Dr Q has come up with a novel and intuitive surgical procedure for women desiring removal of their breast implants without replacement implants to help create central fullness of the breast without placing a new breast implant or having to perform any fat-grafting- she is calling it the “Q-Flap” Breast Reconstruction after Explantation. The procedure uses a woman’s native breast tissues and repositions it up against the central-lower chest wall to help secure it with sutures and create an “auto-augmentation” of the central breast where all the volume gets lost after removal of a breast implant to help prevent some of the contour and “concave-in” deformity behind the nipple that can be generated after removal of implants (explants) without replacement. Fat-grafting procedures may not be ideal for a variety of reasons- firstly, one cannot predict exactly how much of the transferred fat will survive… and most surgeons only give a “50 % chance” of fat-take or overall viability of the fat after transfer which is not great. Fat viability after transfer can depend on surgical technique, donor site, the health of the recipient site as well as many other factors. Oftentimes, the amount of fat that can be transferred is limited to the recipient site and may not be enough… resulting in the potential for “serial” fat-grafting procedures that can become both painful and costly to the patient. Using a patient’s native local breast tissues allows a good amount of breast volume to be utilized in a single-stage surgical procedure after explant and capsulectomy.
So who is a good candidate for the Q-flap? Any woman who desires removal of her breast implants without any replacement implants and has a fair to good amount of her own breast tissue is likely a good candidate. Women with saggy breasts are also good candidates for the Q-flap with mastopexies (breastlifts). Typically, a woman should have a starting breast size of at least a Full C-cup size (with implants) prior to explantation to be a good Q-flap candidate. Women with smaller breasts, very thin women, and women with extremely thin (“paper-thin” native breast tissue) are NOT good candidates for the Q-flap, and Dr Q can better help determine a woman’s candidacy during the office Consultation. Women who have had the troublesome issue of postoperative Capsular Contractures (hardening of the breast tissue around a breast implant) and thus desire to get rid of their implants for good may be ideal candidates for the Q-flaps reconstruction in order to avoid new implants, as well as severe deformity after explantation. Some women after explantation then have very deflated breasts that can be not only much smaller, but can oftentimes lose all the upper pole and central breast fullness causing a “scooped-in”, or cancave-in type deformity similar to a severe ski-slope deformity that is not ideal and this is where the Q-flap can truly help. Women with severe breast deformities pre-operatively need to be realistic regarding their ultimate aesthetic goals and sometimes revisionary procedures or staged procedures may be required. However, great results can oftentimes be attained in a single surgery with the Q-flap.