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.
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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.
