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Why more women are having their breast implants removed or ‘downsized’

Image courtesy of today.com

The baby-boomers who are the initial generation to have implants are getting older and wish to down-size without the challenges of dating or feeling less self-esteem from lack of breast fullness. They wish to be small and perky.

While Dr. Kane’s breast augmentation case load has remained the same, noting the latest younger generations desirous of fuller but not over-sized breasts, he has definitely increased the number of surgical procedures for women wishing to down-size and lift.

A newer implant called the “Ideal” Structured Saline implant which as the best properties of saline and gel implants without the downsides.

Ideal implants:

  • Maintain a gel-like round appearance when lying down and teardrop shape when standing up.
  • Have multiple stacked baffles which have them jiggle like gel implants and not wave like saline implants
  • Have less rippling than both.
  • Have less leak rate than both.
  • Have less capsule contracture rate than both.
  • Have the ability to be asymmetrically filled like the saline implant.
  • ie, they look and feel more natural with fewer concerns regarding leak and cancer.

Dec. 7, 2016 at 12:18 PM  |  Sarah Elizabeth Richards  |  TODAY


Dr. Dean Kane, a Board Certified Plastic Surgeon of Baltimore, Maryland enjoys reblogging factual and interesting article to add to his substantial website archive. Please enjoy the following.

When Darline Miller got breast augmentation surgery 16 years ago, she wanted to fit in with a culture that prized women’s large breast size. She went up from her natural “B” cup to a fuller “C” on her petite frame.

But about a year ago, Miller was tired of her bigger chest. It was a pain shopping for supportive running bras or bikini tops that didn’t reveal “too much side boob.” Her breasts got in the way of her golf swing. She also worried breast implants might pose long-term health risks.

“I was at that point in my life that I didn’t need any more hassle,” said the 45-year-old San Diego resident, who works as a property manager. “When I first got them, I wanted to conform. Now that I’m in my 40s, I just want to be me.”

So Miller did what she never imagined 16 years ago: She had her breast implants removed.

Miller is part of a growing trend of women opting for breast “explant” surgeries. British Vogue recently faced a backlash when it asked “whatever happened to the cleavage” in its December issue, after noting the lack of pushed-up breasts on runways and red carpets. But some plastic surgeons are clearly seeing more requests for a smaller look.

Even if a more natural, flatter look is more popular, breast augmentation is still the second most popular cosmetic surgery for women.

In 2015, there were more than 38,000 breast implant removals performed, according to the American Society for Aesthetic Plastic Surgery, which started tracking the procedures just last year because plastic surgeons reported more patients were requesting them. During the first nine months of 2016, more than 400,000 people visited the Breast Implant Removal forum on RealSelf, an online community for plastic surgery consumers — a 22 percent increase since 2015.

The majority of women ask for the implants to be replaced with smaller ones.

“Women are downsizing or having them taken out altogether,” said Laguna Beach, California, plastic surgeon Dr. Daniel Mills, president of the ASAPS. Mills performs about 110 explant surgeries a year that cost between $8,000 and $12,000. The majority of his patients have had their implants for decades.

Dr. Kane adds there are other concerns not revealed in this article.

  1. “Removal or breast implant downsizing will also leave more ptotic (sagging) breast tissue and skin. It is the additional breast lift that adds the cost quoted by Dr. Mills.
  2. As we age, the heaviness of the implants, once easily lifted impacts a woman’s posture and fatigue. Explanation and breast lift reduce the weight and lighten the forces acting on the neck and chest skeleton.
  3. Newer style implants provide a better shape and appearance for the older patient.
  4. Women wish to free themselves of supportive tops and slip into upper wear as simple as a tee shirt. My practice has seen a dramatic increase in breast implant revision surgery with implant size reduction and lift as the article portrays.

Implants wear out

Explant surgeries are highest in the 35-50 age group. “They might have gained weight and now feel their breasts are too massive,” said Mills. “Or they realize they’re not going to Coyote Ugly and dancing on the bar anymore. They’ve got kids in soccer.”

There may be another factor: Implants wear out.

Manufacturers of both silicone and saline implants recommend replacing them every 10 years. The Food and Drug Administration warns of potential complications, including hardening of the area around the implant, rupture, asymmetry and scarring that might require re-operation or implant removal.

Even if a more natural, flatter look is in fashion, breast augmentation surgeries are still the second most popular cosmetic surgery for women after liposuction in the U.S. More than 300,000 procedures were performed in 2015, double the rate from 2000. Numbers for 2016 aren’t available yet, so it’s not clear if fewer women are getting them in the first place.

The women who do are opting for smaller sizes or requesting breast lifts or fat-grafting, which only increases size about a cup.

‘I just like the natural look’

Culturally, the love of big breasts is still as strong as ever, even if they’re not quite as enormous as before, said David B. Sarwer, associate dean for research at the College of Public Health at Temple University.

“We see the ideal is still curvy bodies with large breasts,” said Sarwer, who studies the psychological aspects of cosmetic surgery. “Yet women are also engaging in higher levels of intense physical activity, and they’re finding that the larger-sized implant impairs their ability to be as active as they want to be.”

Another sign of the trend: sales of bralettes, the flimsy athletic undergarments that don’t support larger breast sizes, are soaring, said Elisabeth Dale, founder of The Breast Life, a website about lingerie trends and breast health.

Before her breast explant surgery in September, Miller worried she’d regret it.

“My implants had been such a part of me for so long,” she said.

She decided against smaller implants, instead going for an internal lift of the extra skin that left her breasts slightly bigger than they were before implants.

She’s happy with the results. “I just like the natural look of it,” she said. “It’s like there’s no barrier between me and the world anymore.”

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

Give us a call at  410.602.3322  or email Lauri@DrDeanKane.com and make an appointment soon. We’re located on Reservoir Circle just a block off the Baltimore beltway, convenient to greater Baltimore, Annapolis, the Eastern Shore, Southern Pennsylvania, Delaware and Carroll County.

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