This 50 year old woman had saline breast implants placed by another physician about 15 years prior to consulting with Dr. Lyle. She had a periareolar lift done at that time. She now felt her breasts were too large. She had begun an exercise regime and with weigh loss and aging her breasts were beginning to sag and her breast implants caused aching when she worked out. She wanted her implants removed with no replacement. She was concerned about size and shape after explantation.
She underwent a breast implant removal and mastopexy. She had some liposuction with fat grafting to the breasts to fill deficient areas rather than to truly augment the breast. She was found to have 350 cc saline implants filled with 400 cc. She had almost no capsule formation and the implants were under the muscle. She had 90 cc of fat placed in the subcutaneous space of the breasts avoiding deep injections into breast tissue. she was very happy with her smaller but lifted breasts. She was more comfortable working out and had relief of discomfort of her breast implants.
Explantation with mastopexy is a difficult operation. The prior breast implant surgery will have altered the blood flow patterns to the nipple and potential nipple loss and sensory changes are possible. It is different than a standard mastopexy as the tissues have thinned out . Fat grafting may be performed however if a capsulectomy is performed, only a limited amount of fat can be added as an intact capsule can keep fat in place.