In short
- Four factors decide it: the volume removed, the plane of the implant, the gland that remains and the quality of the skin.
- 🔑 The plane matters more than it seems. The FDA points out expressly that the risk of a significant aesthetic deformity is greater with large implants placed in front of the muscle.
- The result of the first month is not the result. The breast is swollen and takes up more space than it is going to; the skin retracts over months.
- There are three ways of improving it, and they can be done in the same procedure: lifting, filling with your own fat, or both.
- The combination is described and measured: removal, breast lift and lipofilling in a single operation, with an improvement of 19 points on the BREAST-Q questionnaire in a series of 14 patients.
- ⚠️ A breast left with only its own tissue goes down a size. In that series 100% of the patients went down a cup size, and that is the starting point of the conversation, not a surprise after surgery.
- Most women do not have implants put back. In the twenty-year series, of 77 explantations only two patients went back to an implant.
How your breast will look when the implants come out can be anticipated in consultation, and it depends on four specific things: the volume of the implant removed, the plane it was in, how much of your own gland remains and how the skin responds. None of the four can be seen in a photograph; all four are seen by examining.
It is the question that most holds the decision back, and it deserves an answer without dressing: the breast does not go back to the one before surgery. It goes back to the one you would have today had you never had surgery, with years, pregnancies and changes in weight on top, and with whatever skin is left.
This page sets out the most asked-about way out of breast implant removal.
The four factors
The volume removed
It is the most intuitive and the one that weighs most. Removing 200 cc and removing 450 cc do not leave the same space, and the skin that wrapped the large implant has spent years stretched to accommodate it.
The plane
A submuscular implant sits behind the pectoral, and when it is removed the muscle covers the area again. A subglandular implant sits directly beneath the gland: when it is removed, the only thing between the skin and the rib is whatever is left of your own gland.
⚠️ That is why the FDA’s warning is not a generic one but a specific one: women with large implants, especially those placed in front of the chest muscles, may have a significant aesthetic deformity if they choose not to replace them or to undergo further surgery. It is information for deciding, not an argument against explantation.
The gland that remains
The implant does not replace the gland, but it compresses it for years. How much there is and in what state is seen on examination and, where needed, on ultrasound. It is what is going to give the breast its volume afterwards, and that is why a slim patient operated on twenty years ago and another who has gained weight since do not end up in the same place.
The skin
It is checked with a pinch: how far it stretches and how far it comes back. Elastic skin retracts and follows; skin that has borne a large implant, pregnancies and changes in weight retracts less.
What happens in the months that follow
The breast does not stay as you see it at the first check-up. There is a journey, and knowing it avoids decisions taken too soon.
- The first few weeks. There is swelling and the breast takes up more space than it is going to. The result is not yet on show.
- The first and second month. The swelling goes down and the real shape appears. It is the moment when the change is most striking, and also the most misleading.
- From three to six months. The skin gradually retracts. A good part of what looked like excess skin stops being so.
- At a year. That is when the result is stable and when it makes sense to assess whether anything more is needed.
🔑 The practical consequence is that a touch-up should not be decided in the second month. If the plan was to remove and see, the assessment is made once the breast has finished settling.
The three ways of improving it
Lifting
A breast lift in the same procedure raises the nipple, trims the excess skin and repositions the gland. It adds no volume: it rearranges what is there. It is the option when what bothers you is the position and not the lack of fullness.
It leaves scars, and that comes first: around the areola always, and depending on the case vertical or an inverted T. How they evolve is on the page about breast lift scars.
Filling with your own fat
Lipofilling adds volume with fat from your own body. It has two limits that have to be known beforehand: part of the graft is reabsorbed —how much survives varies a great deal from one patient to another and the systematic reviews themselves point out that there is not even a standardised method for measuring it— and a sufficient donor area is needed. In a very slim patient, the fat available is the limiting factor.
The page that owns this technique is breast augmentation with your own fat.
Both at once
It is described as a single-stage procedure. In the published series of 14 patients and 28 breasts, with mean volumes of 980 mL of liposuction and 295 mL of grafted fat:
- 100% went down a cup size compared with the breast with an implant;
- one patient (7.69%) asked for a second session of grafting;
- satisfaction with the breast measured with the BREAST-Q rose by 19 points, and physical well-being fell by 17.
⚠️ It is a series of 14 patients, without a control group and with a mean follow-up of 11 months. It serves to describe what can be achieved with the technique; not to promise a result or to compare it with the alternatives.
What the patients who have already done it say
It is worth looking at the real reasons, because they tend to be surprising.
In a series spanning twenty years with 4,909 augmentations and 77 bilateral explantations, the commonest reason was not fear of the implants: it was weight gain and the feeling of having breasts that were too large (35%), followed by loss of implant volume (31%). The mean time to explantation was 12 years and the mean age 43.
🔑 And one figure that answers the question almost nobody asks out loud: of those 77 patients, one had a smaller implant put back at nine months, another opted for a larger one five years later and one needed a breast lift three months afterwards. The rest stayed as they were.
And if I do nothing
It is an option, and in some patients it is the right one. The same series describes that management with simple explantation and a compression dressing gave satisfactory aesthetic results in its cohort.
🚨 But it is worth saying plainly what is seen most of the time: the breast is left empty and more dropped than before the implants went in. It does not go back to the starting point. For years there has been a volume inside that has stretched the skin and displaced the gland, and when it is removed that skin does not fully retract. Anyone expecting to get back the breast they had at twenty is going to be disappointed, and it is better to be disappointed in the consulting room than in the mirror.
⚠️ But that cohort had round, smooth saline implants, with a mean volume of 413 cc. It is not automatically transferable to a larger gel implant placed in front of the muscle. What does carry over is the principle: not every removal needs something more, and deciding it too early is what leads to operations that were not needed.
What recovery is like
This is the clinic’s regimen for breast surgery without an implant, which is the one that applies to implant removal. ⚠️ It is not a fixed calendar: the surgeon individualises it according to how each case progresses and to the circumstances.
| ICPM protocol | |
|---|---|
| Walking | From the same day |
| Arms and weight | No raising your arms above the horizontal and no carrying more than 2 kg for the first two weeks |
| Driving | From 2 weeks onwards |
| Office work | At 2-3 days, if there is no excessive discomfort |
| Work with light physical activity | At around 3 weeks |
| Work with heavy physical activity | 1 month |
| Gym and exercise | Resumed gradually at one month |
| Post-operative bra | 1 month, and sometimes it has to be extended |
| Stitches | At 2 weeks |
| Shower | Once the dressing is removed, if one is used |
| Sun on the area operated on | At one year, and with factor 50. On areas not operated on, from the first week |
| Check-ups | 2-3 days · 2 weeks · 1 month · 3 months · 6 months · 1 year |
🔑 And here is the difference from an augmentation: with no implant in place, from the first week onwards you can be a little less strict with arm movements. It is what makes a simple explantation easier to get through than the surgery that put the implants in.
⚠️ A note about the stitches that almost nobody explains. All the stitches are internal; what is taken out at two weeks are the external ends of the intradermal sutures, not a stitch in the skin.
🚨 Smoking has a rule of its own, and it belongs not to explantation but to all the clinic’s surgery: stop a month before and a month after. It is the measure that weighs most on the risk of healing problems.
Risks
Those of whichever operation ends up being done, and they are not the same in all four ways out:
- Seroma, the one most closely related to the size of the cavity the implant leaves.
- Haematoma and infection, uncommon.
- Healing problems, more likely in smokers.
- Altered sensation of the nipple, particularly if a breast lift is added.
- Asymmetry or an insufficient result, which in lipofilling is related to uneven reabsorption between the two sides.
- The need for a second operation, mainly for a further grafting session.
Book an appointment
You can book your own appointment. Pick the day and time from the free slots in the diary, in a panel that opens right here, without leaving this page.
Frequently asked questions
Is the breast left dropped or empty?
The commonest outcome is that it is left empty and more dropped than before the implants went in, and it is best to start from there. How much depends on the four factors at the beginning: with small implants, a submuscular plane and good skin quality it can end up reasonably well with nothing else done; with large implants, a subglandular plane and skin with little elasticity, it will end up drooping and with less volume than you expect. You do not go back to the breast you had before surgery: the skin has spent years stretched by a volume that is no longer there. The good news is that this can be anticipated before surgery, and that is the point of the consultation.
Can the implants be taken out and nothing put in?
Yes, it is one of the ways out and in many patients it is the one that applies. The honest conversation starts with what volume and what shape will be left, and not with whether it is possible.
Will I need a breast lift when the implants come out?
Not always. It is decided by the position of the nipple relative to the fold and by the excess skin left once the volume is removed. If the question is right on the borderline, it is defensible to remove first and assess the lift once the breast has settled, at six months or a year.
Can everything be done in the same operation?
Yes: removing, lifting and filling with fat is described as a single-stage procedure and with measured results. It has an obvious advantage —one anaesthetic and one recovery— and one drawback: if anything has to be adjusted, it is adjusted afterwards, because everything has already been done.
How long does the breast take to settle?
The result is judged at six months or a year. The first month is no use for deciding anything: there is swelling and the skin has not yet begun to retract.
Will I go down a size?
Almost certainly, and it is best to expect it. In the series on breast lift with lipofilling after explantation, every patient went down a cup size compared with the breast with an implant. Fat grafting softens that change, it does not avoid it.
I regret my augmentation — how long should I wait to have them taken out?
There is no medical interval that obliges you to wait if the implant is fine. What is advisable is that the decision should not be taken on the spur of the moment: it is an operation and it deserves the same reflection as the first one. If the regret is recent and the implant is causing no problems, there is no hurry at all.
What is recovery like? Is it easier than after an augmentation?
When the implants are simply removed, it usually is: there is no new implant stretching the tissue and none of the feeling of pressure of the first few weeks, and from the first week onwards you can be a little less strict with arm movements, precisely because there is no implant in place. The clinic’s regimen is walking from the day itself, office work at 2-3 days, driving at 2 weeks, the bra for a month and the gym gradually at one month, with check-ups at 2-3 days, 2 weeks, 1, 3, 6 and 12 months. If a breast lift is done in the same procedure, the recovery becomes that of a breast lift.
Sources
- Risks and Complications of Breast Implants. U.S. Food and Drug Administration, updated 14 December 2023. fda.gov — It describes the possible aesthetic result after removal without replacement —dimpling, chest wall concavity, folds, drooping— and points out a greater risk of significant deformity with large implants placed in front of the muscle. Checked on 05-09-2026.
- Eisenberg TS, Pilla J, Chapa G. A 20-Year Experience with Round Smooth Saline Breast Implant Explantation: Reasons, Trends, and Management. Aesthetic Plastic Surgery. 2026;50(3):1073-1081. PMID 41023230 — 77 bilateral explantations out of 4,909 augmentations; a mean of 12 years to explantation and a mean age of 43; mean volume of 413 cc. Reasons: weight gain and breasts that were too large (35.06%) and loss of implant volume (31.17%); only two patients went back to an implant and one needed a breast lift. Level of evidence III. ⚠️ A cohort of round, smooth saline implants, a limit this page declares. Checked on 05-09-2026.
- Mangialardi ML, Ozil C, Lepage C. One-Stage Mastopexy-Lipofilling after Implant Removal in Cosmetic Breast Surgery. Aesthetic Plastic Surgery. 2022;46(4):1542-1550. PMID 35064339 — 14 patients and 28 breasts, mean follow-up of 11.3 months. Mean liposuction of 980 mL and mean grafting of 295 mL; a reduction of one cup size in 100%, a second session in 7.69% and +19 points in BREAST-Q breast satisfaction (p < 0.00001), with −17 in physical well-being. Level of evidence IV. Checked on 05-09-2026.
- Wang CL, Luan SS, Panayi AC, Xin MQ, Luan J. Methods used for evaluation of volume retention rate in autologous fat grafting for breast augmentation: a systematic review. Chinese Medical Journal. 2019;132(18):2223-2228. PMID 31490259 — 12 studies and 1,337 cases. The retention rate of the graft varies even when the technique and the method of measurement are the same, and the authors conclude that current tools have limitations and that a standard protocol is lacking. It is the reason this page does not publish a percentage for reabsorption. Checked on 05-09-2026.
Book your consultation
If what is holding you back is not knowing how it would look, that uncertainty is settled by examining: the volume of the implant, the plane, the gland that remains and the skin are all assessed at a consultation, and from that come a reasonable forecast and what options you would have.
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