Nowadays, the safest way to ensure a proper augmentation of your breasts is through the breast implant plastic surgery technique. The pros and cons of this intervention have been discussed for many years now and in all sorts of settings, starting with chat rooms and online forums to extensive debates on TV. The reality is that breast augmentation with implants can provide you bigger, fuller, rounder breasts and a greatly enhanced appearance. Even so, there are cases when breast implant removal becomes necessary such as developing deep tissue infection that is resistant to antibiotics, a severe case of capsular contracture, implant rupture, or you simply want to remove the implant and not replace them with new ones. The removal of the implants is a surgical intervention that comes with its own associated risks and complications. When the removal of the breast implants is not complemented with the replacement of the implants, breast sagging may occur, especially if the ones removed were big sized implants. About silicone implants The breast implants are like bags, pre-filled with sterile silicone gel that is inserted behind the pectoral muscles or the mammary gland in order to augment the breast. The common technique is to insert the implants behind the muscles unless the patient is actively involved in sports as a volleyball, handball, or tennis player, a swimmer, dancer or engaged in activities that extensively use the pectoral muscles. In these cases, the mammary implants should be positioned over the muscle to preserve muscle condition and to achieve the best aesthetic result. The submuscular placement, wherein implant is placed under the chest muscles, is mandatory when there is not enough tissue to cover the implants. The advantages of breast augmentation using silicone implants cannot be refuted. Most of the techniques used are not as invasive and if the removal of the implants is desired or needed, it can be performed without any additional complications. After the breast implant removal procedure, the breasts will revert to their initial shape over the course of a few months. But, it must be pointed out that this is only valid in the case of smaller breast implants. If you had inserted huge breast implants and you need to remove them because they cause back, neck or shoulder pains, please keep in mind that breast sagging will occur. Breast sagging after the breast removal intervention is a completely normal offshoot and is the result of the skin and ligaments being stretched over time, under the pressure exercised by the weight of the breasts with implants. If the breast implant removal intervention is performed shortly after the initial breast augmentation, there is still a chance for the breasts to get back to their initial shape without sagginess. However, if you had sagging breasts before the initial breast augmentation that was not corrected and big implants were introduced, most likely you will end up with much bigger breasts that are also sagging. In this case, removing the breast implants, won’t completely correct the sagginess unless the removal procedure is combined with a mastopexy (breast lifting procedure). About the mastopexy intervention The breast lifting procedure is sometimes performed conjointly with the implant removal procedure or at a later date. The breast lifting procedure can help correct breast ptosis of various degrees, as well as reshape your breasts to the original size and shape prior surgery. Mastopexy is not always needed after the breast removal procedure unless you had huge implants then, it will be required. Whether mastopexy is necessary or not depends on skin elasticity and the positioning of the breast implant, as well as the dimensions of the implant. Bear in mind that the bigger the implants, the more stretching there will be. Reasons for breast implants removal There are aesthetic and medical reasons behind the breast implant removal procedure. The patient chose an implant type that turned out to be disproportionate for her body frame or the patient is unhappy with the results of the surgery in terms of shape, position of the breasts, visibility of the implants and so on. The aesthetic reasons are plenteous and can trigger the realization that it was better before the implants were placed. We have plenty of celebrity cases as proof for this. When medical reasons are behind the breast implant removal surgery, we are usually talking about deep tissue infection resistant to antibiotics, severe capsular contracture, capsular calcifications, or implant rupture. Sometimes, women who opted for huge implants subsequently realize that the weight of the implants is affecting their posture and causing pain and discomfort in the neck, back and shoulder. Conclusion Many patients who come looking for a breast implant removal surgery almost always ask if implant removal require mastopexy. The truth is, the answer is different from patient to patient. In some cases, the plastic surgeon will be able to tell you upfront what are the risks associated with the breast implant removal procedure. In other cases, it greatly depends on your body’s ability to heal and your skin’s capacity to retract. The quality of the skin on your breasts, as well as the position of the implants and the size of the implants are essential factors in determining whether the breast removal should be combined with a breast lifting procedure or not. Skin elasticity tends to decrease with aging and huge implants causes the overstretching of ligaments that keep the breasts firm and upright. If you had your huge implants for a long period of time, you will likely need breast lifting if you want your breasts to look youthful and appealing.