Explant with Breast Lift in Dallas, Texas- Dr. John Burns, MD

When the time comes for explant surgery, many women are left with saggy and volume-depleted breasts. An explant with breast lift is a unique procedure designed specifically for women seeking breast implant removal coupled with skin tightening and rejuvenation.

As a board-certified plastic surgeon specializing in explant surgery, Dr. John Burns understands the unique concerns and desires of women facing this transformative procedure. Whether due to health reasons, lifestyle changes, or personal preference, my goal is to provide expert care, ensuring a smooth and confident transition.

Here you'll find everything you need to know about the explant surgery process, the benefits of combining it with a breast lift, and how this dual approach can restore a natural, youthful contour to your breasts. Explore detailed information, patient testimonials, and answers to frequently asked questions to help you make an informed decision about your journey to renewed confidence and wellness.

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Why Women Choose Breast Implant Removal Surgery

Breast implants are not lifelong devices and must be removed or removed and replaced at some point. On average breast implants last about 10 years but that number varies widely. There are many reasons women choose to move forward with removal of breast implants. Some of these reasons are:

  • Aging implants or implant failure
  • Capsular contracture: the entire capsule of scar tissue around the implants becomes hard and deforming or painful
  • Aging skin and breast tissue resulting in loose skin and resulting ptosis (sagging of the breasts)
  • Illness
  • Pregnancy-induced, changes in breast tissue
  • Malposition of the implant over time. Usually manifests as inferior and lateral displacement of the implants
  • Animation deformity where the implant moves unnaturally with contraction of the chest muscles
  • Pain or discomfort

Regardless of the reasons, breast implant removal is likely something that every breast implant patient will need to decide at some point. Dr. Burns specializes in making your breasts look beautiful after explant. One popular option is a breast lift which both removes excess skin and lifts the breasts after explant.

What Is Explant With Breast Lift Surgery?

Breast implants are solid structures that support and shape the breasts. Regardless of the size of the implants, there will always be some stretching of the skin, muscle, and soft tissue with breast augmentation. When the implants are removed there is typically a deflation of the breasts due to excess skin and soft tissue. In some cases, the amount of excess skin results in the breast looking saggy or ptotic. Some women will experience loose breast tissue, adhesions, and drooping of the breasts.

One excellent solution to this problem is to remove the excess skin using traditional breast lift incisions (anchor incision placement) designed to be less visible and also function to lift and shape the breasts. Doing a breast lift at the time of explant leaves the patient with smaller, perkier, and more shapely breasts.  

Explant with Breast Lift- Before and After by Dr. John Burns in Dallas, Texas

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Reasons Women Have Explant + Breast Lift

The primary reason women opt for breast explant with a breast lift is to remove excess skin and prevent the breasts from appearing deflated and droopy. A breast lift eliminates excess skin and lifts and shapes the breasts, resulting in smaller, perky, and beautifully contoured breasts.

Capsular Contracture

Normally, breast implants form scar tissue around the implant itself. In some cases, the degree of the scar tissue can thicken and distort the breasts, becoming painful for many women. Implant capsules are graded on a scale, of 1 to 4:

  • Grade I: No symptoms, the breast looks and feels normal.
  • Grade II: Mild symptoms, slight firmness, or palpable breast tightening.
  • Grade III: Moderate symptoms, noticeable firmness with visible distortion of the breast shape.
  • Grade IV: Severe symptoms, the breast feels hard, and there is significant distortion of the breast shape.

A capsulectomy is done at the time of explant and breast lift to remove the capsule. Removing the implant capsules allows the tissue planes to re-adhere after explant and prevent fluid build-up in the implant pocket (called a seroma).

Implant Leaks

Implants are not permanent. Implants can develop issues in their shell or coating over time leading to rupture or leaking.

Saline implants are filled with sterile saline, making ruptures easy to detect as the breast quickly flattens.

In contrast, silicone implants are semi-solid, so ruptures are less obvious and often silent. Diagnosing a silicone implant rupture usually requires an MRI or ultrasound. If an implant fails, it needs to be removed or replaced. During this procedure, any free silicone should be cleaned from the implant pocket, and often the surrounding capsules are removed as well.

Illness

Some patients may experience an illness that requires implant removal. Cancer, autoimmune disease, etc., can necessitate implant removal. In instances like this, women need an aesthetically-driven solution that gives them more peace of mind.

They No Longer Want Larger Implants

Many women simply “age out” of their implants and prefer to move forward with solely their natural breast tissue While larger breasts might be desired during their 20s and 30s, the weight of the implants can become problematic as they mature into their 40s and beyond. A woman’s preferences typically change as she moves through new seasons of life.

Old Implants Greater Than 10+ Years

There is no specific age at which implants must be replaced. However, since implants are not permanent medical devices, they should be periodically removed or replaced. The timing depends on the condition of the implants and the appearance of the breasts over time. Regular exams by your board-certified plastic surgeon and, if necessary, imaging studies such as an MRI or ultrasound are recommended to monitor your implants.

Read More: 
4 Reasons Women Want Explant Surgery
Time For An Upgrade? 3 Signs You Need New Breast Implants

Different Types Of Breast Lifts For Explant Patients

Mild Breast Sagging (ptosis)

If the implants are small there is a good amount of breast tissue the degree of deflation can be very mild. In these cases simply removing some excess skin using an incision around the areolar can tighten the skin envelope and restore a normal appearance to the breasts.

Moderate Breast Ptosis

If the implants are larger and the amount of breast tissue less there may be a more significant degree of deflation and drooping of the breasts. These cases will require a more traditional breast lift with an incision around the areola, an incision from the areola to the breast crease to centralize the breast tissue, and a limited incision in the breast crease.

Severe Breast Sag After Implant Removal

If the implants are large and the amount of breast tissue is small then there will be a lot of deflation and sagginess of the breasts with explant. Unfortunately, this case is very common and represents the majority of explant cases. In this case, a full scar mastopexy or breast lift will be necessary to remove the excess skin and lift and shape the breasts. This involves an incision around the areola to lift the nipple-areolar complex, a vertical incision from the areola to the breast crease to centralize the breast tissue creating projection, and a full incision in the breast crease to remove excess skin.

How Is An Explant And Breast Lift Surgery Performed?

In most cases, it is recommended to remove the implant capsule during explant surgery. The capsule does not naturally dissolve and can impede the body's ability for tissues to re-attach. Leaving the capsule in place may lead to the formation of a potential space where fluid can accumulate and require drainage, known as a seroma. Removing the capsule is a straightforward procedure called a capsulectomy. This allows the body's tissues to re-adhere properly and prevents any potential spaces in the chest.

Can the two procedures be done at the same time?

A breast lift is often performed with an explant procedure. This leaves the patient with perky and shapely breasts after surgery and does not require additional surgery. If excess skin is not removed there can be problems with adhesions and deformed breasts after explant. For this reason, simultaneous explant with breast lift or fat transfer is recommended.

Board-certified Anesthesia

As with any elective plastic surgical procedure Dr. Burns insists upon using a board-certified, anesthesiologist to ensure maximal safety and a better outcome.

With any breast lift procedure, the areola is often addressed. In most cases, the areolas are reduced in size to give them a normal size. The ideal size of the areola diameter is ⅓ the distance of the base width of the breasts. There is no additional charge for areola resizing.

In some cases, the nipple can be overly long and can be reduced at the time of surgery. This is not typical of breast lifts and is performed at an additional fee.

Procedure Length

The time required varies depending on many factors such as the degree of breast lift, type of implant capsule, and size of the patient. On average, an explant and breast lift takes about 2 hours.

Review Our Facilities at Dallas Day Surgery Center and Cloister Recovery

Muscle Repair

In cases where the breast implants were placed beneath the muscle, reattaching the muscle to the chest wall is beneficial. Over time, the muscle may shorten, preventing it from stretching back to its original insertion points on the sternum and breast crease. However, it can be stretched as much as possible and reattached to the chest wall. This helps restore normal anatomy and prevents muscle animation with chest contractures, which can occur if the muscle is not properly attached.

How Dr. Burns Gets Beautiful Breast Shape, Size, And Volume After Explant

Explant with Immediate Fat Transfer

Dr. Burns is dedicated to ensuring the breasts look beautiful after explant surgery. Recommended procedures vary based on the amount of breast tissue, size of the implant, and degree of ptosis or sagging. Options include restoring volume with a fat transfer, removing excess skin, and lifting the breasts with a breast lift, or a combination of both.

Fat transfer is an excellent option for women who want to replace lost implant volume in keeping with a natural size. The process involves harvesting fat through liposuction, purifying it, and then injecting it back into the breasts. Younger patients with minimal excess skin, good nipple position, and little sagging are ideal candidates for fat transfer.

If there is a significant amount of excess skin, its removal is necessary. A breast lift is the perfect solution for this. A breast lift will reposition the nipple to the correct height, remove the excess skin, and lift the breasts to a perky and beautiful shape.

In some cases, simply lifting the breasts might result in overly small breasts with little upper pole fullness, shape, and cleavage. These patients will benefit from a combination of a breast lift and fat transfer. This combination removes excess skin and provides a needed lift while adding volume, creating round, full, and perky breasts.

Read More: Why C Cup Is The Most Popular Goal Size

Research Explant with Immediate Fat Transfer Here

Before and After Explant with Immediate Fat Transfer- Dr. John Burns, MD

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Explant with Fat Transfer Results

Explant + Lift Recovery Time

Do I wear compression garments or a special bra after surgery?

Yes. Wear a supportive sports bra without an underwire for the first 3 months following surgery. This promotes healing in a perky and lifted position while preventing the sagging of the breast tissue. Patients are provided a bra at the time of surgery and an additional one to wear as a backup. After 3 months, patients can stop wearing the bra at night and only wear it during the day. Maintain good bra support during exercise, as this can strain the breasts.

Will I need help at home?

It is helpful to have help at home with activities of daily living and childcare. The first few days are critical and most patients become self-reliant after several days.

When can I drive?

Most patients can drive for about a week if they are off all pain medication and feel their reflexes are working normally. We recommend driving with someone first to ensure you are up to the task.

When can I work out?

Ensuring proper healing after explant surgery is crucial for optimal results. It typically takes about 3 to 6 months for the chest muscle to fully adhere to the chest wall. During the initial recovery period, patients should engage in light activity, such as walking, using a stationary bike, elliptical, or stair master, starting at 2 to 4 weeks post-surgery. Light activity involves low impact with minimal lifting.

As patients progress in their recovery, they can gradually incorporate light lifting to tone the arms and legs. Around the 3-month mark, more lifting becomes possible and can be advanced as tolerated. By 6 months, patients are typically fully healed and can engage in any physical activity with confidence.

When will I see my final result?

Following your procedure, you'll notice immediate results, although there may be some swelling and bruising, and the scars will appear fresh. Typically, scars begin to fade around one month post-surgery and continue to diminish over the first year. Bruising and swelling are mostly resolved in one month, although some swelling may persist for several months. In general, your final results can be expected around the 6-month mark. Standardized photos are taken at this time for your medical records.

Scar Refinement & Resurfacing for Breast Lift Incisions

Optimizing scar quality is a multi-step process that begins in the operating room, where meticulous care is taken to reapproximate the skin in multiple layers. Early in the healing process, we recommend scar gel and silicone sheeting. Our recommended scar gel options include Skin Medica Scar Recovery gel or BioCorneum, both are available for purchase at EpiCentre.

In addition to scar gel and silicone sheeting, laser therapy is highly beneficial for optimizing scar quality. Our scar care package at EpiCentre Skin Care and Laser Center includes a series of four laser treatments. Combining medical-grade scar gel, silicone sheeting, and laser treatments will help optimize the appearance of your scars.

Cost And Payment Options

The cost of an explant and breast lift is approximately $12,000. Dr. Burns offers third-party financing here.

FAQs

What will my breasts look like after surgery?

Your breasts will be smaller yet perky, depending on the amount of remaining breast tissue and whether a fat transfer has been performed. Incisions will typically encircle the areola, extending downward from the areola to the breast crease, and may vary in length within the breast crease. Initially, the incisions may appear red and more noticeable, but they tend to fade quickly within the first few months. Some bruising and swelling may occur, which typically resolves within a few weeks. In general, most patients are satisfied with their smaller, perky, and more shapely breasts.

Will I need drains afterward?

Yes, Dr. Burns utilizes drains for all explant surgeries. There is a significant space where the implant resides that must be kept free of fluid to prevent a seroma or fluid collection. Keeping the area dry facilitates the healing of tissue planes and enables the body to eliminate any potential dead space in the chest. In most cases, the drains remain in place for approximately one week.

Will I need antibiotics after surgery?

Yes, antibiotics are administered during surgery and for approximately a week afterward to prevent infection. This practice is standard for all breast surgeries. Since there are bacteria present in breast tissue, it can be susceptible to infection. Before surgery, please communicate any allergies or concerns regarding antibiotics so that an appropriate antibiotic can be prescribed.

Exparel pain management

Dr. Burns recommends local anesthetic injections (blocks) to minimize post-surgery pain and discomfort. One of the most popular options is Exparel, which typically provides relief for about a week. By reducing pain, patients experience a faster recovery and require less use of narcotic medications.

How soon can I fly after surgery?

Most patients typically return home within 2 to 3 days after their procedure. Adhering to a stringent deep vein thrombosis (DVT) protocol is crucial to prevent blood clots. Patients should prioritize staying well-hydrated, wearing compression socks, and engaging in regular walks during their flight. Upon returning home, patients should aim to walk every 2 hours for the following 2 weeks. Additionally, some patients may require a blood thinner injection called Lovenox if they are in a higher-risk category.

I live in another country. Will I have to come back for follow-up appointments?

Not at all. Our out-of-town patients receive all their scheduled follow-up appointments virtually, utilizing platforms such as FaceTime, Zoom, Google Meet, or WhatsApp. Ensuring you have access to all necessary follow-up appointments and information is essential for a smooth recovery and optimal outcome.

What if I don't want fat injected into my breasts after explant? 

Many patients opt for explantation alone initially to assess their appearance. Fat transfer can be pursued as a secondary procedure following explantation. Alternatively, some patients may elect to undergo a breast lift procedure, which not only lifts the breast but also removes excess skin. Various options are available to tailor the approach and achieve the best results for each individual.

Should I gain weight before the procedure?

Typically, no. Dr. Burns recommends that you maintain your average weight, as it's likely where you will naturally settle following your procedure.

For various reasons, numerous women opt to have their implants removed without replacement. While implants offer volume and a rounded shape, they also stretch the skin and underlying tissues. Upon removal, breasts may appear deflated and saggy, with excess skin potentially forming awkward adhesions. Hence, it's crucial to address both the volume loss and excess skin to achieve optimal outcomes.

You Deserve Beautiful Breasts After Explant Surgery

Dr. Burns’ is a board-certified plastic surgeon, and is nationally recognized for his work in explant surgery. His mission has always been to create beautiful breasts after explant. While many surgeons simply focus on the explant procedure, Dr. Burns places value on the cosmetic outcome. He is a pioneer in fat transfer procedure and patients seek his care from all over the United States and the world.

Schedule Your Explant with Breast Lift Consultation with Explant Specialist Dr. John Burns, MD

Schedule your consultation today with Dr. John Burns, MD, a board-certified plastic surgeon and expert in explant surgery. Transform your look with the precision and care you deserve!

Dr. Burns is named among 
America's Top Plastic Surgeons by Newsweek Magazine and Statista. Dr. Burns offers both virtual and in-office plastic surgery consultations for men and women seeking plastic surgery in Dallas, throughout the United States, and the world.

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