Breast explant surgery, or implant removal, is a significant decision often driven by medical concerns, aesthetic preferences, or simply a desire to return to a natural state. Understanding your specific reasons and the surgical options is the crucial first step in determining if explantation is the right choice for you.
Reasons for Considering Breast Explant Surgery
Patients choose to undergo breast implant removal for a wide range of personal and medical reasons. These motivations play a critical role in the surgical planning process and post-operative satisfaction.
- Capsular Contracture: This is the most common reason, where scar tissue around the implant hardens, causing pain, distortion, and a tight feeling in the breast.
- Implant Rupture or Leakage: Both silicone and saline implants can rupture over time, potentially requiring immediate removal or replacement.
- Aesthetic Dissatisfaction: This includes changes in breast appearance due to aging, weight fluctuation, or simply wanting a smaller, more natural breast size.
- Breast Implant Illness (BII) Concerns: A growing number of women report a cluster of systemic symptoms (e.g., fatigue, joint pain, cognitive fog) that they attribute to their implants, seeking explantation as a necessary medical step.
- Preventative Measures: Some patients elect for explant due to concerns about the long-term risks associated with certain types of implants, such as BIA-ALCL (a rare type of cancer).
Explant Options: Simple Removal vs. Total Capsulectomy
There are two primary methods for breast explantation, and the choice depends heavily on the reason for removal and the condition of the surrounding tissue, which must be carefully discussed with a board-certified plastic surgeon.
- Simple Explant (Removal Only): The implant is removed, leaving the surrounding scar tissue capsule intact. This is typically chosen when there is no rupture, contracture, or suspicion of tissue pathology.
- Total Capsulectomy (En Bloc): This procedure involves removing the implant together with the entire scar capsule that surrounds it. This is often recommended for ruptured silicone implants, severe capsular contracture, or in cases concerning BII or BIA-ALCL.
Accompanying Procedures for Better Aesthetics
Removing breast implants often leaves the remaining breast tissue deflated and sagging. Most patients require an additional procedure, usually a lift, to achieve a satisfactory aesthetic result and a better overall contour.
- Breast Lift (Mastopexy): This is the most common procedure, removing excess skin and reshaping the breast tissue for a firmer, elevated look following implant removal.
- Fat Grafting: Transferring the patient’s own fat to the breast area can help restore lost volume, smooth out implant-related ripples, and improve tissue quality.
- Downsizing with Smaller Implants: For those who still desire some augmentation but a less dramatic result, the surgeon may replace the existing implants with smaller ones.
Tps Clinic Expert Warning
Never undergo explant surgery before receiving a full, comprehensive medical evaluation; if you are experiencing symptoms consistent with Breast Implant Illness (BII), a full medical workup is essential to rule out other treatable conditions before committing to surgery, as explantation is a major surgical event that must be approached with caution and realistic expectations.
Key Differences in Explant Planning
The table below summarizes the crucial planning differences based on the patient’s primary concern.
| Primary Concern | Recommended Surgical Approach | Additional Procedure Often Needed |
|---|---|---|
| Capsular Contracture/Rupture | Total Capsulectomy (Removal of implant + capsule) | Breast Lift (Mastopexy) |
| Aesthetic Change Only | Simple Explant (Removal only) | Breast Lift or Fat Grafting |
| Symptoms of BII/BIA-ALCL Fear | Total Capsulectomy (En Bloc) is usually preferred for complete tissue removal | Breast Lift and Volume Restoration |
Frequently Asked Questions (FAQ)
Does explant surgery guarantee relief from Breast Implant Illness (BII) symptoms?
While many women report symptom improvement after explant, there is no scientific guarantee that BII symptoms will be completely resolved.
What is “En Bloc” removal?
En Bloc is the technique of removing the implant and the entire surrounding capsule of scar tissue as a single, intact specimen.
Will my breasts look saggy after implant removal?
The degree of sagging will depend on the size of the original implant and the quality and elasticity of your remaining skin.
Can I get a breast lift and explant at the same time?
Yes, combining the explant with a breast lift is a very common procedure to achieve optimal aesthetic results.
How long is the recovery time for explant surgery?
Most patients require 1 to 2 weeks off work, with a restriction on heavy lifting for 4 to 6 weeks.
Are explant scars larger than augmentation scars?
Explant often requires a slightly longer incision than augmentation, especially if a full capsulectomy is performed.
Will insurance cover breast explantation?
Explantation is often covered if it is medically necessary due to rupture, severe contracture, or documented medical complications.
Will my natural breast volume return after the implant is removed?
No, the breast tissue that has been compressed by the implant will not recover its previous volume, leading to a smaller, more deflated appearance.
What is BIA-ALCL?
BIA-ALCL is a rare type of T-cell lymphoma that is associated almost exclusively with textured breast implants.
Can I replace my silicone implants with saline implants?
Yes, some patients choose to replace their current implants with a different type, often a smaller, rounder saline implant.