Explant mastopexy (aka breast lift) can be a very satisfactory procedure for patient and surgeon. If ready to be without implants for any reason, removal/explantation will make you feel better. Also, as long as there is adequate native breast tissue to work with you can have a very nice result without the maintenance needed.

Published on Jul 11, 2012

It might not look too bad to remove implants, leaving the capsules to provide some body to the breasts, but you will be smaller. Are you over the muscle? Your alternatives are to remove the upper portion of the capsule, replace implants and take Accolate 20 mg twice daily for 3 mos. Or, just try the Accolate first or remove the implants.

Published on Jul 11, 2012

Unfortunately, the cause of contraction is not known. Many plastic surgeons believe that implants on top of the muscle have a higher risk of contraction. However, every surgeon has a different experience. If your implants are modest, then removal will return you to your pre-surgery form. If they are very large, then the shape of the breast after removal may not be flattering. Your surgeon can help you with what to expect. If I have a patient that has a contraction, I will operate on them and release the scar tissue, and possibly move the implant to a new pocket. Severe contractions are also treated with a product called allograft.

Published on Jul 11, 2012

Take them out and just see if you are satisfied with the result, or you have choices to have a lift, if needed, or put in new implants. That all depends on how you feel and what you want to look like. Most likely you will need a revision.

Published on Jul 11, 2012

The appearance of the breasts after implant removal depends of the amount of breast tissue, the quality of the breast skin, and the presence or absence of ptosis (droopiness). If the implants are saline, one can deflate them in the office (10 mins procedure) and have a realistic view, herself, of what the breast will look like when the protrusion of the implants is no longer present. The patient will feel instantly lighter and may be satisfied with her appearance so that she wants to be rid of them permanently, rather than replacing them. I have seen this quite often. Its also gives the patient a significant advantage in choosing newer, smaller implants WHILE SHE IS AWAKE AND ABLE TO MAKE DECISIONS, rather than awakening post-surgery and seeing what the surgeon has chosen for her.

Published on Jul 11, 2012

Everyone will get a capsule, and some women will get unnatural firmness. Sometimes Singular 10mg/day can help. But, if it gets too bad, then a capsulectomy needs to be done, whereby the pocket has the scar tissue excised so it is soft again. From there, I have patients do massage 2x/day.

Published on Jul 11, 2012

Thank you for your question. I'm sorry to hear of the problems you are having with your breast implants. The simple answer is yes, there is life after implants. If this is your first capsular contracture, I would recommend surgery (capsulectomy) with implant replacement, and ADM (acellular dermal matrix) if nonoperative treatments were not successful. If you have had recurrent capsular contracture, then implant removal may be your best option. In the case of implant removal, the breast appearance afterwards depends on several factors: the amount of breast tissue, the size of the implant removed, and the degree of breast ptosis or sagging that is present. You may be a candidate for a breast lift or fat grafting to the breast to enhance the appearance once the implants are removed. Another option is to remove the implants, wait 3 to 6 months, and then reinsert new implants or perform a breast lift at that time. I know this is a lot to digest, but the important thing to take away is that there is a solution to your problem and things will get better. Don't be discouraged. Best of luck to you.:)

Published on Jul 11, 2012

I am sorry for what you are going through. Yes, many patients choose to remove their implants. I suggest visiting with an experienced plastic surgeon who can discuss options with you as well as going over pro's and con's associated with this procedure so that you can make a good decision.

Published on Jul 11, 2012

How you will look with your implants out depends on several different things. If your breasts have not gotten significantly stretched out due to pregnacy or the size and weight of your implants more then likely you will look fine. Obviously major life events like pregancy can really alter breast size and shape in which case you may need a lift after implant removal. Capsular contracture is a known risk of having implants. With the newer implants the risk of getting capsular contracture is around 5% older data showed as high as a 15% risk. These are low numbers but if you get capsular contracture it does not matter how low the risks are. Several factors contribute to decrease your risk of capsular contracture. These would include sub-muscualr implant placement, textured implant surface and post-op daily massage. Unfortunately, these won't guarantee that you still won't get capsular contracture. If you decide to have the capsular contracture worked on I would suggest complete capsulectomy and implant replacement. Bacteria on the surfcae of the implant is the most common cause of capsualr contracture and therefore the capsule should be removed and the implant replaced. Intrestingly some implant companies have started providing a warranty against capsular contrature for 3 years. The warranty provides you free implants to replace the old ones.

Published on Jul 11, 2012

Your question is one that is very common with women who have had breast implants. You can certainly remove breast implants and do not necessarily have to replace them. However, the way your skin shrinks back or doesn't shrink back depends on the size of the implants, your age, and how long you have had the implants in place. If you think you may have capsular contraction, I advise you to seek a consultation with a board-certified plastic surgeon who has experience in doing many breast augmentation and implant exchange, as well as removal surgeries. You should get a list of choices of what is best for you. Even with capsular contracture, patients are able to replace implants if they wish. I use Strattice in patients with a history of capsular contracture when removing and replacing implants. Strattice acts as a sling to protect the implant in place and greatly reduces the risk of capsular contracture in the future. Unfortunately, this is not an inexpensive procedure but well worth the investment. Another option is to simply remove the implant if you feel you can live with the result. Other patients choose to remove their implants and have a breast lift (mastopexy) in order to get rid of the excess skin and sagginess after having implants in for a while. I hope this helps in your decision.

Published on Jul 11, 2012