it lifts and reshapes sagging breasts too.
Breast reduction can improve posture and may relieve any back, shoulder and neck pain you are experiencing. If your breasts are different sizes after implant removal, breast reduction surgery can also be used to create symmetry between the breasts.
This is a good option after removal as it helps you to attain a more uplifted and symmetrical breast and nipple position. It can improve the appearance of sagging and droopy breasts, something particularly beneficial if your skin lacks resiliency and is unable to bounce back to its original position.
Many women simply remove their old implants and allow their breasts “to be” in their natural-looking state, even if their breasts sag.
- If your skin is still healthy and elastic, you may be happy enough with your breast appearance after explant surgery.
- If your skin sags excessively due to ageing or stretching, or looks empty, then you may decide you want a fat transfer, breast lift or breast reduction.
You’ll likely be able to tell if you require further surgery after 6 months of waiting.
Contact Dr Doyle if You’re Considering Breast Implant Removal Combination Surgery
Regardless of whether your reason for seeking removal is personal, medical, or aesthetic, it’s important that you partner with a specialist plastic surgeon who can shape your new look around your honest aesthetic goals.
If you’d like to talk about your breast implant removal and subsequent reconstruction options, please contact Dr Mark Doyle from Gold Coast Plastic Surgery for a consultation.
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