Ask the Doctor: ‘I had a breast augmentation and regret it. My implants feel hard and look unnaturally large — is it possible to get these removed without major scarring?’

“I had a breast augmentation some years ago and have regretted this now for a while. My implants feel a little hard and look unnaturally large for my body shape. Is it possible to get these removed without major scarring and return to a more natural look?”

Answer from Ms. Éilís Fitzgerald, Consultant Plastic Reconstructive & Aesthetic Surgeon, Fitzgerald Plastic Surgery, Beacon Consultants Clinic

Breast implant removal has become one of my most requested procedures, to the point where I am now seeing more women for implant removal, than I am for primary augmentation.

My first thought on reading your query, is that you are likely to require a mastopexy, or breast uplift procedure, in order to achieve smaller, neater, and more naturally-shaped breasts, in proportion to the rest of your body. This does mean that more extensive scarring than you are likely to have at present would be needed. However, with careful management, scars typically fade and become inconspicuous over time. I commonly hear feedback from my patients, that the favourable changes to the overall aesthetics of the breasts, make these scars worthwhile.

Unfortunately, it is likely that simply removing the implants will leave you with droopy, empty breasts, and this may not be a desirable outcome for you. Placing new, smaller implants, without additional scarring, is almost never an option, as there is too big a space for them inside the breast. This means they can move around, droopiness is exaggerated, and a favourable natural look is not achievable. While fat transfer can be used for modest volume replacement following implant removal, it won’t deal with drooping or extra skin, and may require a number of procedures to get to the final result.

Many women will have more breast tissue at the time of implant removal than they had at the time of the first operation. Pregnancy, breastfeeding, and weight gain all influence breast tissue to grow over a woman’s life. It is possible that you will have enough tissue, to allow for a procedure without new implants. An “autoaugmentation”, in which your own tissue is used to give volume and shape to the upper part of the breasts, may well be an option.

I would advise any woman seeking to remove her implants to prepare a priority list before meeting with her surgeon. She should consider whether she wants new implants (understanding the inevitability of more surgery in the future if she does make that choice), what size she would like to be, how she feels about additional scarring, and whether she is concerned about any drooping that may have developed over time. It is then the job of the surgeon, to explain all viable options, and to help guide the patient to the right choice for her circumstances.

Have a question for the professionals you’d like answered? Get in touch with sarah.gill@image.ie with the subject headline ‘Ask The Doctor’.

This article was originally published in August 2022.