You must have either been through pregnancy or pregnancies and/or gained some weight in the 8 years since your surgery for your size A cup breasts to now be a D cp with only 180 cc implants. Typically each cup size is approximately 150-200 cc which would make you only a B or C. Seek consultation with a plastic surgeon for recommendations on explant (removal only) vs replacement depending on your size desires and with or without lifting depending on your degree of droopiness.

Published on Jul 11, 2012

The downsides of removal are primarily aesthetic.

It is difficult to make 100% accurate predictions following explant. There are a number of factors to consider including age (the breast changes over time regardless of augmentation), weight change, skin stretch, and residual elasticity.

Following removal, one can expect:

-Loss of volume- Not an exact correlation between pre- and post augmentation due to the changes over time. You may be bigger or smaller than you remember.

-Ptosis/sagging-Ptosis develops over time and may be worsened by the presence of an implant. If a patient has pre-explant sagging, removal is likely to worsen this to a certain extent. If there is no ptosis, it does not necessarily mean there will be no ptosis after removal.

-Skin laxity/stretch- There is inherent skin elasticity which will allow for some measure of snapback. However, the greater the volume differential pre- and post- the more likely there will be excess skin.

In my experience, it is usually a safe assumption that there will be some changes post-removal which oftentimes may necessitate further operative intervention (i.e. lift), however, this is often a function of size and length of time post-op. Small implants that have only been in place for a short period will lead to an improved response/recoil post removal. Whereas larger implants which have been in for several years will often necessitate a lift.

As always, discuss your concerns with a board-certified plastic surgeon (ABPS).

Published on Jul 11, 2012

I doubt you'll have a lot more sag than you do now. Those, as you noted, are pretty small implants. This could even be done under local anesthesia which should keep your cost down. Good luck!

Published on Jul 11, 2012

These small implants are providing a very small amount of size increase. The majority of the size are from your own breast tissue. If you need a lift, you need lift, regardless of the removal of the implants.

Published on Jul 11, 2012

180 cc's is about 1 1/4 cups. Being young, you should not sag from submuscular 180 cc implants. The number doesn't change; the cup should be B/C.

Published on Jul 11, 2012

Sometimes the skin will retract over time after removal of small implants. You can wait and see; however, you may still need a breast lift. And if you had children in the last 8 years, that may be a factor to your breast tissue sagging. But your surgeon should give you choices, just as Dr. Stein will do for our patients.

Published on Jul 11, 2012

180cc implants are very small, and you should not have much more sagging than you already have.

Published on Jul 11, 2012

180cc implants are very small implants. Its difficult to answer your questions without photos but generally speaking, I would doubt you would have much more sagging if you removed them. You are likely to have less fullness, especially in the upper breast area. Regarding bra size, I cant answer without photos but you are likely to drop one size.

Published on Jul 11, 2012

Good morning, without actually seeing you, it's difficult to say if you'll need a breast lift (or mastopexy). There are several variables that come in to play with that question, but the answer could be yes. When an implant is removed, there is loss of volume leaving more "drooping" (ptosis) or "sagging" of the breast.

Published on Jul 11, 2012

Having a smaller implant does help since it is not contributing very much to your overall volume. However, it is your own breasts that can sag and not the implant. The implant does add weight to your breasts but yours is a small size. If your breasts have grown in size recently, you may need a breast lift whether or not the implant is removed. I would recommend having a consultation with a board certified and experienced plastic surgeon to determine what type of breast lift, if any, is best for you.

Published on Jul 11, 2012

Thank you for the question. I don't believe 180 cc implant removal would make much of a difference in terms of breast soft tissue sagging. I have taken 200 and 300 range size implants out in patients who have good breast and skin quality and the patients have done well.

Published on Jul 11, 2012

I would expect that your cup size would only go down one size at the most if you were to remove your current implants. 180cc is a very small implant, so removing it from a D cup breast will probably result in being in the C cup range. Whether you would need a lift after removal is impossible to say without an examination. I would go for a consultation with a board certified plastic surgeon and see what they recommend.

Published on Jul 11, 2012

There are a lot of variables that go into making the proper decisions in your particular case. Your present height and weight compared with they were eight years ago, when you had kids and breast-fed, the actual physical exam by a board certified plastic surgeon, whether you have capsular contractures are just some of the variables to consider. A small implant will certainly stretch the skin less than a large implant, so the other factors may come into play more importantly.

Published on Jul 11, 2012

Thank you for your question. There should be minimal change in your breast size when you remove an 180cc subpectoral implant. You may have breast ptosis or sagging that would require a lift depending on the position of your nipple and areola in relation to your breast crease (inframammary fold). If you are happy with the appearance of your breasts now other than the size then you may want to remove the implants, allow your breast to heal prior to having a breast lift. It is best to be examined by a board certified plastic surgeon and discuss all your treatment options. Best wishes.

Published on Jul 11, 2012

Thank you for the question and pictures. Specific advice would necessitate in-person evaluation and a full communication of your goals and options. Overall, given your situation, I would anticipate that you will have a very nice outcome if you choose to remove breast implants.

Generally speaking, what your breasts will look like after explantation depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back), the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation).

Patience is definitely indicated after removal of breast implants; it will take many months for the skin to “bounce back” and for you to see the final appearance of the breasts.
When the time is right, seek consultation with board certified plastic surgeons who can demonstrate significant experience helping patients with revisionary breast surgery. I hope this, and the attached link (dedicated to breast implant removal surgery concerns), helps. Best wishes.

Published on Jul 11, 2012

Good morning!
I would really have to see some photos to determine which I would recommend- some patients do fine with an explant alone, others definitely need a lift! It all depends on your current shape and position of your breast on your chest wall- the lower they are currently the more likely you are to need a lift!

Published on Jul 11, 2012

Hello, thank you for your question. It is very difficult to judge what you will look like without any pictures at this point and also a physical examination. During examination a surgeon can discuss all of this with potential patients as well as do a formal physical exam to evaluate the quality of the patient's skin. Many patients have smaller implants removed and had only a minimal amount of sag but they are quite comfortable with that.also discuss with your surgeon the type of breast lift that they may recommend.I would recommend you seek out a qualified board certified plastic surgeon in your area with expertise in these procedures. Best of luck.

Published on Jul 11, 2012

Thank you for your question. Even though the implants that you have mentioned are quite small, there is a possibility that you may need a different type of either an internal or external lift after removal of your implants. You would need to have a consultation for precise recommendations by a board certified plastic surgeon with expertise.

Published on Jul 11, 2012

180 mL is approximately 1 1/2 cup sizes so your breast size will probably only go down by one and a half or two sizes . Most likely your breasts grew on their own .Once the implants are removed you will probably sag on your own accord, not because of removing the implants . You then have a choice to have a lift.

Published on Jul 11, 2012