Explantation and Mastopexy in Raleigh, NC*

This 59 year old woman had bilateral 400 cc Siltex subglandular breast implants placed 14 years ago by another plastic surgeon. She developed a capsular contracture as well as breast ptosis ( drooping) and desired removal of her breast implants and breast lift with smaller breast implants. It was explained that single stage removal, lifting and exchange was riskier- especially with patients with subglandular breast implants because of compromised blood supply. Plan was for removal and mastopexy and possible replacement of her implants ( depending on concern about blood supply to the nipple). During surgery she had an en bloc capsulectomy and was found to have bilateral intra capsular ( contained within the capsule) rupture of her breast implants. She had removal and breast lifting. During the procedure- she did have evidence of reduced blood supply to the left nipple so no re-implantation was performed. Her left nipple recovered nicely with no loss. She was offered delayed placement of new breast implants 3 - 6 months later but she was so happy with her smaller , perkier breasts that she felt it wasn't necessary. Removal and replacement of breast implants with simultaneous lifting can be a challenging operation and often it is recommended to perform these procedures in stages . Careful dissection and appropriate planning can allow this combination to be performed safely but a "plan B" should always be ready and the patients should be informed of this possibility.