BREAST IMPLANT REMOVAL / EN BLOC CAPSULECTOMY / EXPLANT SURGERY
While breast augmentation continues to be the most popular cosmetic procedure in the United States, a growing number of women are opting to have their breast implants removed. Dr. Brian Reuben performs these surgeries at 22 Plastic Surgery.
What are the common reasons a woman would want to have her implants removed?
Compared with augmentation, the numbers of women choosing to have their implants removed is quite low. More common is breast revision surgery to either exchange implants that have ruptured, increase implant size, or correct issues such as asymmetry.
For women choosing to remove and not replace their implants, these are typical reasons we see at 22 Plastic Surgery:
- Capsular contracture — Capsular contracture is the process of excessive scar tissue forming around the implants causing tightness and pain in the chest. The implants are removed through revision surgery, along with most of the excess scar tissue. Most women opt to have new implants placed, however.
- Health concerns — Some women have symptoms of a condition being called “breast implant illness.” Although there isn’t any research to specifically link implants to health outcomes, patients anecdotally report these symptoms: fatigue, memory loss, headaches, joint and muscle pain, hair loss, recurring infections, and swollen lymph nodes. The other concern is the recent recall of textured implants by the FDA (see associated section on that below).
- Age — Some women as they become older don’t want the prospect of their older years having breast implants in place. They simply opt to remove them and have a breast lift. This removes sagging tissue and firms up their breasts and that’s how they want their later years to go.
How is breast implant removal performed?
These are not difficult surgeries. Dr. Reuben enters through the original incisions used to place the implants. He then removes the implants. If you have any signs of capsular contracture, where scar tissue continues to build around the implant, the hardened capsule of scar tissue will also be removed. If the scar tissue is still soft, it will likely be left in place.
"I couldn’t be any happier with Dr. Reuben and his team! He did an EnBloc Capsulectomy with a Lift. He is skilled and practiced with this difficult and tedious procedure and took pictures as requested. His manner, and that of his team is unhurried, caring, and always explaining what to expect , clear instructions and offering time for questions. No pre surgery jitters for me, I was 100% confident in Dr.Reuben from our first meeting."
What should I expect my breasts to look like after implant removal?
As mentioned above, once your implants are removed it’s likely your breasts will have the classic characteristics where women usually opt to have a breast lift. That’s why Dr. Reuben almost always recommends a breast lift along with implant removal. This is because with a breast lift, we are able to remove the loose hanging skin, reposition the remaining breast tissue, and likely relocate the nipple/areola complex.
The goal with a breast lift is to return the breasts to a higher position on the chest, which will be important for you to be satisfied with the appearance of your breasts after removing your implants. As mentioned, without a lift, it’s likely your breasts will be quite flat and saggy without the implants. This is especially true the longer you have had implants, and with larger implant sizes.
Will I need a breast lift after having my implants removed?
While you could have implants placed at a later date, the procedure is much more complicated if you’ve had a breast lift. This really isn’t a time to waffle with your decision making. It’s a good idea to come in and see Dr. Reuben and discuss why you’re considering having implant removal surgery.
They can go through the potential risks of leaving your implants in place. After removing your implants and having a breast lift, it’s a better idea to consider the issue closed moving forward.
Are there any risks involved with having breast implants removed?
In July 2019 the FDA announced a mandatory recall of all textured implants with the brand name Biocell made by Allergan. These textured implants have been linked to a very rare form of cancer: anaplastic large-cell lymphoma. In the announcement, the FDA called the cancer “breast implant-associated anaplastic large-cell lymphoma” (BIA-ALCL).
The occurrences of this lymphoma are exceedingly low — of the 40 million women who have had implants only between 300 to 500 have been diagnosed with genuine cases of anaplastic large cell lymphoma — but the news has brought implant removal to the forefront of the public consciousness.
This does not apply to any other implants but the Biocell textured implant from Allergan.
"I had 19 years old saline breast implants. Dr. Reuben removed the old implants and did a breast lift. I never dreamed they would look so good. I feel 20 years younger...My expectations were far exceeded. Thank you Dr. Reuben!"
If I have my implants removed can I have implants placed again in the future?
What is this I’ve heard about lymphoma linked to breast implants?
These are very low risk procedures. That’s because our surgeons can enter through your original incisions to access and remove your implants. It is still surgery, so there are some inherent risks, but they are small.
Some women assume their breasts will return to their appearance prior to having implants placed. However, this is not the case. The weight and bulk of the implants will have stretched your skin and support tissues. They tend to also create changes in the rib cage area. Once the implants are removed, the breasts typically appear flattened and saggy. They may be uneven.