Case #1104
Breast Implant Removal (+/- Lift)
A woman in her 50s with submuscular implants she felt were too large underwent implant removal and a mastopexy.
A 50-year-old woman with a previous submuscular breast augmentation done six years earlier through a peri-areolar approach. The implants were 375cc and she felt they were too large. Dr. Azadgoli performed an explant, pectoralis muscle repair, and mastopexy.
Why this approach
The decisions that shaped this surgical plan.
- Revision case — prior tissue patterns, scar locations, and anatomical changes from the first procedure all factored into the surgical plan.
- Bilateral breast implant removal (+/- lift) performed in one operative session so symmetry, tissue handling, and final shape track between both sides.
- A concurrent lift was the right complement to the main procedure for this anatomy — done concurrently to consolidate recovery.
Pre-op preparation
What to do before surgery. Specific to this case.
- Stop NSAIDs, aspirin, and high-dose fish oil two weeks before surgery; the surgical team provides a full medication list at the pre-op visit.
- Full nicotine cessation 6 weeks pre- and post-op. This includes vapes and nicotine replacement products; the constriction effect is the same.
- Arrange button-front or zip-front tops for the first three weeks — overhead reaching is restricted. A drain holder or apron is provided.
- Day-of transport and an overnight companion (24 hours minimum) are required for discharge.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Both sides healing in parallel means the early phase is quieter — short walks, full rest periods, and no driving until off pain medication.
- Week 2
Walking distance doubles. Showering rules relax. Compression garments transition to the long-wear schedule.
- Week 4
Most patients back to gym cardio at 50 percent intensity. Scar massage protocol begins. Driving restored if not already.
- Week 6
The "back to normal" week for most patients. Final compression schedule transitions to optional.
- Month 3
Tissue softens, scars begin to fade, and overall shape settles toward final. Scar maturation continues for another 6 months.
- Month 6
Revised tissue softens on a longer timeline. Final shape and scar appearance continue to mature through month 12.
Continued care
Recommended aftercare, skincare, and MedSpa services for Breast Implant Removal (+/- Lift).
- Compression bra continuously for 4 weeks
- Lymphatic drainage massage starting week 2 to reduce residual edema
- Sleep elevated for 2 weeks
- Gentle breast massage from week 4 to encourage tissue redrape
- Medical-grade silicone sheeting on the incision lines
- SkinCeuticals C E Ferulic for scar healing
- Body hydration protocol while skin retracts
- SPF 50+ on incisions for 12 months
- Indiba radiofrequency for skin tightening as tissue retracts
- Fractional laser from 3 months if additional tightening is needed
- Lymphatic drainage weekly for the first month
- Aftercare
Bilateral HBOT protocol — 10–15 sessions over the first 6 weeks.
Bilateral procedures heal more reliably with sustained HBOT.
- Aftercare
Active scar treatment delayed by 2 weeks to give revised tissue more time to settle.
Revised tissue tolerates active treatment less well than primary cases.
- Skincare
Layered scar protocol — silicone sheeting under tape, daily for 12 weeks.
Revised scars respond best to sustained, layered pressure therapy.
