Breast Implant Removal (Explantation)

Out of all individuals who undergo cosmetic surgery each year, breast augmentation patients continually rank among the happiest and most satisfied with their decision and results. That being said, there are some cases in which women decide, at a later point in time, that they no longer wish to have their breast implants—whether because their aesthetic preferences have changed, they are experiencing implant-related issues or for a variety of other reasons.

Breast implant removal, also known as an “explantation,” is the surgical procedure that permanently removes breast implants and, if necessary or desired, some degree of the surrounding scar tissue (partial or total capsulectomy). Depending on the specific needs and desires of the patient, explantation can be a standalone operation or done in combination with another breast surgery such as a breast reduction or a breast lift.

For the last several years, Arizona breast specialist Dr. Steven H. Turkeltaub has seen a tremendous increase in the number of requests that he gets from patients seeking this procedure. With his extensive experience of performing explantations over more than thirty years, he can provide you with a customized surgical plan based on your unique motivation(s), anatomical needs and cosmetic preferences to help you achieve the desired breast appearance.

To assist you in learning more about explantation surgery, we have provided interesting and useful information in the sections below, including before-and-after photos that can give you a good idea of the type of outcomes that are possible with breast implant removal. If you have additional questions, or if you wish to schedule a private consultation with Dr. Turkeltaub to obtain personalized details and recommendations regarding your particular case, please contact our practice online or by telephone at (480) 451-3000 today.

• What Are Some Typical Motives for Breast Implant Removal?
• What Are BII and BIA-ALCL?
• How Is the Breast Implant Removal Procedure Performed?
• What Does Breast Implant Removal Recovery Entail?
• Before-and-After Pictures of Breast Implant Removal

What Are Some Typical Motives for Breast Implant Removal?

Some of the most common motives women have for pursuing breast implant removal include:

• Changes in Lifestyle and/or Aesthetic Tastes – Some women simply decide that they now prefer to have smaller breasts for personal, physical or other reasons. Explantation will make this a reality.
• Issues Pertaining to the Breast Implants – In response to rippling, rupture, capsular contracture or other implant-associated issues, some women decide that they no longer desire implants or they do not wish to deal with any potential implant-related problems in the future. Consequently, breast implant removal is the ideal solution in these instances.
• An Increase in Breast Size/Volume Due to Significant Weight Gain – If a substantial amount of weight is gained following breast augmentation, the breasts can become overly large and/or heavy for one’s cosmetic desires and physical stature. Permanent explantation reduces the volume of the breasts while helping to at least partially resolve any neck, shoulder or back discomfort potentially caused by the increase in breast size and weight.
• Changes in Current Cultural Preferences – An excessively large, over-augmented breast appearance is not generally considered to be as desirable or attractive as it once was. Instead, many women today opt for a smaller, more natural breast aesthetic. Consequently, when the time comes to exchange one’s implants due to a leak or another issue, some women choose to have theirs permanently removed instead of being replaced with smaller ones.
• Long-Term Fiscal Decisions – For a small number of women, the prospect of future costs associated with replacing old implants and/or addressing potential implant-related issues outweighs the benefits of having them. Therefore, rather than getting new implants when replacement is necessary, they instead opt for explantation.
• Health Problems – Whether their concerns are real or imagined, some women decide that breast implants are responsible for or might potentially lead to medical issues that negatively affect their overall health (see section on BII and BIA-ALCL below). Others simply no longer wish to have a foreign object in their bodies. In these cases, breast implant removal is requested.

Whatever your motivation is to have your implants removed, Dr. Turkeltaub will happily customize a treatment plan to help you attain your desired breast appearance.

What Are BII and BIA-ALCL?

Respectively, BII and BIA-ALCL are acronyms that stand for “breast implant illness” and “breast implant-associated anaplastic large cell lymphoma.”

Breast Implant Illness (BII)

Breast implant illness encompasses a broad array of systemic problems that some women believe are caused by their breast implants. These issues include but are not limited to headaches, chest pain, chronic fatigue, body chills, hair loss, light sensitivities, brain fog and anxiety.

Considerable scientific research has been conducted on the matter, though there is currently no evidence linking breast implants to BII. That being said, Dr. Turkeltaub always errs on the side of caution when it comes to adverse reactions to breast implants and will make every effort to fully resolve the problem(s) for any woman experiencing unfavorable responses. In certain instances, this may involve explantation.

Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

Despite occurring in the breasts, breast implant-associated anaplastic large cell lymphoma is not breast cancer—it is a rare* form of non-Hodgkin’s lymphoma that manifests in the scar tissue enveloping particular types of breast implants. The most common signs of BIA-ALCL include the spontaneous increase in the size of one breast (and, very rarely, of both breasts) over a relatively short period of time and often years after surgery, unexplained breast pain, lumps in the breast(s) and/or armpit, capsular contracture and skin rashes. However, these signs alone are far more likely to be present for other reasons but BIA-ALCL still needs to be considered/ruled out.

All the information up to this point in time reveals that this disease is linked exclusively to textured surfaced implants and not smooth surfaced ones. Allergan’s Biocell^® textured implants have by far the highest risk of this association of all textured implants. Consequently, they were voluntarily removed from the market in July of 2019.

In the vast majority of cases, BIA-ALCL has proved to be highly curable when detected early and promptly treated via explantation and complete removal of the surrounding scar capsule. It is the strong consensus of plastic surgeons along with the major plastic surgery societies (American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery) and the U.S. Food and Drug Administration (FDA) that it is not necessary for women who have textured implants to get them removed if no symptoms of BIA-ALCL are present. However, breast implant removal and capsulectomy (with or without the placement of new implants) can be performed for anyone who is uncomfortable with their textured implants.

*As of February 2020, the American Society of Plastic Surgeons (ASPS) reports the estimated lifetime risk of BIA-ALCL for women who have textured implants to be between 1:2,207 and 1:86,029. In the United States, 307 suspected/confirmed cases have been reported to the PROFILE registry, which is a partnership between ASPS, the FDA and the Plastic Surgery Foundation (PSF) to track BIA-ALCL patients.

How Is the Breast Implant Removal Procedure Performed?

There are different breast implant removal techniques that can be employed and Dr. Turkeltaub will determine what the most appropriate option would be for you. In many situations, just the breast implants alone can be removed. There are other instances where a partial or complete capsulectomy will also be indicated such as certain occurrences of capsular contracture or other capsular problems. If warranted or specifically requested for other reasons, Dr. Turkeltaub will utilize the en bloc technique for a complete capsulectomy.

Total operating time for explantation is highly variable and based on factors such as the condition of the implants (intact or ruptured), whether or not a capsulectomy is part of treatment, the extent of the capsulectomy if it is performed and even the quality of the breast tissue and skin. The length of the procedure will further be extended if a breast lift or breast reduction is performed concurrently.

Drainage tubes (JP drains) are often placed at the time of surgery depending on a few factors. These may remain in place from several days up to a week or more at which point they are removed in the office (no surgery or local anesthetic required).

What Does Breast Implant Removal Recovery Entail?

A comfortable, compressive dressing is placed immediately after the breast implant removal procedure. This is left on for a few days before being replaced by a sports-style bra that is worn around the clock for one to two weeks. Thereafter, Dr. Turkeltaub suggests wearing a supportive bra on a regular basis.

The discomfort associated with just a simple explantation is most often minimal to none. Most of our patients can and do return to an office job and/or resume non-strenuous routines generally within a few days. Any heavy lifting or vigorous activities will need to be avoided for a minimum of three to four weeks to aid with proper healing, limit potential complications and help ensure an optimal final outcome.

Before-and-After Pictures of Breast Implant Removal*

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*Individual Results May Vary

Schedule Your Breast Implant Removal Consultation

If you are interested in an explantation and wish to learn more about treatment specific for your particular situation, please contact us today to schedule a consultation with Dr. Turkeltaub. He is happy to assist you in achieving the breast appearance that you desire.