Skin may loosen, then gradually tighten.
The choice of breast implant removal (Explant Surgery) is sometimes connected with one, extremely scary question: “What will I look like underneath?” Many ladies postpone the removal of their old or unwanted implants for years as they are frightened of being left with “empty bags” or “deflated balloons.” Their concern is justified as to what will happen to the skin after being expanded for years by silicone or saline volume, that the skin will fall and become loose without any control.
What happens to the skin cannot be answered as a mere prediction; it is more of an expression of the variables, Elasticity vs. Volume. On the one hand, some women find their skin bounces back so much and thus are quite delighted, but on the other, the sudden disappearance of volume exposes a significant Ptosis (Sagging) that was only an implant shadow. Removal of the implant means removal of the structure. At Lin Europe Clinic, we value being radical in honesty: we think that knowing how your skin will behave is half the battle in whether you need an explant or an explant combined with a lift.)
The Balloon Analogy: Why Sagging Happens
Take a balloon as an example if you want to understand the mechanism. The balloon will shrink back to its original tightness if you blow it up and keep it inflated for 10 minutes, then let the air out. However, if you keep that balloon inflated for 10 years, its rubber will deteriorate, get thin and stretch. It then becomes evident that the balloon has more wrinkles and a bigger size after you let the air out.
The skin on your breast is similar to that. Implants are constantly pressing outwards within the skin envelope and the internal Cooper’s ligaments. Over a period of 10 years or more, these tissues become thinner (atrophy) and some of the elastin fibers get destroyed because of this pressure. It is only after the implant is removed that the skin can shrink to the breast tissue. This causes a phase of “Deflation” during which the breast looks flatter and is positioned lower on the chest wall than it was before the augmentation.
Factors That Determine Your “Snap Back”
Being left with only a few injuries does not necessarily mean that every woman has experienced severe sagging. Your reaction to your body is only influenced by a handful of crucial factors:
- Implant Size vs. Tissue: Having moderate implants (300cc) and enough natural glandular tissue means your breast will retain a lovely shape for the most part. However, if you have had big implants (500cc+) that have stretched the skin a lot and, on top of that, you have almost no natural tissue, the deflation will be quite extreme.
- Duration of Implantation: The retraction of a woman who takes out implants after 20 years will be lower than that of a woman who takes them out after 2 years.
- Skin Quality (The Genetic Factor): This factor, however, is unpredictable. Younger patients with thick dermis and high collagen levels can have the first-year skin retraction reaching up to 20-30%. The elderly, smoker, and sun-damaged lawns tend to have “lazy” skin that merely stains what was left without dropping or folding into itself.
The “Wait and See” Approach
Don’t contemplate the results the moment you judge them. The worst aesthetic appearance of your breasts will be the day after surgery, and they will be wrinkled, indented, and unhappy. This is not the end result.
We recommend that our patients not think about the second surgery for six to twelve months. During this time, a biological phenomenon named Tissue Contraction takes place. The scar capsule inside the breast and the skin will gradually shrink and firm up. After six months, many women who’ve experienced what looked like “disaster sagging” at week 1 find their breasts acceptable, natural, and normal.
The Solution: Explant with Mastopexy (Lift)
We have about as many explant patients who just taking away the implant is sufficient for a pleasing aesthetic outcome as those in which in is not enough. So, if when the implants are there your nipple level is more than a cinch below the breast fold, then obviously, once the volume is gone, the nipples will be even lower. In that kind of situation, to provide you with an Explant with Mastopexy (Breast Lift) is the answer.
- The Procedure: First we take out the implant (and the capsule if required), then immediately we excise the excess, stretched-out skin. We reshuffle the leftover natural tissues into a tight, higher mound, and then the nipple is repositioned.
- The Trade-off: It gives you fresh scars (usually in an anchor pattern) but at the same time, it precludes the “empty bag” look. Perky and youthful shape is traded with volume.
Volume Restoration: Fat Grafting
If you neglect to remove the implants just because you are concerned about breast size reduction and/or top emptying appearance or “concaveness”, then Fat Grafting is a perfect compromise.
We will fill the breast pocket with the living fat after taking out the implant by carrying out liposuction on your abdomen or thighs and then injecting it. This soft, natural padding will not only stop the chest from looking meagre and bony but also, to a degree, from inside, it helps to fill the skin that has come loose.
Explant Surgery in Turkey
At Lin Europe Clinic in Turkey, our specialty is “Aesthetic Explantation.” We do not just pull the implants out; we handle the removal as if it were a beauty restoration operation.
During your consultation, we use the “pinch test” to check your skin’s elasticity. In case we determine that your skin is too loose to retract without help, then we shall be very clear about the lift requirement. Explant, lift, and fat grafting are frequently performed by us in a single operation which we call “Mommy Makeover in Reverse” to give you a natural, self-supporting breast shape you are proud of, and this without the silicone.
Frequently Asked Questions About Implant Removal
It’s very uncommon. Usually, they will be a bit smaller and looser than before because the implant’s weight has made your natural tissue thinner and the skin stretched over the years.
Not really. If the capsule is in good condition and thin, it might even be better to leave it because it helps the breast maintain its shape; removing it (Total Capsulectomy) takes away some of the tissue and might make the breast look more deflated.
Yes, it is most effective if the implant capsule is taken out so the fat can be put into normal tissue with a good blood supply; if the fat is put into scar tissue, the survival of the fat cells is usually very low.
If they are facing forward at the moment, after removal they might point a bit down due to the loss of the upper pole volume; if they are already pointing down, the drooping will probably increase.
Usually no. Although insurance might pay for the removal of problematic or ruptured implants, the lift is seen as a cosmetic procedure to enhance the look and is not covered by insurance.
Gabriel, S. E., et al. (1997). Complications leading to breast implant removal. New England Journal of Medicine.
Spear, S. L., et al. (2005). Management of the patient requesting implant removal. Plastic and Reconstructive Surgery.
