Explantation (Removal of Implants Without Replacement)
Though breast augmentation has been one of the leading cosmetic procedures for several years and typically has a high rate of patient satisfaction, there are situations in which some women wish to or need to have implants removed. If you are dissatisfied with the appearance of breast implants or are experiencing complications, you may be interested in breast implant removal.
Can I have my breast implants removed?
There are several reasons why a woman might want to undergo removal of their implants. Breast implant removal is possible and may be warranted for a number of reasons. Circumstances for this procedure includes:
- You have a ruptured/deflated implant and do not want to replace them
- You have capsule contracture but do not want to replace your implants; you just want them out
- There is a desire to return to a completely natural state
- You have gained weight and now you have more than enough natural breast tissue and no longer need breast implants
- You no longer want your breast implants
- You have systemic symptoms that you believe are related to your breast implants – understand that the existence of breast implant illness (BII) has not been substantiated – there is no guarantee that removing your implants will give you relief of your symptoms.
If I have my implants removed, will My Breasts Look Like they Did Prior to Breast Augmentation
When contemplating implant removal without replacement, the most frequent question I am asked is “what will my breasts look like after removal of the implants, will they look like they did before I got implants?” It is impossible to predict what the breasts will look like after implants are removed, although in some cases, you can make an educated estimation, but that is on a case by case basis. Your breasts will continue to age, with or without implants. The longer your implants have been in place, the less likely your breasts are after implant removal to resemble the way they looked when the implants were first placed. Consider that since your implants have been placed, your breasts have naturally aged and they have been lifted off the chest wall and stretched by the implant. Therefore, your breasts usually (but not always) will not resemble the way you last remember them before your breast augmentation surgery.
Will I need a breast lift?
When breast implants are removed, there is a potential for the skin and superficial tissue to be too loose to “bounce back.” In such a situation, removal without a breast lift could result in significant drooping. By lifting the breasts, volume and height can be improved using natural tissue alone. There are surgical options that allow the surgeon to optimize the appearance of your breasts after removal of implants. The most common complaints are sagging of the breast and loss of upper breast fullness.
If your breasts have stretched significantly, a breast lift can be performed. This will involve a scar around your areola, and almost for certain a vertical one from the lower areola to the lower breast crease. Surprisingly, both scars usually heal quite nicely. The quality of the scar depends greatly upon your own tissue biology of healing. No one can change this. Depending upon the amount of excess skin, a scar may also be required in the lower crease of the breast.
Is Fat Transfer an Option?
If you are lacking in upper breast fullness, fat can be taken from your abdomen, flanks, and/or thighs and transferred to the upper portion of your breasts to restore some of the lost contour after explantation. This is a simple procedure to do and can greatly improve the overall appearance of your breasts. Not all the fat will survive, so more is put into the breast at surgery than is desired in the result.
Are there any risks to having breast implants removed?
Breast implant removal carries some of the same risks that are present in breast augmentation. These include bleeding, infection, anesthesia risks, diminished nipple sensation, and poor scarring. A change in nipple sensation is extremely unusual as removal of an implant generally does not put the nerves to the nipple at risk unless another procedure such as a breast lift is performed at the same surgery. During your consultation, Dr. Epstein will discuss potential risks based on the details of your case.
Breast Implant Removal Surgery
Dr. Epstein conducts a thorough consultation and examination to determine the best surgical procedure to achieve the desired outcome. The surgical procedure is performed on an outpatient basis and may involve local and twilight anesthesia or general anesthesia. Details regarding anesthesia and surgical techniques are discussed well before the day of surgery.
If implants are being removed, but not replaced, and capsular contracture has occurred, the capsule, or layer of scar tissue around the implant, usually does not need to be removed (capsulectomy). I generally do this only if the capsule is calcified, which is an uncommon finding. Any additional tissue removal or adjustment is conducted through the same incisions as implant removal or replacement. If a breast lift is needed to refine shape after implant removal, additional incisions may be required around the areola and from the bottom of the areola to the lower breast crease (“Lollipop scar”). Tissue and skin are adjusted through this incision to relocate the breast to a higher position on the chest wall.
If implant removal is all that is required, I do not generally place drains. If a capsulectomy is required as well, but without implant replacement, then I usually do place a drain. If required, drains are secured into place to facilitate fluid drainage from the surgical site. These may be removed within a few days to a week after surgery. Discomfort is usually minimal after implant removal surgery. Drains removal is generally painless.
If I have my implants removed, can I get implants again at a later date?
Breast implant surgery may occur at any point after implant removal. When breast implants are removed due to infection or capsular contracture, there may be an increased risk of tissue hardening after the revision procedure. However, most implant revisions are straightforward and successful when conducted by an experienced, board-certified plastic surgeon.