Once the most popular procedure performed by plastic surgeons, breast augmentation has dropped down to number two. There are a variety of reasons for this but over the last few years the number of women choosing to remove their breast implants is increasing.
The reasons for removing implants range from personal preference to complications. The surgical technique used for breast implant removal—also called explant surgery—depends on the reason the patient is choosing to remove her implants and is something I discuss with each patient during their consultation. Breast implants are durable devices that have been studied more than any other medical devices for safety, but unfortunately they do not last forever. The question of when you should remove your breast implants is one that virtually every breast augmentation patient will ask at some point. Many women choose to replace their implants, but implant removal is an increasingly popular option. In this blog post, I’ll describe the different reasons for implant removal and the various techniques used for explant surgery.
Reasons for Removing Breast Implants
The decision to remove breast implants is often one that women think about for months or more before scheduling a consultation with a plastic surgeon. In some cases, it might be that the implants have simply worn out. There is no specific “shelf life” for implants, but typically they need to be removed or replaced every 10 to 20 years. That’s why, in addition to getting regular mammograms, women with breast implants should also schedule ultrasounds every 3 years to ensure the implants remain intact.
Some of the most common reasons for removing implants include:
Personal preference: Aesthetic ideals change over time. So do lifestyles. You may lead a more active life now, and having larger breasts is uncomfortable. Implants can also change shape over time, and you may not be as happy with the appearance of your breasts as you were initially.
Complications: The risk of complications after breast augmentation is relatively low, but they can occur. The most common issue is a condition called capsular contracture. This happens when the scar tissue surrounding the implant hardens, squeezing the implant and creating an unnatural look. It can also be painful.
Ruling out implants as the cause of health problems: Some women with breast implants develop chronic health issues, such as weight gain fatigue, joint pain, hair loss, mental fogginess, anxiety and depression. These issues are often included under the umbrella of breast implant illness (BII), which consists of a variety of symptoms. There is no specific clinical definition of BII, but our practice supports patients who choose to remove implants if they believe implants are related to their symptoms. Another medical concern, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), has also prompted some women to have implants removed.
How Is Breast Implant Removal Performed?
I create custom surgical plans for each of my explant surgery patients because each person has unique conditions and concerns. The most common techniques used for this procedure include:
Simple implant removal without capsule removal: This is the least invasive technique and involves removing the implant only. It’s possible when there is minimal to no capsule formation, the implant is unruptured and in good condition and the patient has no systemic symptoms.
Implant removal with capsule removal: Also called total capsulectomy, this technique removes both the capsule and implant separately. This procedure is more invasive and can cause more tissue and muscle trauma but if performed carefully it can be successfully performed to minimize damage to breast tissue and muscle. This is the technique I utilize the most for under the muscle explant surgery.
Implant removal with en bloc capsulectomy: The most technically demanding option, an en bloc capsulectomy removes the implant and capsule of scar tissue intact in one piece. This is the technique I utilize the most for on top of the muscle explant surgery. I also utilize this technique for ruptured silicone gel implants on top of the muscle and below the muscle because the capsules are thicker and sometimes even hard and calcified.
Implant removal with en bloc capsulectomy and breast lift: A breast lift is typically necessary to restore an attractive, more youthful shape to the breasts after removing breast implants. After implants have been in place for years the implants become the foundation and support of the breasts. When you remove the implants the support goes away which can result in sagging or drooping. I perform many types of lifts such as “Donut”, “Lollipop” and “Anchor-Style” lifts. The type of lift is selected based on each patients unique anatomy.
Your Choice of Surgeon Matters
Explant surgery requires a plastic surgeon with unique skills because of the complicated nature of the procedure. Dr. Masters specializes in breast implant removal surgery at his Oklahoma City practice and has years of experience performing complex breast surgeries. If you’re considering removing your breast implants, request a consultation with Dr. Masters using the online form or by calling us at (405) 849-6354.
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