Silicone Breast Implant Removal and Immediate Fat Grafting
Q: Dr. Eppley, Inquiring about en bloc explant of 700cc mentor moderate plus silicone breast implants, implanted April 2014, and fat grafting to reshape breast (either immediately after explant or at a later date). 32 year old female. Experiencing pain/tingling/itchy sensation in left breast.
My commitment to explant waivers greatly with the uncertainty/fear of outcome and the inevitable mental ramifications. I understand that I have very large implants and it’s virtually impossible for my skin to retract. The desire for fat grafting would be to restore some volume and “correct” shape, in lieu of a lift (if that would even be possible). I do want to try to avoid more scars. The plastic surgeon who performed my initial breast augmentation said that I could easily drop 200ccs without the need for a lift. I had contemplated staged breast implant revisions with smaller implants until eventual explant, but that seems like unnecessary trauma and certainly expense. I do have a good amount of native breast tissue. My implants are subglandular and were implanted via inframammary incisions.
A: While I don’t know what your breasts looked like before the implants or now, I can say as a general statement is that it would be unlikely that fat grafting would the a substitute for a breast lift should that really be needed. Fat grafting is a volume addition procedure but doesn’t have the push that an implant provides, it is too soft to do so.
I would caution you to be very careful about trading off one problem for another. Total explantation of 700cc implants is a drastic decision and should be done for a problem that is equally significant in magnitude to justify the aesthetic sequelae that will occur. Recovery of breast volume is not going to be done by fat grafting as that is not realistic.
Dr. Barry Eppley