Send us Fan Mail

Would you choose the same breast implants today? For some patients, the answer changes after pregnancy, weight loss, or years of living with a size that no longer feels right. Others start thinking about removal when one breast suddenly looks smaller, an implant feels firm, or the breast sits lower than it used to. In this episode of Fuller Butz: A Behind the Scenes Plastic Surgery Podcast, Dr. Sam Fuller and Dr. Daniel Butz walk through what brings patients in for a breast implant removal consultation and how they decide what to do next.

The conversation starts with a question the surgeons ask in consultation: what would you most like to change? Maybe you want less volume because running feels different or clothes fit differently than you’d like. Maybe your own breast tissue has changed with age, pregnancy, or weight fluctuations, and you still like the volume but want a different shape. Dr. Fuller and Dr. Butz explain ptosis, the surgical term for breast droop, and why they look at the nipple position, skin, breast tissue, and implant position separately. A breast can look lower even when the implant itself is intact.

Then they get into rupture and deflation. When a saline implant ruptures, the breast typically loses volume as the body absorbs the saline. A silicone gel implant can rupture without an obvious change in size or shape, and imaging can help identify it. The surgeons explain how the implant type, exam, and imaging findings guide the conversation. They also discuss capsular contracture, when the scar tissue around an implant tightens and can make the breast feel firm, look distorted, or become uncomfortable.

The episode also covers two topics that often come up together online. Breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) is a rare, recognized lymphoma associated primarily with textured implants. The doctors explain why persistent new swelling or a lump years after surgery needs evaluation before an operation is planned. Breast implant illness (BII) is a term patients use for symptoms such as fatigue, brain fog, and joint pain. Some patients report feeling better after implant removal. The cause of these symptoms and who is likely to improve remain uncertain, which makes it important to hear the patient’s concerns and consider other possible causes.

What can the surgery actually involve? Implant removal alone may mean less dissection and lets patients go without another device, though they may notice less upper breast fullness, loose skin, or more visible asymmetry. Removal with a capsulectomy takes out some or all of the scar tissue surrounding the implant. The surgeons explain when a tight or abnormal capsule can change the plan, why taking out more scar tissue can add surgical risk, and why the term “en bloc” has a specific meaning in cancer surgery. Implant exchange can preserve fullness or allow a patient to downsize, with the ongoing possibility of future implant-related surgery.

For patients who want to go without implants but still want to change their breast shape, the doctors discuss a breast lift and fat transfer. A lift can remove excess skin and reposition the nipple, with scars that vary according to how much reshaping is needed. Fat transfer can add some volume using fat from elsewhere on the body. It requires enough donor fat, and some of the transferred volume is lost as healing progresses. Depending on the exam and the patient’s goals, these procedures can be combined with removal or considered later, once the breast has settled.

Along the way, Dr. Fuller and Dr. Butz share the questions they want patients to ask. How much fullness am I comfortable losing? What scars would I trade for a lift? Is there a reason to remove my capsule? And what might my breasts look like if I simply take the implants out? The answers depend on what brought you in and which changes matter most to you.

Send us Fan Mail

In this episode of Fuller Butz: A Behind the Scenes Plastic Surgery Podcast, Dr. Sam Fuller and Dr. Daniel Butz take on the questions patients ask all the time—and a few they may be a little embarrassed to bring up. With their usual candid conversation and perspective as plastic surgeons, Sam and Dan cover breast augmentation, breast lifts, fat transfer, tummy tucks, symmetry, and more in a rapid-fire Q&A.

First up: breast implants and what they actually feel like. Can you feel an implant after breast augmentation? Can someone else? The answer depends on several factors, including the amount of natural breast tissue you have, the implant’s position, and your individual anatomy. Sam and Dan discuss what patients might notice and why the look and feel of an augmentation can vary from person to person.

They also talk about a question that comes up frequently for women planning a family: What happens to breast implants when you breastfeed? The conversation covers the difference between the implant itself and the changes breast tissue can experience during pregnancy and breastfeeding. They also explain why breastfeeding ability can depend on several factors, including the type of surgery performed and a patient’s individual circumstances.

Another popular topic: Can you get upper-pole fullness with a breast lift alone? A lift can reshape the breast and move the nipple into a higher position, but it doesn’t add volume the way an implant or fat transfer can. Sam and Dan discuss the trade-offs, what may be possible with your own tissue, and how to think about the results you’re hoping to achieve.

The hosts also tackle symmetry—because breasts are sisters, not twins. Some degree of asymmetry is normal, and it can involve breast size, shape, nipple position, or the chest wall itself. Sam and Dan explain how a customized surgical plan may improve balance, while setting realistic expectations about what surgery can accomplish.

Curious about fat transfer? They discuss how fat can be taken from one area of the body and used to add volume or refine contours elsewhere. They also cover why fat transfer may be a good option for some patients, why it may not replace an implant for everyone, and why the amount of volume that remains can vary.

The rapid-fire questions continue with abdominoplasty, better known as a tummy tuck. Sam and Dan talk through common concerns about loose skin, abdominal muscle repair, scars, recovery, and how a tummy tuck differs from liposuction. They also discuss why the right procedure depends on what’s causing a patient’s concerns and what they want to improve.

Throughout the episode, the conversation goes beyond simple yes-or-no answers. The doctors share why anatomy matters, how to think about the trade-offs between procedures, and why a thoughtful consultation is the best place to discuss your individual goals.

Whether you’re considering breast surgery or a tummy tuck, researching your options, or simply curious about what happens behind the scenes, this episode is packed with straightforward answers to questions you’ve probably wondered about—and a few you might not have thought to ask.

Tune in for a fast-paced, informative conversation with Sam and Dan as they unpack some of the most common questions in plastic surgery.

Send us Fan Mail

Every patient hopes for one thing after surgery: to love their results and never look back. The truth is that avoiding regret starts long before you enter the operating room.

In this episode of the Fuller Butz Podcast, Dr. Sam Fuller and Dr. Dan Butz discuss the most common reasons patients experience regret after plastic surgery, and most of them have very little to do with the surgery itself. From choosing a surgeon based solely on price to traveling out of the country for discounted procedures, we explore how seemingly small decisions can have a lasting impact on safety, recovery, and long-term satisfaction.

We also dive into the importance of setting realistic expectations. Plastic surgery can be life-changing, but it cannot create perfection or solve every insecurity. Understanding what surgery can and cannot accomplish is one of the biggest predictors of a happy outcome.

Recovery is another area where patients often underestimate their role. Following post-operative instructions, attending follow-up appointments, wearing compression garments when recommended, avoiding nicotine, and giving your body the time it needs to heal are all essential parts of achieving the best possible result. Even the most technically perfect operation can be compromised when recovery instructions are ignored.

Finally, we share practical tips for choosing the right surgeon, asking the right questions during consultation, recognizing red flags, and making decisions that prioritize safety over short-term savings.

Whether you're just beginning to consider plastic surgery or already have a procedure scheduled, this episode is packed with practical advice to help you make informed decisions, maximize your results, and approach surgery with confidence.

The best plastic surgery isn't just about what happens in the operating room. It starts with thoughtful planning, realistic expectations, and a commitment to the recovery process. If you want to make the best possible decisions and give yourself the greatest chance of loving your results, this is an episode you won't want to miss.