Everything to Know About Fat Grafting After Explant Surgery
There comes a time where every woman, sometime after undergoing breast augmentation surgery, needs to consider removing their breast implants. This is simply because breast implants aren’t considered a lifelong medical device. In fact, some brands of breast implants only have a lifespan of 10 years, while newer breast implants are expected to last somewhere between 10 and 25 years. For women wanting to remove and not replace their implants, fat transfer to the breast is a viable option following breast implant removal surgery.
Fat Transfer to Breast
Breast augmentation using fat transfer makes use of the unwanted fat present in specific parts of your body to improve the shape and size of your breasts. It involves liposuction to remove fat from specific areas of the body, most commonly the abdomen, thighs or buttocks. Once this fat has been suctioned out, the procedure involves reinjecting that fat into the breasts. This is a great alternative to breast implant replacement, as the results are permanent and a second surgery isn’t necessary as there’s no foreign object being placed inside your body.
This procedure can be performed in women instead of a breast augmentation, alongside a breast augmentation (in a hybrid procedure), or following breast implant removal.
Breast augmentation using fat transfer helps you get a more subtle and natural look to your breast compared to using breast implants. There is no need to use foreign material to increase breast size as fat from your body is used. It has a shorter recovery period and is associated with minimal scarring when compared to breast implant surgery.
When do Breast Implants Need to Be Removed?
Breast implants need to be assessed for removal once they get to a certain age. This can be anywhere between 5 and 25 years, depending on the brand of implants used. Motiva breast implants are one of the longest-lasting breast implants available. Dr Doyle uses Motiva implants in all of his breast augmentation patients, although he has used a variety of FDA-approved implants throughout his 30-year career as a Specialist Plastic Surgeon.
Breast implants need to be removed (or replaced) if there is a problem with them. These problems include:
Rippling of the Implant
Breast implant rippling occurs when the implant develops wrinkles or “ripples”. These wrinkles may be felt when you touch your breast. In some cases, these changes can also be seen through the skin. If you see or feel wrinkling in your implant, you may want to consider replacing or removing it.
Rippling is more common with saline breast implants over silicone, although it’s a known complication of both. It typically occurs in women who don’t have a lot of breast tissue as the implant is closer to the skin. It’s also more common when the implant is placed over the muscle.
If your implants are relatively new, but form ripples, fat grafting or fat transfer may be an option to restore the appearance of your implants without needing to remove your implants.
Breast Implant Malposition or Flipping
Breast implant malposition is the condition following breast implant surgery that results in one or both implants sitting in a position different from where it was originally placed.
Breast implant flipping, on the other hand, occurs when the implant/s rotate in such a way that the back surface of the implant faces forward. It often occurs when the pockets are large, making it easier for the implants to rotate/ move freely. This rotation of implant in the pockets causes distortion of breast shape.
Over time, implants can become hard due to a thick wall of scar tissue developing around the soft breast implant. More often than not, this “capsule” actually helps to keep the implant in place and prevents it from moving around within the pocket.
However, in some women, this capsule of scar tissue becomes unusually hard and starts to contract around the implant. This can lead to both aesthetic problems and, in extreme cases, pain in the breasts. Roughly 1 in 6 breast augmentation patients experience some degree of capsular contracture. If this starts to cause discomfort or aesthetic disturbances, Dr Doyle will remove the implant and capsule as a whole using an En Bloc technique.
Changes in Aesthetic Goals
Often women simply regret getting implants and feel that they have reached a stage in life when they are no longer required. Unfortunately, many women have implants that are just too large and they tire of the “fake” look with the increased upper pole fullness caused by the implants.
Breast Implant Illness
Some women may choose to remove their implants if they believe they are suffering from a condition known as Breast Implant Illness. This refers to a vague group of autoimmune symptoms such as fatigue, rashes and muscle and joint pains. Although this condition is poorly researched and even denied by the manufacturers of breast implants, many of Dr Doyle’s patients report an increased sense of wellbeing following the removal of their silicone implants.
If you are suffering from an unexplained autoimmune disease and believe your symptoms can be attributed to your breast implants, Dr Doyle recommends that you remove and NOT replace them. This is where fat transfer after breast implant removal presents as a good option.
Benefits of Removing Breast Implants
If over time, your implants have become problematic and you are experiencing one of the above circumstances, taking out your implants can be of great benefit. Removing them can relieve these issues as you will no longer have a foreign medical object inside your body. It isn’t without risk though, as undergoing any type of surgery poses some form of risk.
Generally, the majority of women with an implant-related concern, are better off without their implants. The downside? Your breasts won’t look the same as they do with implants.
Consequences of Removing Breast Implants
Removing breast prosthetics can cause some unwanted aesthetic changes. Think of it as a balloon. When inflated, the breasts appear full and round. When the balloon pops (or the implant is removed), the breasts can appear stretched out and deflated.
Consequently, removing breast implants (especially large ones which have been in place for a long time) can lead to a saggy and deflated breast appearance. Some ladies may have enough skin elasticity to combat this issue and their breasts may “bounce back” into their original position. While this is the goal, it isn’t always possible.
Fortunately, you can mitigate these cosmetic effects by working with a highly skilled specialist plastic surgeon. ‘Lipoaugmentation’ or fat transfer after breast implant removal presents as a good option if you choose not to re-insert new implants, but would like to retain your volume and breast shape.
Fat Transfer to Breast After Breast Implant Removal
Lipoaugmentation helps to refine the breast contour by using fat extracted from your own body. This fat replaces lost breast volume after removing your implants. It results in a more natural look and feels more natural to the touch when compared to traditional breast augmentation. Dr Doyle is highly skilled and is an expert at performing this specialised fat transfer procedure.
Also known as fat grafting, fat is harvested from your choice of the hips, thighs or abdomen. This brings the added benefit of reducing the size in these areas. If minimal excess fat is present, Dr Doyle usually succeeds in harvesting fat from the inner thighs through his careful liposuction techniques.
The fat is then purified and then reinserted into the breast. The fat does not fill the space or pocket left behind by the implant, rather it is grafted into the breast tissue itself. Depending on your aesthetic goals, the fat is typically grafted into the cleavage and upper pole of the breast. This can reduce any sag or deflation that might’ve occurred when removing your implants.
For most patients, fat transfer provides up to a 1.5x increase in bra cup size after implant removal, although this varies between patients. It’s also possible to retain your original breast size (before implants) but create a rounder shape by adding volume to the upper breast.
Overall, explantation with fat transfer is a great option for patients who no longer wish to have breast implants but still want full, shapely breasts. Many patients find they enjoy the soft, natural look and feel of their breasts, and may feel more at ease that the increased volume came from their own body rather than outside material.
Options for Fat Transfer After Implant Removal
If you choose to proceed with fat grafting, you typically have two options. You can remove the implants, wait a few months to see if you need a fat transfer, then have a second surgery. Or, you can choose to do a combination implant removal and fat transfer surgery.
Option 1 – Remove, Wait, Then Fat Transfer
Some women experience “fluffing” of the breasts after removing implants. This means that the breasts fill out or ‘bounce back’ without surgical intervention. For many women this happens weeks after surgery, for others, it takes around six to nine months.
This is why many women choose to remove their old implants and allow their breasts “to be” in their natural-looking state, even if their breasts sag. If your skin is still healthy and elastic, you may be happy enough with your breast appearance after explant surgery.
If your skin sags excessively due to ageing or stretching, or looks empty, then you may decide to explore further surgical options – such as fat transfer after implant removal.
Pros of Waiting
Waiting to make a post-implant removal decision has some benefits:
- Waiting allows your surgery results to “settle” into place before making a decision.
- Your post-surgery recovery will be easier as you won’t have to wear a post-liposuction compression garment.
- You’ll avoid paying Dr Doyle’s fee if you decide against liposuction augmentation surgery.
Waiting allows you time to determine whether or not you need further surgery. If you end up being happy with your results, then you can effectively avoid undergoing a second surgery.
Cons of Waiting
The main negative of waiting to make your decision is that you’ll often be required to wait until you’re completely recovered to undergo your next surgery. This is normally at least three months for a two-stage procedure. However, if you’d like to allow significant time for your breasts to “fluff,” you may be advised to wait up to 12 months.
If you do choose to wait and then decide that you’d like to undergo fat grafting, the negatives include:
- You’ll have to undergo general anaesthesia twice, increasing your risk of experiencing anaesthesia related complications.
- You’ll have to pay your anaesthetic fees twice.
- You’ll have to pay your hospital fees twice.
- You’ll have two recovery periods.
Option 2 – Simultaneous Implant Explant and Fat Transfer
This is a popular option for a number of reasons. Essentially, by combining two plastic surgery procedures into one, you get the following benefits:
- You’ll only need anaesthesia once which decreases your risk of experiencing anaesthesia related complications.
- You’ll have only one recovery period (although you may find this recovery period to be more strenuous).
- You’ll only pay the hospital and anaesthetic fees once.
- You’ll have a more dramatic post-surgery transformation.
By undergoing liposuction to graft fat into the breasts, Dr Doyle can sculpt your body into a more flattering shape. You may be able to flatten the tummy, melt away your muffin top, accentuate the waistline or tone your arms or thighs. With Dr Doyle’s precise liposuction technique, he is able to precisely target certain areas that you’re most self-conscious of, adapting to your unique desires.
This keeps your breasts looking full after you remove your implants, and also tones and tightens the area of your choosing.
Fat Transfer After Implant Removal FAQs – Frequently Asked Questions About Lipoaugmentation
How are breast implants removed?
Dr Doyle removes implants in a similar manner to how they are placed. This typically involves an incision along the lower fold of the breast (the inframammary fold) which is made over the previous augmentation scar. Then, Dr Doyle will remove both the implant and the surrounding capsule from the breast.
What happens when you remove your breast implants?
Breast implants add fullness to your breasts. Removing the implants returns your breasts to their original shape however they may have more sag due to the skin being stretched by the implant.
How will my breasts look after removal surgery?
Immediately after your surgery, your breasts may appear ‘deflated’. Your breasts may regain their volume over the following weeks.
If I get a fat transfer, will my breasts be the same size as they were with an implant?
No, they’re unlikely to be as full as they were with an implant. The total volume of the fat graft is likely to be less than the volume of the old implants. However, many women find that their breasts have a better appearance and a far softer, more natural look.
Can you remove implants and replace them with fat?
Yes. With a procedure known as fat transfer after implant removal, Dr Doyle offers patients the chance to refine their breast contour using the fat that has been extracted from their own body.
How long does it take to recover from breast fat transfer?
Once your implant removal with fat transfer is complete, your recovery time will be approximately 2 weeks. Over the next few weeks, any swelling and soreness will resolve. The complete healing process can take anywhere from a few weeks to a few months.
Is it painful to have breast implants removed?
During surgery, you will have a general anaesthetic so you won’t feel any pain during your explant procedure. Healing can vary but recovery is more uncomfortable than painful. This can be managed by pain medication provided by Dr Doyle.
Does fat that has been transferred go away?
Approximately 30% of fat transfer is reabsorbed over the first 6-12 months after surgery. The fat that does survive the transfer will remain permanently and will behave like any other fat in the body. It will respond to normal weight gain and loss as any other fatty tissue.
What should I wear after breast fat transfer?
Your breasts will be swollen and sore immediately following your surgery. During this recovery period, you will need to wear a surgical bra or medical compression bra without underwires. You will also be required to wear a post-liposuction compression garment.
Am I too skinny for fat transfer surgery?
Since fat can be harvested from various areas of the body, patients are rarely too thin to disqualify for a fat transfer altogether. You may, however, be required to undergo liposuction on multiple areas to obtain sufficient fat to restore your breast shape.
Is it worth getting undergoing fat transfer breast augmentation?
Fat grafting after implant removal can be worth it if:
- You don’t want to replace your implants but want to retain some fullness of your breasts.
- You’re concerned about your breast size following explantation.
- You had little breast tissue before breast augmentation.
- You want a natural and subtle enlargement of your breasts.
- You are healthy with adequate fat stores.
Book a Consultation
If you would like to learn more about fat transfer after implant removal, book a consultation with Specialist Plastic Surgeon, Dr Mark Doyle on the Gold Coast.
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- What Is Breast Implant Illness? – a Social Media Phenomenon or a Real Condition?
- Nipple Reshaping and Areola Reduction: Who Is the Ideal Candidate, Benefits, and More
- Hybrid Breast Augmentation: Breast Implants & Fat Transfer
- Breast Implant Removal What to Expect – ASAPS
- What Happens When You Have Breast Implants Removed – AEDIT
- What is Capsular Contracture and How Can It Be Treated – ASPS
About Dr Mark Doyle FRACS (Plast) – Queensland Plastic Surgeon
Servicing patients in Gold Coast, Brisbane, Sunshine Coast, Cairns and New South Wales NSW – Northern Rivers, Byron Bay, Ballina, Lismore and more.
Dr Mark Doyle is a Specialist Plastic Surgeon with over thirty years of experience performing Breast, Body, Face and Nose surgery. As a highly esteemed plastic surgeon, Dr Mark is driven by an intense passion for helping patients achieve a happier, more beautiful self through advanced cosmetic surgery procedures.
He maintains a strong commitment to achieving the best possible results for all his breast, body, face and nose patients, both men and women.