Is it safe to have the removal of breast implants and a breast lift at the same time?

Q:

I have capsular contracture in one breast and have consulted with two doctors about removal of implants and doing a lift again.  One says he won't do both procedures at the same time because of blood loss and loss of nipple sensation.  The other, while expressing the same issues about blood loss, has said the most safest and conservative way to go is to do both at the same time.  If I don't get the lift after implant removal - I will have nothing left and major sagging.  Please advise.

A:

I have been doing breast implant removal, capsulectomy and mastopexy (lift) together for many years and have never worried about blood loss or had any problem with nipple blood supply or sensation. If the surgeon is experienced, there is no reason that the two should not be done together. This also reduces the cost and risks.

R. T. Buchanan, MD

A:

Doing an implant removal and a breast lift at the same time, is what I have always done and is very straight forward and should be the preferred method to reduce costs and minimize the number of operations a patient needs. Blood loss from this surgery is minimal and I have never experienced any issues with poor blood supply to the skin or nipple area.

J. M. Darrow, MD

A:

Safety of Breast Implant Removal and Breast Lift Simultaneously- This can be done safely depending on multiple variables including the size of the implant, the amount of breast tissue, and how much of a lift is required. This should be done in the hands of a Board Certified Plastic Surgeon with expertise and experience in Breast Reshaping surgery.   

A:

Blood loss should not be a problem, it is rather the grade of capsular contracture and the decision of size of implants which can limit the decision of doing everything together i.e. if the capsular contracture it is very severe and is calcified then it is not advisable to put new implants as the small bleeding which is coped with a drain normally after the operation could cause a new capsular contracture. Furthermore if the choice is for big implants then making the lifting at the same time with greater degree will make strains on the scar specially around the areola make it unpleasant. However, in the moderate situations with lifting degree and size of implants the two procedures could be done together. However if you get away with only one procedure you're lucky otherwise you should not be disappointed if you need the correction as this is rather usual. This procedure needs high experience and a board-certified plastic surgeon should be your ultimate choice. Good luck

A:

There is no good reason not to have both procedures done at the same time.  I do this all the time.  It does take a higher skill level and i can not imagine how blood loss would be a issue. I would advise to find a PS who is comfortable.

A:

Yes it is safe to remove breast implants and do a simultaneous breast lift if your board certified plastic surgeon is experienced with this combined procedure and comfortable doing it.

The most important issue is preservation of blood supply to the areola and nipple. An experienced surgeon who is comfortable doing this combined procedure should be aware of and able to manage this issue.

If you have a severe Baker 4 capsular contracture with textured breast implants and very little breast tissue which requires a difficult dissection to remove implant and capsule then delaying the lift as a second procedure may be necessary. This scenario could impact blood supply to the nipple areola. Discuss this issue with your surgeon

A:

Removing your implants, performing a capsulectomy and a breast lift can all be done safely at the same time provided that there is enough breast tissue that the capsulectomy does not compromise the blood supply to the nipple or breast tissues. In women who have very little breast tissue (thin over the implant) and a severe capsular contracture, the capsulectomy may have a negative effect on the blood flow and could cause problems. Whether or not this is feasible is a matter of judgment by your surgeon. The amount of blood loss from the surgery should be relatively small and should pose no problem alone.

There is an advantage to having the procedures done in stages however. After the weight of the implant is removed from the breast, there will be some retraction or “shrinkage” of the breast tissues as the forces on them to stretch them out are removed. The amount of retraction is unpredictable but will be less for very thin breast tissues that have supported an implant for a long time. If the breast lift is performed after all the breast tissue retraction has taken place then the results of the mastopexy will be more stable and more predictable.

Seek the consultation of a plastic surgeon certified by the American Board of Plastic Surgery. They have a website listing all the certified plastic surgeons. Members of the American Society of Aesthetic Plastic Surgery will all be board certified in plastic surgery and have demonstrated an interest and competence in cosmetic plastic surgery as well.

A:

In my practice it is safe and normal to remove implants, remove the scar tissue around the implants, and do a lift at the same time. This can be done with or with out replacing the breast implants. While I understand that many plastic surgeons will not preform a lift and a argumentation at the same time, we do it routinely with very few problems. Make sure you see a Board Certified Plastic Surgeon with extensive experience with this combination of procedures and ask for before and after photos. 

A:

Absolutely!  Now some problems with your breasts now (ie: incisions, capsule, etc) may make it more challenging but you can have the procedures done at the same time and done safely.  The lift may leave you with an unusual looking breast in the early post-op period but with settling, it usually turns our quite nicely.  If your capsules are under the muscle, you may not be able to removal all of it anyway.  As for the risks, its your surgeon's job to make sure you know the risks and bleeding is a risk but in my experience, if you're careful about stopping the bleeding when it happens, it becomes a non-issue.

A:

While both approaches are acceptable, most experienced plastic surgeons will do the removal, replacement and lift at the same time. There are factors that would influence that decision which include: experience of the surgeon, size and location of the implant, individual anatomy,  the amount of breast tissue, and  medical history.

Most patients prefer undergoing one anesthesia and one recovery period which is usually more cost effective​. I would suggest that your Plastic Surgeon be certified by The American Board of Plastic Surgery who is ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). Discuss your concerns with that surgeon in person.

Robert Singer, MD  FACS

La Jolla, California

 

 

A:

While both approaches are acceptable, most experienced plastic surgeons will do the removal, replacement and lift at the same time. There are factors that would influence that decision which include: experience of the surgeon, size and location of the implant, individual anatomy,  the amount of breast tissue, and  medical history.

Most patients prefer undergoing one anesthesia and one recovery period which is usually more cost effective​. I would suggest that your Plastic Surgeon be certified by The American Board of Plastic Surgery who is ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). Discuss your concerns with that surgeon in person.

Robert Singer, MD  FACS

La Jolla, California

 

 

Related Questions

Copyright © 2009-2015 ASAPS. All Rights Reserved.