Dr. Robert Whitfield explains when to combine breast implant removal with fat transfer, and when to stage them separately. Large implants on small frames or stretched skin often need two surgeries instead of one. He details the operative sequence: remove implant and capsule, reconstruct the pectoral muscle, assess for skin lift, then place fat in the native layer.
Simultaneous can mean, you know, one obvious procedure to the OR and then one recovery and then one set of fees associated with that. But the convenience should not outrank, is it the correct time? Is the person in the correct state of health for that? If the tissue, which many times has been compressed for years, or someone's Inflammation is such that we can't help control it. Really, really large implants can also be a problem on a small frame. If the skin is really out of balance in terms of stretch, potentially waiting and doing it at a later time can be an advantage. When we combine explant fat transfer, you know, we're doing several things at one time, controlling as many variables at one time as possible. removing the implant and the capsular tissue as we always do and send it off for PCR testing and pathology. We want to reconstruct the muscle there because that helps protect the rib cage and provide better support for the breast mound and the fat transfer and decide whether the skin needs any type of skin lift. Then obviously get the fat in the fatty layer and once again, not in the old pocket.
