Breast Implant Removal or Explant: Is a Mastopexy or a Breast Lift Always Needed? – Part 3

When getting explantation or breast explant, most women do NOT need a breast lift at the same time. At first thought, it might seem that you will need the lift or mastopexy, because implant removal can make you deflated or droopy. But I have found this is often not the case, and most women will not need the lift or mastopexy operation. This educational writing will review the concepts that apply to this operation. “To lift or not to lift?”…..that is the question that will be discussed. This writing was done in response to a question from a patient from Philadelphia, PA.

Breast implant removal operations are reviewed by me in detail in Part 1 and Part 2. You should read these educational writings for those seriously considering the procedure. When the implants are removed, with or without capsulectomy (scar tissue removal), the breast will be smaller. The breast will get a more deflated look. Some women will feel too droopy, which is medically called ptosis. So the question of adding a lift is wise to discuss.

Many plastic surgeons will just say that you will always need a lift, because you will be droopy after surgery. Many doctors always recommend it, almost like a knee jerk reaction. In my experience, I have found this is not the case. Many women in fact do not need a lift and will be happy with their breasts after implant removal. They will be slightly deflated, but many are not significantly droopy. I have found that the majority of patients after breast explant are happy or satisfied with their appearance. You can’t guarantee this of course, but it is true for many patients.

If someone was unhappy after healing from explant or implant removal, they can always safely do a lift in the future. I explain that by not doing a lift at the first operation you do not burn a bridge for doing a lift later. The mastopexy can always be done safely in the future after healing. In this situation only the woman who find they really need it will get the lift.

As I have said, most women do not need a breast lift, and they will be happy after implant removal alone. The addition of a simultaneous lift is the addition of a big operation with significant risks added. Mastopexy, in general, are longer operations that have bigger incisions and expenses. I do wonderful lifts in my opinion, but the concept is that lifts at the same time as implant removal or capsulectomy, adds to overall risks. Longer operations have more risks, and capsule removal can compromise blood supply and healing. It is safer to perform a lift at a later time if ultimately this is needed.

When capsulectomy or scar tissue is done as part of the surgery, you are removing tissue that is important to the blood supply of the nipple. Think of it almost like coring out the center of the breast. With a lift or mastopexy, the incision must go around the nipple to elevate it. The scar tissue removal can compromise this nipple blood supply even further, and that can increase risks. Risks are still low overall, if we decide to do them together. It is just important to understand that the pathophysiology favors a safer operation when doing the lift later than at the time of explant.

In summary, it is important when having breast implants removed to consider whether you want or desire a lift at the same time. It is NOT something that is necessary for all women. Many women will be happy without a lift. The decision to do a mastopexy with explant adds risks to the operation. These risks include a lot more incisions, and risks to blood supply and injury to the nipple. The mastopexy can be safely done at a later date if it becomes desired.
I specialize in breast augmentation, mastopexy, and breast explant surgery. It is always best to come in for a complete and thorough consultation. I will review your options and possible surgery in detail. This includes discussing risks and recovery. Please contact the office and schedule a consultation if you are interested in these procedures.