Breast Implant Removal (Explantation)

Who is the Ideal Candidate for Breast Implant Removal?

The typical candidate for breast implant removal surgery is no longer satisfied with their breast implants and would like to have them removed. The most common reasons for removal include pain or discomfort associated with the implants, damage to one or both implants (such as a rupture or a leak), capsular contracture, or because the patient is unsatisfied with the way the implants look or feel.

An ideal candidate for breast implant removal is one that feels motivated to remove the implant, and is also:

• In good physical health
• At a healthy, stable weight
• Is a non-smoker
• Has realistic expectations about their surgery

A board-certified plastic surgeon will discuss the patient’s medical history, their cosmetic surgery background, physical health status, and their motivations for breast implant removal during an initial consultation. If the prospective patient is considered a good candidate for breast implant removal, they will be given more information on the procedure and how to prepare themselves for surgery.

What are the Pros of Breast Implant Removal?

The pros of breast implant removal will vary depending on the patient, their reason for removing the implant, their medical history, health background, and many other factors unique to their situation. In general, those that wish to have breast implants removed are doing so for important reasons—whether to improve their health, eliminate pain or discomfort, boost their self-confidence, or a combination of these.

In general, the pros of breast implant removal also include reduced implant-related stress. Having implants requires regular maintenance and attention, especially monitoring implant rupture. The U.S. Food and Drug Administration recommends that women have regular MRI screenings performed after having a breast augmentation with silicone implants—starting three years after surgery and every two years after that, for as long as the patient has the implants. The cost of regular MRI screenings can add up over the lifetime of the patient, and breast implant removal can sometimes come as a relief that rids the patient of this monetary and time-consuming obligation.

Living in constant fear of the rupture of an implant can cause emotional stress in some patients while dealing with an actual leak can be quite tricky in and of itself. Stress-related anxiety over implant ruptures is especially true for patients with older breast implants. Rupture rates for both silicone and saline implants were as high as 10% in the recent past—before the availability of cohesive gel silicone materials, which are much less likely to become damaged. Ruptures can be quite expensive to fix as well, with estimates for breast implant revision, screenings, and rupture and revision surgery costing anywhere between $637 and $2908. In other words, breast implant removal can be quite a relief for some patients, even if they are having them replaced with newer and superior implant materials that are safer, more comfortable, more attractive, and less likely to rip, tear, leak, or cause other problems.

Another significant health benefit that can come with breast implant removal is safer mammogram screening. According to the FDA, women with breast implants are at risk for delayed detection of breast cancer and other breast diseases during mammogram screenings. Implants can obscure the visibility of the breast tissue during examinations, which results in lower-quality and less-thorough or accurate results. They are also at risk for capsular contracture, rupture, pain, and other adverse reactions during the compression and imaging process.

Pain relief is another significant benefit for many patients of implant removal surgery, especially if they have larger, heavier implants that cause shoulder, back, and neck pain. Patients that have suffered from capsular contractures might also experience relief from pain with implant removal once the scar tissue that has hardened around the breast implant is removed. Similarly, for many women with unexplained health problems thought to be connected with their breast implants, a breast implant removal procedure is an excellent option that often results in curing all symptoms and relieving health-related stress.

The Cons of Breast Implant Removal: Side Effects and Complications

As with any cosmetic procedure, there are also cons that accompany the pros. In all surgeries, the biggest downside of surgery includes risks and complications from general or local anesthesia, infection, scarring, swelling, deep vein thrombosis, hematoma, and fat necrosis.

For breast implant removal, in particular, the most common downsides are cosmetic. These include decreased fullness, loose, sagging or excess skin, uneven breast shape, and a loss of elasticity in the natural breasts after implant removal. For some patients, the doctor will need to remove more breast tissue than expected, which can intensify this adverse aesthetic effect. This is usually due to a rupture of an implant (and leakage of the gel or other materials into the breast tissue) and can result in the patient appearing to have had the entire breast removed—such as in a full or partial mastectomy. In some cases, patients will want to have a breast lift done to decrease these symptoms, or breast augmentation with fat transfer procedures to mitigate these side effects.

Complication risks that are not cosmetic include increased loss of feeling in the nipples (especially if your previous augmentation surgery resulted in a partial loss of sensation) and poor healing around the incision sites that could lead to infection.

Ask your doctor what cons you can realistically expect for your breast implant removal, and what you can do to deal with or reduce the risk of these downsides if you decide to proceed with the surgery.