Choosing what comes next
The choices after explant are concrete. Close the breast as it is, with a lift of extra skin if that skin is in the way. Restore volume with fat grafting, usually more than once, because some fat does not survive. Move your own tissue when the skin is thin, radiated, or you are done with implants. Place a new implant only when the reason the last one failed will not simply repeat, and when the skin can cover it.
Those options are examined, not chosen from a list in the waiting room. Radiation, smoking, the thickness of the flaps, infection, and an unsettled pathology result are reasons to delay reconstruction or to avoid an implant. A same-day rebuild is appropriate when none of those are present and you want it.
The goal is a chest you can live in, matched as closely as the tissue allows, with scars you have been shown in advance. Dr. Sayah describes the likely number of operations. A promise of one procedure and a final result is not how this work goes when fat or a flap is involved.