Whether one wishes to remove their implants for personal reasons, illness, or complications, breast implant removal with or without the surrounding capsule is a relatively simple procedure. However, simply removing the implants often leads to saggy breasts and loose skin. To avoid this, a comprehensive approach to breast lift, reshaping, and restoration is usually needed, which is why it is important to understand what happens to the breasts after breast augmentation.
By Dr. Siamak Agha, MD, PhD, FACS — Founder of The Aesthetic Center
What is the impact of breast implants on breasts?
Breast implants are man-made devices that permanently alter the shape of the breast. Depending on one’s breast size and the size of the chosen implant, the placement of an implant can stretch the breast skin and tissue over the implant, making the breasts wider and thinner over time.
If a large implant is used, surgeons often lower the inframammary crease to accommodate a larger size. This displaces the footprint of the breast and makes the breast lower on the ribcage. Thus, the larger the implant, the lower and the wider the breast will become.
Breasts after implants
Breast implant removal may be combined with or without the capsule surrounding the implant. If the implant and capsule are removed together, this is referred to as en bloc implant and capsule removal. For most patients, implants can be removed without excising the capsule. However, en bloc implant and capsule removal may be advised or necessary in patients with capsular contracture and breast implant illness.
Once implants are removed with or without the capsule, patients may be left with breasts that are:
- Deflated and Sagging
- Wider than before implants
- Lower on the chest than before
- Stretched out with thinned breast tissue
- Substantial skin excess
Hence, the choice of breast lift will dictate a patient’s ultimate results. Though various techniques can be used to perform a breast lift, different surgical methods do not yield the same outcome.
For instance, the Internal Dermal-Bra Breast Lift (IDBBL) is an innovative approach that has been modified and enhanced for over 20 years to offer not only superior breast lift outcomes but also Breast Reshaping and Breast Restoration. This advanced technique controls not only the shape of the breast but also its height, width, and profile (projection), as well as its location and the amount of cleavage.
The IDBBL and reshaping
Today, the IDBBL is a three-dimensional technique that corrects the breasts’ width, height, and projection by utilizing all of a patient’s remaining breast tissues to:
- Create projection
- Create cleavage
- Narrow a wider breast
- Reshape to create a rounder breast
It uses an internal bra that is created from a patient’s own breast excess skin and multiple internal suturing to the chest muscle to result in:
- More long-lasting outcomes
- Better healing because there’s no internal pressure on the incisions
- No breast volume loss that is usually associated with a standard breast lift
This internal dermal-bra breast reshaping is unique and natural because it includes a third dimension or projection that is often absent from other breast lift procedures.
Breast repositioning
As mentioned above, to accommodate a larger breast implant, the inframammary crease is often released, and the breast footprint is lowered. This results in breasts being on the lower third of the chest than the normal mid-third. To correct this, we have developed breast repositioning techniques that relocate the breast to its mid-third position via elevation and reconstruction of the inframammary crease at a higher position. This Breast Elevation technique repositions the breast footprint and elongates the height of the abdomen to create the ideal breast/abdominal proportion. The breasts are then lifted from this already elevated position, enabling double correction.
Breast creation using patients’ own tissues or fat
In addition to the IDBBL, patients can undergo autologous breast augmentation, using their tissues as flaps or their own liposuctioned fat to augment their breasts after implant removal. When there is excess tissue around the breasts, we utilize this excess tissue to augment the size of the breasts. Upper abdominal fat can be added to the breasts through a specialized combination of a reverse tummy tuck and inframammary fold reconstruction procedures. As a result, the breasts are augmented, and the upper abdomen becomes tighter and firmer.
Outer chest fat can be added to the breasts through the specialized internal J-thoracoplasty procedure. In this manner, the outer chest is tightened, the breast is augmented, and the whole breast unit is made narrower and rounder. Midback fat can be added to the upper breasts via a Spiral flap procedure combined with a bra-line upper body lift, which can offer a sizable amount of fat to be added to the breasts.
All these techniques are permanent since the fat is brought to the breasts based on blood supply. The beauty of this approach to Breast Restoration is that the breasts are made fuller with a patient’s own tissue, and the surrounding chest and abdomen will also be firmer and polished.
Revolutionary Autologous Breast Augmentation Techniques:
- Breast Autologous Augmentation with Upper Abdominal Tissue (flaps)
- Breast Autologous Augmentation with Outer Chest Tissue (flaps)
- Breast Autologous Augmentation with Midback Tissue (Spiral flaps) with Bra-line Upper Body Lift
If possible, we can perform future fat cell transfers to the breasts for patients without excess tissue surrounding them. However, it is important to remember that, unlike a flap, which can be essentially permanent, about half of the injected fat will resorb or die after the transfer.
— Dr. Siamak Agha, a Cambridge-trained MD/PhD, is redefining the art of plastic surgery with groundbreaking techniques like the three-dimensional facelift and high-definition tummy tuck. A trusted expert for celebrity clients and global patients, Dr. Agha is known for creating life-changing transformations that look natural and stunning. With over 15 years of experience and a passion for innovation, he has earned two international patents in gene therapy and regularly shares his expertise on trending aesthetic procedures, cutting-edge technology, biohacking, and the psychology of beauty. Featured in People Magazine, E News, Bravo TV, and Yahoo Entertainment, Dr. Agha is the go-to authority on everything from modern body contouring to the rise of cosmetic tourism. At The Aesthetic Center in Newport Beach, he combines personalized care with advanced treatments, offering virtual consultations and a world-class experience for those seeking confidence and beauty.
