When implants come out, the breast is usually smaller and lower than it was before you ever had them. The tissue has been stretched around a device, sometimes for decades, and it does not spring back. A lift addresses that — but whether to do it at the same operation or later is a real decision, not a formality.
The two approaches
| Removal and lift together | Removal first, lift later | |
|---|---|---|
| Operations | One | Two |
| Cost | One anaesthetic, one admission, one excess | Two of each |
| Predictability | The breast is being lifted while still swollen and changing | The breast has declared its final shape before it is planned |
| Blood supply | Removing the implant and lifting in one operation asks more of the tissue | Lower risk at each stage |
| Best suited to | Good tissue quality, modest stretch | Very stretched or thin skin, larger implants, smokers, any healing concern |
Why delaying is sometimes the better operation
After removal, the breast retracts over three to six months. What it looks like at two weeks is not what it will look like at six months, and a lift planned on a breast that is still changing can be over- or under-corrected.
There is also a safety point. Removing an implant lifts the skin off the tissue beneath and interrupts some of its blood supply. A lift does the same thing from a different direction. Doing both at once is routinely done and usually fine — but in a patient with thin, stretched skin, a large implant or any healing risk factor, staging is the safer choice.
Dr Kumar will tell you which he recommends for your tissue rather than defaulting to one operation because it is fewer appointments.
What a lift can and cannot do
A lift repositions the nipple and removes skin. It does not add volume. If you want upper fullness back without a device, that needs your own tissue — removal with fat grafting or auto-augmentation.
Scars are those of a mastopexy: around the areola, usually vertically to the fold, and along the fold where more skin has to come out. How lift scars settle.
Medicare
Two separate items, and both have their own criteria.
The removal. Item 45548, removal as an independent procedure. Item 45551, removal with excision of at least half the capsule and no new prosthesis — intended for capsular contracture, a mass within the capsule, or evidence of BIA-ALCL, with the capsule sent for histopathology.
The lift. Item 45558 requires at least two-thirds of the breast tissue including the nipple to lie below the inframammary fold, with marked photographic evidence in your notes. Claimable once per lifetime.
That last point matters when you are deciding whether to stage. What implant revision costs.
Recovery
Where both are done together, follow the breast lift timeline: Prineo and Micropore for six weeks, a compression garment for six weeks, desk work at about two weeks, full exercise at six. Removal alone is a smaller operation with a quicker recovery.
Common questions
How long should I wait if I stage it? Usually three to six months, once the breast has settled.
Will one operation look as good? In suitable tissue, yes. In very stretched skin, staging usually gives the better shape.
Can I decide after the implants are out? Yes — that is exactly what staging allows.
Is the capsule removed? It depends on what is found. En bloc capsulectomy.
What if my reason is symptoms? Breast implant illness: what we know.
Next step
Bring a GP referral — it is required to see Dr Kumar — and your implant cards. Call 1300 267 726. More about explant surgery and implant removal and revision.
The initial consultation with Dr Kumar is $400, with a Medicare rebate of approximately $88 where you have a GP referral. Surgical fees are quoted individually after your consultation, in a written itemised quote.
All surgery carries risks, and individual results will vary. Read more about the risks of surgery here. A GP referral is required to see Dr Kumar.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
