Choosing Breast Explant Surgery
A breast explant procedure involves the removal of breast implants. It is major surgery, and therefore the decision to undergo it should be made only after reviewing the benefits, risks and options.
There are many reasons women choose to remove their breast implants. A woman may decide she does not like the look or feel of her implants. She may not have received the result she was hoping to achieve. Some patients may have developed health conditions that they feel may have been caused or worsened by the presence of their breast implants. In some women, their breast augmentation may have gone wrong and could not be corrected by their surgeon. These situations include:
• Capsular contracture, when the scar tissue that naturally forms around an implant begins to shrink and tighten around the implant. Capsular contracture can cause patients to feel pain and have firmer than normal breasts. This tight scarring can even cause an implant to rupture, due to the pressure of the scarring.
• Synmastia, in which the implants are too close together in the middle of the chest, causing a loss of natural cleavage and the appearance of a “uniboob.”
• Breasts that are asymmetrical can be caused by implant malposition, and may be obvious soon after surgery. It can also be the result of implants that were properly placed but subsequently shifted from their original location due to scar tissue tightening.
• Implants whose outlines are very visible or have developed a “rippling” appearance. This is more common in very thin women.
• Implants that have ruptured.
Breast explant surgery may be more complicated than the original placement. Some women may desire to have the scar tissue capsule removed as well as the implants, to assure themselves that they have removed all traces of the implants. With saline implants, some women will opt for in-office deflation (removal of the saline with a syringe and needle) to determine their true breast size and to see how the breast will look after simple removal. The implant shells can be removed after 2-3 months of letting the breast tissue “adapt” to the reduced volume. If the implants were large, or the breast skin is stretched out and droopy, a breast list may be helpful to restore a more natural shape, a better nipple position, and a firmer, although smaller, breast. Dr. Johnson is skilled in reshaping and lifting your breast tissue to ensure your best possible result after breast explantation surgery.
Some implant patients may decide to opt for a different type of implant. Some women may feel that saline implants feel less natural than they expected, and will swap saline for a silicone gel variety. Other women may have concerns about silicone gel implants, and choose saline for replacement breast implants. If you decide to switch to smaller implants, the capsule surrounding the new implant may need to be tightened, and the breast may need to undergo a lift. If you wish to increase your breast size, a bigger implant may require the surgical creation of a larger pocket to accommodate the larger volume.
Currently, there is no hard evidence that removal of breast implants will improve a woman’s health or reduce her symptoms. Women choosing to remove their implants for health reasons need to understand that this surgery may have no effect on their general state of health. Research into “Breast Implant Illness” is ongoing, as we plastic surgeons are trying to understand if there are “markers” that can identify patients at risk for the development of symptoms after placement of breast implants. This research may allow us to determine which women should NOT undergo implant placement.
If your explant surgery involved the removal of scar tissue, you will have some discomfort, which will be managed with prescribed medication. Beyond that, your recovery will be very similar to that of your initial surgery. You will again experience soreness and swelling, and will need to limit your vigorous activities for two weeks. It may take several months for the final result to be stable.