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Is it OK to have an implant explantation and breast lift at same time?

Q:

I have 800 cc's Mentor smooth round implants placed over the muscle. According to the plastic surgeon I saw last year, I have severe ptosis, thin skin, the cc's worth of breast tissue I started with is gone, and I do not have much fat in the breasts. My concern is some doctors say I have to take the implants out and wait several months before a lift, while others say they can drain them, then do it after a month or so.  The doctor I plan to use is Board Certified, specializes in this procedure, and does it all at the same time.  Which is correct?

A:

Thank you for your question. Without the benefit of photos or an examination it is difficult to give specific advice. As you state, you have very large implants (saline?) and very little, thin breast tissues. I personally like to deflate the implant and allow your tissues to recoil from being overstretched. I prefer to come back later (1-3 months)and do a short scar breast lift and possible fat grafts to the breasts, which are mainly intramuscular fat injections. It is possible that it can be done together, but you need to discuss with your surgeon the risks and potential complications. Doing a breast lift at the time of removing very large implants and having very thin tissues places you at a much higher risk of nipple loss.

Good luck!

G. Marosan, MD

A:

The reason you have differing opinions on this case is that this is not a simple operation. Your surgeons have concerns about the blood supply to the breast and are offering solutions which have worked for each of them in the past. Safety is always a primary concern. Your surgeon has decided after careful evaluation based on experience that a lift can be done at the same time as the implant removal. Staged operations and drain placement are well supported and are safe ways to approach a complex problem. Surgical procedures and management after surgery differ among surgeons. Express your concerns to your board certified plastic surgeon and be sure you are comfortable with his answers before proceeding. I hope this was helpful.

R. W. Kessler, MD

A:

I have done all my implant removals and lifts at the same time and have not had problems with blood supply to the breast tissue. But I should stress that each patient is different and without a direct exam to see where prior incisions were made and their length and how your tissue looks, it would be very hard to give you a solid recommendation about how to proceed. The most important issue to consider is your safety. Perhaps your surgeon could allow you to speak with some of his other patients who have had this done and inform you of there experience. Best of luck.

J. M. Darrow, MD

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