Back to Gallery
Patient Details
Breast Implant Removal After 20 Years: An Austin Patient’s Story
This 50-year-old woman wanted her breast implants removed after nearly 20 years. Her decision reflected a change in lifestyle and personal preferences: she was ready for smaller breasts and no longer wanted implants.
Like many patients who had breast augmentation years ago, she did not know her implant type or size. Based on her examination, I anticipated relatively large implants.
Breast Implant Removal Under Local Anesthesia
I removed her textured silicone implants under local anesthesia. She tolerated the procedure very well, and both implants were intact. The surrounding scar tissue, called the implant capsule, appeared normal.
Local anesthesia can be an option for selected breast implant removal patients. The appropriate approach depends on the implants, the condition of the capsules, and the extent of surgery needed.
Her photographs show her early results four weeks after breast implant removal. She is pleased to be implant-free, particularly after learning that her implants had textured surfaces.
Understanding Textured Breast Implants
Textured breast implants are associated with breast implant-associated anaplastic large cell lymphoma, or BIA-ALCL. This uncommon cancer affects the immune system and generally develops in the fluid or scar capsule surrounding an implant, rather than in the breast tissue itself. The risk varies by implant type.
Although I have never encountered a case in my practice, patients deserve clear information about this association. The FDA does not recommend routine removal solely because of BIA-ALCL concerns in patients without symptoms. Persistent swelling, a new lump, or pain should be evaluated.
For this patient, removal was a personal lifestyle choice.
Loose Skin and Loss of Fullness After Implant Removal
Although happy with her decision, she was considering ways to improve the loose skin and loss of upper breast fullness that became more apparent after removal. She wanted to feel comfortable and confident with her breasts.
At four weeks, healing is still underway, and breast shape can continue to settle. However, removing an implant does not remove the skin that previously accommodated it.
She asked about lasers and nonsurgical skin-tightening treatments. Based on her examination and the amount of correction she wanted, I explained that these treatments would not provide the lifting and reshaping she hoped to achieve. My recommendation was a breast lift, also called mastopexy.
Breast Lift or BRA: Matching the Procedure to the Goal
A mastopexy removes excess skin and reshapes the breast tissue to improve contour and nipple position. It can improve sagging without another implant, but it does not replace the volume an implant provided or reliably recreate pronounced upper breast fullness.
For patients with substantial, heavy, sagging breast tissue who also want implant-supported upper fullness, I may recommend my BRA procedure—breast reduction and augmentation. The reduction removes dependent breast tissue, while the implant provides upper fullness and helps adjust the final breast size. BRA does not necessarily mean smaller breasts; implant selection helps tailor the size to the patient’s goals.
BRA involves placing implants, so it serves a different goal from remaining implant-free. For this patient, a mastopexy offers a way to improve shape while respecting her desire to avoid implants.
What About Breast Lift Scars?
The lift I recommended would create an anchor-shaped scar: around the areola, vertically down to the breast crease, and along the crease beneath the breast. This incision pattern allows me to remove excess skin and reshape her breasts.
Scars are permanent, but they generally soften and fade with time. Many of my patients find that the improvement in breast shape makes the scars a worthwhile trade-off. We discuss both carefully so each patient can decide what matters most to her.
If you are considering breast implant removal in Austin, a personal consultation can help you understand what removal alone may achieve and whether a breast lift would better meet your goals. Visit Westlake Plastic Surgery’s breast implant removal information or submit a virtual consultation for an individualized assessment.
