What is this procedure?
The goal of breast implant removal surgery is to remove breast implants from breast augmentation or breast reconstruction patients. Often, the scar tissue that forms after the placement of an implant is soft and does not need to be removed, but it may harden, causing pain and discomfort.
The goal of breast implant removal surgery is to remove breast implants from breast augmentation or breast reconstruction patients. During these procedures, the surgeon may also remove silicone material from implant leaks and the breast capsule, which is the scar tissue that forms after the placement of a breast implant. Often, the scar tissue that forms after the placement of an implant is soft and does not need to be removed, but it may harden, causing pain and discomfort. This is often a reason to have the implants and scar tissue removed.
Breast implants are not lifelong devices and it is important to have them exchanged or removed approximately every 10-15 years. This decision is typically based on the individual and the patient’s needs and desires.
In some cases, the outside shell of the implant breaks down causing silicone to leak and the scar tissue around the implant to harden. It is important to understand that your implants should be removed for this reason.
Who needs this procedure?
Breast implant removal might be a good choice for you if:
You’re unhappy with the way your breast implants look. The majority of women who have their implants removed do so because they’d like to see some type of esthetic change to their breasts. Some women experience shifting, sagging, or changes due to age, weight fluctuations, or pregnancy, others simply want to return to their natural cup size. Many women feel that their breasts, with implants, no longer match their body or their lifestyle. They may have gained weight, had a baby, gone through menopause, or taken up marathon running.
The scar tissue (or capsule) around your implants hardens or tightens. Sometimes the capsule can harden, become calcified, or shrink down around the implant, causing it to become firm, painful, or misshapen. This is known as capsular contracture, and it’s the most common complication of breast implants.
One or both of your implants leaked or ruptured. Studies of silicone breast implants, the most popular type, suggest that most implants last 7–12 years. However, some break during the first few months or years, while others may last more than 15 years. Reported rates of implant rupture vary by implant type, from 3.9% to more than 16%. The likelihood of rupture increases every year.
You’re experiencing systemic symptoms that you associate with your implants. While the FDA has made clear that it doesn’t have definitive evidence suggesting breast implants are associated with these symptoms. The potential cancer risk is one reason you might be thinking about having your implants removed. You may just want a smaller or larger size, though, or perhaps it’s time to get them out since they don’t last forever.
A brief note on the cancer the FDA is looking into: First of all, it’s not breast cancer. It’s actually a type of lymphoma called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Not every type of breast implant is linked to this cancer—only textured implants are connected to BIA-ALCL, and NBC reports that only 12% of women with implants in the U.S. have the textured kind.
Breast implant removal surgery is a highly individualized procedure. It should be performed if you have capsular contracture (hardening of the breast), pain with implants, imaging has shown a leak of the capsule and/or if you no longer desire implants or wish to exchange them.
In general, you may be a good candidate for breast implant removal if:
- You are physically healthy and at a stable weight
- You have realistic expectations
- You are a nonsmoker
- You are bothered by the appearance of your implants
- You have experienced discomfort or pain
- You feel your breasts are too heavy
- You are starting to feel your breast scar tissue is getting harder or tighter
- Imaging suggests a leak or rupture of implants
- You have experienced a rupture or leak of implants
For many women, fitness is an important part of their lives. But large implants can make jogging uncomfortable and upper body toning moves difficult.
By removing breast implants, many women have found it easier to perform their exercise routines. Complications from an infection or a leakage are also reasons why women decide to have breast implant removal.
What is the advantage of this procedure?
Breast implant removal can provide plenty of benefits for you if:
- You’ve changed and are no longer happy with the way your breast implants look because of aging, weight fluctuations or pregnancy
- You are ready to return to your breast’s natural size
- You feel discomfort due to the hardening of your implants, often caused by capsular contracture
- You feel pain, especially back pain
- One or both of your implants have leaked or ruptured
- One or both of your implants have shifted in position over time
- One or both of your implants are now sagging
Are there non-surgical treatments?
Deflation is a non-surgical option if your breasts are saline. Ultrasound is a non-invasive and non-surgical procedure that can soften the scar tissue through the use of sound waves and increasing blood supply to the area. Your breasts can be deflated under local anesthesia. However, a breast lift or breast implant replacement surgery may be necessary depending on the results of the breast implant removal surgery
What is the surgical treatment like local or sedation?
General anesthesia or intravenous sedation can be administered for your comfort during your breast implant removal.
The breast implants and capsules are taken out using one of three techniques:
Breast implant removal surgery only with the incision done in the same place as the original breast implant surgery was performed.
Breast implant removal surgery with a breast lift, if your breast skin is too stretched or sagged, to take out excess skin and tighten your breast tissue for better support. Your areolas may also be resized to fit the new shape.
Once your procedure has been completed, your surgeon will use sutures, skin adhesives or clips to close the incisions.
What is the recovery like?
The final results of breast implant removal surgery will depend largely on the size of the implants being removed and the quantity and quality of your breast tissue that is left. The scar tissue that was surrounding your implants also will play a large role in your overall outcome. Swelling and postoperative changes will also need time prior to the final results. Healing can take up to one year before the final results are visible.
Over-the-counter pain relievers such as acetaminophen may help relieve discomfort. Your doctor may also prescribe pain medication for you. You will probably have some swelling in the area where the surgery was done. Over time, the swelling should ease and the scars will fade.
The practice of medicine and surgery is not an exact science. With this particular surgery, the results are not always cosmetic because the breast tissue is thin as a result of having implants for an extended period of time. The results can also be affected if the implants have been leaking. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary. It may also be necessary to have a mastectomy if silicone has gone throughout the breast and the free-floating silicone is no longer within the scar tissue.
When you go home, if you experience shortness of breath, chest pains or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
Typically, recovery from exploratory surgery tends to be much easier than the initial surgery to place the implants. You’ll likely be sore, but there’s usually a minimal amount of pain, and narcotics aren’t usually required for longer than a day. Normal daily activities, like showering, eating, and walking, can be resumed within 24 hours after surgery.
You may even be able to return to work after a day or two, so long as your job doesn’t require heavy lifting. Restrictions on activity will vary, depending on the type of surgery, the patient’s own tissues, and how they heal.
How long will full recovery take?
The procedure can take between one to three hours. A breast implant removal surgeon will place an incision along the lower fold of your breast or around/below the areola.
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor and anesthesiologist will recommend the best choice for you.
Step 2 – The incision
A breast implant removal requires an incision to be placed along the lower fold of your breast (the inframammary fold) or an incision around or below the areola.
Step 3 – The operation
During your follow-up appointment, your doctor will be able to assess how far along your healing has progressed. Generally speaking, after two months, most patients are fully cleared to resume all normal activities.
Step 4 – Closing the incisions
Sutures, skin adhesives, tapes or clips close the skin incisions.
Your breast implant removal will result in a different shape of the breast profile, which may be flatter or droopier than before surgery and have irregularities and/or indentations. You may also notice that the breast can take on a different shape with indentations depending on how much scar tissue was produced around your implants.
What are the complications?
The decision to have breast implant removal surgery is dependent on many factors, including your overall health, if the implant is leaking, if the implant has ruptured and your personal desire. You’ll have to decide if the benefits will achieve your goals and if the risks and potential complications of breast implant removal are acceptable.
Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedures you will undergo and any risks or potential complications.
The possible risks of breast implant removal surgery include, but are not limited to:
- Poor healing of incisions
- Anesthesia risks
- Fluid accumulation (seroma)
- Skin loss
- Numbness or other changes in skin sensation
- Numbness or other changes in nipple/areola sensation
- Skin discoloration and/or prolonged swelling
- Unfavorable scarring
- Recurrent looseness of skin
- Fatty tissue found deep in the skin might die (fat necrosis)
- Deep vein thrombosis, cardiac and pulmonary complications
- Suboptimal aesthetic result
- Possibility of revision surgery
- Persistent pain
These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions directly with your plastic surgeon.
Do you need to rest up afterwards and for how many days?
Following your breast implant removal surgery, gauze dressings or bandages and you may have drains. You may be placed in a support bra or surgical garment, and there are times that a compression garment may be used to minimize swelling following surgery.
After your procedure, you may need to have drains, which are small, thin tubes temporarily placed under the skin within the pocket to drain any excess blood or serous fluid that may collect.
You will be given specific instructions that may include:
- How to care for your surgical site(s) following surgery
- Medications to apply or take orally to aid healing and reduce the risk of infection
- Specific concerns to look for at the surgical site or in your general health
- When to follow up with your plastic surgeon
- Healing will continue for several weeks as swelling decreases. Continue to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled