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Breast Implant Removal & Exchange

Some women who have had a breast augmentation may, at some point, consider exchanging their implants or even having them removed all together. The reasons vary from individual to individual and range from personal choice to medical need.

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Our goals, tastes and life situations change over the course of one’s life and a decision made when you had your breast implants placed may be quite different years later. Some women may want to change their size, switch to a different fill material or simply remove their breast implants. Changing breast implants may be related to changes in one’s breasts that occur with having children or simply with age. The loss of support, loss of volume or thinning of breast tissue may require a different size or type of breast implant to achieve the best look and feel of one’s breasts. Some women may develop a problem, such as capsular contracture (hardening of the breast) or implant rupture. Finally, some may develop a medical condition such as breast cancer (which can lead to breast reconstruction surgery) or concern for breast implant illness and get medical advice that it may be best to have their implants.

Implant removal (also known as explantation), with or without replacement, should be performed by a board-certified plastic surgeon (certified by the American Board or Plastic Surgery).

Am I a Good Candidate for Breast Implant Removal Surgery?

When considering a patient for breast implant removal with or without replacement, a surgeon must first understand your reasons you are seeking removal. An experienced plastic surgeon can advise you on what options you have to achieve your goals. The surgeon must also assess your overall surgical risks. This is based on the procedure planned and your overall health. It is the weighing of benefits of surgery against the risks of that surgery that determine whether you are a good candidate.

Breast implant removal by itself, in most cases, is a fairly minor procedure and tolerated by even someone with significant medical conditions. Things can get more tricky when more needs to be done.

What Is the Breast Implant Removal Process?

The process begins by having a consultation with a board-certified plastic surgeon (certified by the American Board or Plastic Surgery) who will discuss your concerns,evaluate your overall health and examine you. They will then discuss with you their recommendations including the specific of the procedure, options and alternatives, as well as the risks involved. You should be given the opportunity to ask any questions you may have. You should be open minded to their advice but not feel pressured. In most cases, with breast implant removal or exchange there is no urgency to make a decision and a second opinion is always an option.

Breast Implant Removal Surgery

The surgery can vary greatly depending on your needs. In its most simple form, removing a breast implant may simply involve making a small incision, removing the implant and sewing up the incision. The complexity increases when more is needed such as removal of the scar capsule or the addition of another procedure such as a breast lift.

Complexity of the procedure will determine the type of anesthesia needed to make the surgery is as comfortable and safe as possible. This can range from local anesthetic alone to intravenous sedation to general anesthesia. Dr. Pollock will discuss this with you during your consultation and will recommend the best anesthesia option for you.

The incisions may vary but whenever possible, Dr. Pollock will use your previous incision. This isn’t always possible as some incisions used to place an implant in the original surgery may not be adequate to perform what is needed in this secondary procedure. The needs of the procedure and your preferences will determine which incision is best for your situation. The most common incision used is the inframammary incision (in the crease under the breast) which allows good access for the surgeon, typically heals with a good scar and is well hidden. A breast lift is planned, your surgeon will discuss the incisions needed.

The surgery is done as an outpatient (meaning you go home after surgery) unless other procedures are done at the same time or your health requires it.

Special Circumstances

When considering removing breast implants without replacement:  Many women who are considering removing their breast implants and not replacing them want to have an idea of what size their breasts will be without implants. If the implants are saline, they may be easily deflated in a minor procedure under local anesthesia. This way the patient may live without an implant for a period of time to make this decision. This also can be helpful to determine whether a breast lift may be needed once the implants are removed.

Rupture silicone implants:  Older silicone breast implants are filled with a liquid silicone and when these ruptured, the implant needs to be removed along with the surrounding scar tissue to assure that all of the sticky silicone is removed. Removal of the scar tissue is called a capsulectomy. Newer implants are filled with a cohesive silicone (sometimes referred to as “gummy bear” which is an analogy for the silicones characteristics and not a specific type of implant) which is more of a semi-solid and the silicone sticks to itself. This type of implant usually does not require the surrounding scar tissue to be removed if ruptured making the procedure simpler and the risks and recovery less.

Women considering implant removal for concerns about Breast Implant Illness (BII):  When considering removing a breast implant for BII, there are some that recommend removing all of the surrounding scar tissue tissue and the breast implant as one unit which is referred to as an en bloc capsulectomy. The reasoning is that if the implants contained something that is causing an illness, the scar capsule may contain that material as well. It is controversial as to whether this is necessary. It also adds more complexity and risk to the procedure. While it is more complex, it does not require a specialized surgeon, as often stated online, but simply a surgeon experienced in doing capsulectomies. The decision to remove the implant alone or as an En Bloc procedure is best discussed with your surgeon.

A word on Breast Implant Illness

Some women who have breast implants and also have common and wide ranging symptoms (such as fatigue, joint pain, muscle aches, headaches, rashes and many more) feel that they are due to their breast implants. While these symptoms may be very real, they are very diverse and there is no consistent pattern and the association between the symptoms and breast implants has not been scientifically proven. In fact, removal of the implants sometimes relieves these symptoms. However, this doesn’t prove that the implants are the cause. These questions have been around for a while but the internet and social media have amplified the discussion. As plastic surgeons, we are sensitive to the patient’s concerns and open to the possibility of an association. Research is currently being done into BII. But in the meantime, a frank discuss with a plastic surgeon.

What Can I Expect During My Breast Implant Removal Recovery?

The recovery varies with what needs to be done. If the surgery is limited to just removing the implant or a simple implant exchange, recovery is relatively easy with some discomfort at the incision site. With the addition of a capsulectomy or a lift procedure the recovery may be a little longer and require some limitations on your activities.

Following surgery the incisions will be dressed in a surgical gauze. You may also be placed in a surgical bra that gives compression and support.

When removing the capsule is necessary, drainage tubes are sometimes used to prevent fluid accumulation during recovery. These are most commonly removed within days but that can vary based on how much fluid is draining.

Patients are provided with post-operative care instructions, which should be strictly adhered to during recuperation. You should plan to take it easy early after surgery though most patients are back to most of their usual activities well within a week. The exception is vigorous exercises, running that will make your breasts bounce, straining or lifting greater than a few pounds. These activities may increase your risk of bleeding and be more uncomfortable. Specific recommendations are dependent on what was done in your surgery and will be specified by Dr. Pollock.

What Results Can I Expect?

Breast implant removal is designed to remove the breast implants along with any hardened scar tissue around the implants. If you opt for new breast implants, then your results will vary depending on your selections. Patients who remove their breast implants without replacing them will be left with only the remaining natural breast tissue.

Dr. Pollock and his team of professionals are dedicated to providing optimal care in a safe, comfortable environment. Every patient is unique and has different cosmetic goals, so please bring up all of your concerns, preferences, and desired results during the consultation.

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