Will My Breasts Look Saggy After Implant Removal?
After breast implant removal, you will likely experience more looseness and reduced fullness. However, the extent to which your breasts will sag after explant will depend on your skin, the size of the implants, and how long they were in your body. The majority of women will experience some degree of sagging after implant removal, and most will elect to undergo a breast lift or another procedure to reshape and lift their breasts simultaneously.
This post will address how removing the implants changes the overall breast shape and the expected changes, as opposed to the amount of actual sagging experienced by patients. We will also discuss options available to restore shape and volume to your breasts. By the end, you will understand the various ways to determine if you should plan for a breast lift, the possibility of utilizing fat grafting or just waiting for your body to heal prior to undergoing additional surgery.
How Implant Removal Affects Breast Shape
Once an implant is removed, there will be a loss of volume, skin elasticity will decrease due to the loss of support from the implant, and the position of the tissue will change. Typically your breasts will be smaller, less full on the upper portion, and the skin will be looser or hang differently than it did prior to the removal of the implants based upon multiple factors.
What Happens to Breasts Once They Have Had an Implant Removed
After an implant is removed the skin and breast tissue lose the support and the stretching caused by the implant. Generally, you will have less fullness on the upper pole of the breast and the contours will be softer and flatter in the area where the implant was located. The nipple(s) will generally sit lower on the breast mound and will likely point downward since the skin has stretched.
The internal structures that supported the implant (such as the pocket and the capsule) may either collapse or tighten. Additionally, the scarring from the implant pocket can affect the overall shape. There will be some areas where the tissue will settle within days and some areas where the tissue will take months to soften and become positioned again. If you wish to achieve more lift or volume, you can opt for a mastopexy (breast lift) or fat transfer — both are common options.
Factors That Determine the Amount of Sagging After Removal
Age affects skin elasticity; as you get older, your skin has less recoil, therefore it tends to sag more easily. Similarly, the size of the implants and how long they have been in your body are important factors as well — larger implants and longer periods of time in your body result in greater stretch. Additionally, your original breast size and the quality of the connective tissue in your breasts will influence how well your breasts bounce back.
Other factors, such as smoking, having children, gaining or losing weight, or having prior surgeries, can all affect the elasticity of your skin and the quality of your tissue. Likewise, the location of the pocket (under muscle vs. under muscle) and the existence of capsular contracture can affect the final shape of your breasts post-removal. It is essential to share your medical history with Dr. David A. Newman so he can advise you on what to expect and what corrective measures would be advisable.
Temporary Changes vs. Permanent Results
Generally, in the short term, you can anticipate swelling, bruising, and increased firmness resulting from the surgery. Within the first 6 – 12 weeks, your breasts will appear smaller and possibly sit higher or in odd positions as the tissues adjust. Your sensation and firmness may also change and ultimately stabilize as the tissues continue to heal.
It is generally within 6 – 12 months post-surgery that the final results will appear. By that time, the tissue will have settled, and the scars will have matured. While some patients may permanently experience sagging or looseness that cannot be corrected without a lift, others may end up with a soft and natural-looking shape due to the elasticity of their skin and the fact that they had small implants. If you desire to achieve a consistent shape and projection after removal, consult with the Newman Plastic Surgery team regarding combining explant with a lift or fat grafting at the time of removal.
Indicators of Sagging Post Explant Surgery
Some of the indicators of sagging post-explant surgery may be less fullness, a nipple that is lower than normal or excessive loose skin. While some of these changes are temporary and will occur during the healing process, others may be permanent if the skin and tissue no longer have sufficient elastic properties to “bounce back” into their original shape.
Identifying Sagging
Identify sagging by looking for drooping of the nipple to below the inframammary fold. One or both nipples pointing downward or being positioned lower than in previous surgery indicates sagging (ptosis). Check for loose or excess skin that causes a folding or wrinkling effect when leaning forward. Compare the two sides. When standing in front of a mirror with your arms at your side, compare the nipple heights, the amount of breast tissue hanging below the inframammary fold, and the general appearance of deflation. Photographs taken before and after explant may demonstrate changes more clearly than memory.
Healing vs. Sagging
Within the first three to six months post-explant surgery, swelling, tissue settling, and skin stretching can create uneven or sloppy appearing breasts. Wearing supportive bras and compressive garments can assist with improving appearance while the skin continues to tighten. Mild asymmetry and tenderness are common and often resolve as time passes.
If, after six to twelve months, the nipple remains below the inframammary fold, or if the skin hangs with a distinct shelf, it is likely a result of a permanent change. Factors that contribute to permanent sagging include large implant sizes, low skin elasticity, pregnancy, and advanced age. If you desire improvement, options include a mastopexy (breast lift), fat grafting, or replacing the implants with smaller ones. Discuss these options with Dr. David A. Newman at our office so you can develop a customized treatment plan based upon your individual anatomical characteristics.
Options for Improving Breast Appearance Post-Explant
You can choose to pursue either surgical or non-surgical methods to enhance shape, lift, or volume. Your skin quality, the length of time you had the implants in place, and your desired outcome will help identify the most suitable method for achieving the results you want.
Breast Lift Options
A breast lift (mastopexy) removes extra skin, repositions the breast tissue and nipple to a higher, more firm position. Depending on how much lift you require, surgeons frequently utilize a variety of techniques including vertical, crescent, and/or anchor incisions. If you had large implants or had the implants for extended periods of time, you may require additional skin to be removed to prevent excessive sagging after the implants have been removed.
You can also elect to perform a lift in combination with fat grafting if you want to restore a more natural fullness to your breasts without the use of new implants. Performing both procedures concurrently may extend the duration of your surgery and subsequent recovery, however, it may produce a more symmetrical shape and projection. Discuss scar patterns, anticipated nipple positioning and achievable projection for your specific anatomy.
Non-Surgical Methods
While non-surgical alternatives may offer some benefit, none will significantly reverse sagging. Fat transfer is one alternative and allows you to utilize your own fat to plump areas of your breasts; however, it typically produces less lift than an implant. Injectable fillers are rarely utilized for breast augmentation and provide minimal, temporary change. Compression garments, supportive bras, and localized physical therapy may aid in enhancing the appearance of your breasts while you heal. Radio frequency and/or laser treatments may help improve mild skin laxity, but will be far less dramatic than surgery. Discuss realistic outcomes so that your expectations align with the potential benefits offered by each option.
Individualized Attention and Treatment Options at Newman Plastic Surgery
Newman Plastic Surgery reviews your implant history, breast tissue, and skin elasticity to recommend the most beneficial course of action. You will meet with our team to discuss the different lift types, the feasibility of using fat grafting, incision locations, and the steps required for recovery.
If you are planning to remove your implants, contact us to set up a consultation to discuss the options that best fit your needs and lifestyle: https://temecula-plastic-surgery.com/breast-implant-removal/.
Our team provides pre-operative photographs, demonstrates the anticipated scar map, and outlines a recovery timeline, so you know what to expect. Our staff arranges follow-up appointments to assess your healing progress and provide support, such as garments or scar management.