Will I Need a Breast Lift After Implant Removal?

Common Reasons for Breast Implant Removal

Your breast implants are causing pain or discomfort

Painful or uncomfortable implants can indicate several issues that require a breast implant revision, including capsular contracture, damaged lymph nodes, a developing seroma, pinched nerves or poor implant placement. If you have silicone implants, pain may be a sign your implant has ruptured or is leaking.

Even if there is no serious issue causing pain, some patients find implants are uncomfortable enough to disrupt their daily lives, especially if the implant used was too large or poorly placed.

Regardless of the cause, persistent pain or irritation is not a normal result of breast augmentation surgery. Patients who are experiencing either should schedule an appointment with their surgeon.

Your breast implant has ruptured

Implant rupture can be caused by abrupt or intense physical pressure (like in a car accident) or through the aging and weakening of the implant shell.

A rupture in a saline implant causes a nearly immediate deflation of the affected breast, making it easy to diagnose. The saline solution inside the implant is the same as IV solution and is easily absorbed by the body.

By contrast, ruptures in silicone implants cannot be diagnosed without an ultrasound or an MRI because the viscous silicone gel inside the implant leaks out slowly.

While the rupture of a breast implant is not a life-threatening emergency, it is important to have the damaged implant removed to prevent infection or the development of excessive internal scar tissue.

Your breast implant has bottomed out

If the skin and tissue cannot adequately support the breast implant, it is possible for the implant to gradually fall below the breast crease, or “bottom out.” This condition is more common with large or heavy implants, but post-surgery pregnancies or skin laxity due to age can also cause an implant to bottom out.

Drooping breasts are not uncommon. But unlike breasts that naturally fall over time, where nipples fall with the breast tissue, bottomed-out implants cause nipples to move upward as the implants fall lower. It is also common for patients to be able to feel and see the outline of a bottomed-out implant.

Your breast implant is moving or rotating

It is normal for breast implants to settle into a slightly different position over time. It is not normal for implants to move to a dramatically different location on the chest wall. This is called implant displacement, and there are several ways an implant can shift.

Lateral displacement of implants (implants moving too far away from the midline of the chest) can occur when the implant pocket is too large. Symmastia, or implants merging in the middle of the chest, is a rare complication caused when too much tissue is removed near the breastbone, which in turn causes the muscle between the breasts to detach.

An overly large implant pocket can also result in implant rotation. Patients may not be able to tell if a round implant has rotated, but a rotation of teardrop implants yields a top-heavy, unnatural appearance of the breast.

Your breast implant has changed shape

Implant shape can change if the implant ruptures, shifts, rotates, bottoms out, or becomes otherwise displaced.

Changes in implant shape usually occur asymmetrically, meaning in one breast or the other. Even if both implants change shape, they may not change in the same way. This asymmetry is not medically risky, but it can cause patients significant emotional distress and make it very difficult to find bras and clothing that fit properly.

Your breast implant is causing capsular contracture

The formation of scar tissue is a normal part of the healing process after placing any kind of medical or plastic surgery implant. Usually, this process is a good thing because the capsule of scar tissue helps support the implant, keeping it from slipping.

In some cases, however, the body mistakes the implant for a dangerous foreign object and creates excessive amounts of scar tissue to isolate it. Known as capsular contracture, this overproduction of dense, hard tissue around the breast implant can affect the success of the augmentation procedure.

There are four grades of capsular contracture, ranging from normal to severe. Grade one is asymptomatic and doesn’t interfere with the results of the implant. Grade two capsular contracture has only minor cosmetic symptoms, leaving the breast normal in shape but firmer to the touch.

Capsular contracture of grades three and four causes hard, misshapen, and overly round breasts that look and feel unnatural. Grade four contracture also often results in breast pain. Patients with either grade three or four capsular contractures usually require a breast implant revision.

You are unhappy with your breast size

While most patients are happy with the results of their breast augmentation, some patients find they wish they had gotten a different size implant – larger or smaller.

If you want to change the size of your implants, most doctors will recommend waiting about a year after your initial surgery before proceeding. Not only will this waiting period allow your body to fully heal, but it will also give your implants time to settle into their final position before you make this major decision.

Will My Breasts Sag After an Implant Removal?

When you have breast implants, your skin stretches to accommodate the size of your breasts. After implant removal, your breasts may sag, droop, or appear misshapen.

Many people choose to have implant removal with a breast lift (mastopexy). During a breast lift, your surgeon removes excess skin and reshapes your breast tissue. If needed, the surgeon can also reposition the nipple and areola. The result is firmer, more elevated breasts.

Factors to Consider

It is important to note that there are no scientific studies proving that breast implants cause systemic issues. As such, one cannot guarantee that removing your implants will improve your health for any reason. Be sure you have seen your primary care doctor first to rule out any diagnosable causes for symptoms, such as Lyme disease. If you cannot find an answer, removing your implants is an option to consider, knowing that implant removal may or may not have any effect. This includes the possibility of adverse outcomes such as bleeding, seroma formation, and/ or poor cosmetic outcome with limited options for additional surgery.

Schedule a Consultation with Dr. Maman

The first step to scheduling a consultation would be doing thorough research. There are many ways to find a plastic surgeon. Arguably the best way would be to receive a referral from another physician, such as primary care, dermatologist, or OB-GYN. These providers often see multiple patients with good results and can attest to those by referring their own patients somewhere. Friends are a secondarily good referral source, especially if they are patients themselves. When it comes to advertising, the most essential consideration is the plastic surgeon’s education, board certification ONLY by the American Board of Plastic Surgery, and before/after gallery. If those components match your desired outcome, then they would be a good source of information to seek in consultation. You will often come across taglines such as “no downtime surgery” or “no anesthesia required”. If it seems too good to be true, it probably is. There are no shortcuts to SAFE plastic surgery.

The next step would be contacting the office of a board-certified plastic surgeon to find a time to meet them. First impressions last a lifetime, so pay attention when speaking to the receptionist upon calling. Should you decide to have surgery, this is the team you will be dealing with multiple times per month for at least a year. The administrative team is a direct reflection of the surgeon’s ways of working. Another thing to clarify would be a potential timeline for surgery. This is sometimes best done before reaching out to qualified providers because they are booked one to six months out, on average. Knowing well enough in advance will give you adequate time to interview surgeons, get any preoperative lab work done, and feel confident moving forward with your scheduled procedure.