When patients think of breast implants, they often envision volume, fullness, and shape. But the reality is that many women eventually elect to remove their implants, whether with or without the surrounding capsule, due to personal reasons, illness, complications, long-term impacts like ruptures or capsular contracture, or personal choices.
Depending on a woman’s breast and implant size, the skin and tissue over the implant can become stretched, thinned out over time, and widened and elongated by the implant. Especially for women who’ve experienced weight changes, pregnancy, or aging, merely removing their implants can lead to loose skin and deflated, longer, and wider breasts that sit lower than before the implants.
This is when the process of Breast Creation truly begins.
Photo Credit: ViDI Studio/Shutterstock
I work with patients to augment their breasts, sculpt them, project them, and refine their final form, particularly in cases where the breast skin and tissue need reshaping. In these cases, what I call an “Internal Dermal Bra Breast Lift” (IDBBL) becomes the foundation for creating a youthful, natural-looking silhouette.
Following breast implant removal, a breast lift is often performed to reposition the existing breast tissue and nipple-areola complex to a more youthful, elevated position while removing excess skin and reshaping the breast mound. When done correctly, the result is balanced, proportionate, and elegant.
The Power of the IDBBL Technique
I often recommend the IDBBL for patients needing a higher level of support, especially those with significant laxity and stretched-out breast tissue. This advanced technique is one that I’ve developed and refined over many years of surgical practice.
Whereas standard breast lifts only aim to lift and reshape the breast by removing excess skin, the IDBBL involves creating a hammock-like support system using the patient’s own tissue and anchoring sutures to reinforce the upper and lower poles of the breast from the inside. This approach helps control the breast’s shape, as well as its height, width, projection, location, and the amount of cleavage the patient desires following their implant removal. It’s particularly effective for patients who have had previous surgeries, experienced weight fluctuations, or are genetically predisposed to weaker tissue.
The IDBBL is not about making the breast artificially perky. It’s about respecting the patient’s natural anatomy and creating support from within. This allows the breast to sit where it should, on the mid-third of the chest, and achieve a natural-looking shape, maintaining a lasting aesthetic contour.
Individualized Design for Every Patient
No two bodies are the same, so every procedure must be customized. Whether it’s a standard lift, an internal bra, or a combination of both, my chosen technique depends on your unique tissue quality, skin elasticity, chest anatomy, and personal goals.
Some patients come in after a previous augmentation that left them with unsatisfying results, while others may simply want to remove their implants due to other reasons, but want to ensure the longevity and shape of their breasts. In both cases, we redesign, reposition, and restore the breast itself.
That’s why I refer to this process as “breast creation,” not just augmentation. We’re not simply inserting an implant. We’re crafting a breast that fits your body, lifestyle, and sense of self.
A Natural Look That Lasts
My philosophy is simple: enhancement should never look like surgery. When you look in the mirror, you should see yourself refreshed, uplifted, and aligned with how you feel. Through techniques like the IDBBL, I can create results that appear effortless and age beautifully over time.
Patients often tell me their biggest fear was looking “overdone.” But with thoughtful planning, precision technique, and a commitment to individualized care, that concern quickly fades. The end goal is always the same — natural, harmonious, and confident.
Whether you’re revisiting past results or starting fresh, breast creation after implants offers an opportunity to refine your shape, strengthen your support, and embrace a look that finally feels like you.
– As a graduate of one of the top Medical Schools in the world, the University of Cambridge, Dr. Agha was selected into the highly exceptional physician scientist program (integrated MD / PhD) on a scholarship funded by The Wellcome Trust. During this time, Dr. Agha’s research in Gene Therapy resulted in two international patents filed by Cambridge University. Dr. Agha then completed a 7-year residency in Plastic and Reconstructive Surgery at the University of Pittsburgh Medical Center, one of the most respected and comprehensive Plastic Surgery training programs in the United States. Dr. Agha has spent the last 15+ years perfecting the art of aesthetic facial surgery, breast reshaping, and body contouring. During this time, he has pioneered new techniques in the field of plastic surgery, such as his signature three-dimensional facelift, high-definition tummy tuck, high-definition mommy makeover, spiral thigh lift, dermal bra-suspension breast lift, and high-definition Brazilian butt lift.
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