Breast implants can be removed through a surgical procedure known as explantation. This operation involves extracting the implant and often the surrounding scar tissue, for reasons ranging from medical necessity to personal preference. The approach is tailored to the individual patient’s needs and goals. Understanding the specific surgical techniques and potential aesthetic outcomes is important for anyone considering explantation.
Surgical Approaches to Explantation
The process of explantation is determined by whether the surgeon removes only the implant or also the fibrous capsule that naturally forms around it. Simple implant removal involves making an incision into the capsule and extracting the implant, leaving the capsule tissue behind to shrink and dissolve over time. This method is less invasive and is an option when the capsule is thin, healthy, and the patient is not experiencing complications related to the capsule itself.
A capsulectomy is the procedure where the implant is removed along with the surrounding scar tissue capsule. The two main types of capsulectomy are total and en bloc. A total capsulectomy removes the entire capsule, but the surgeon may separate the capsule from the implant and remove it in pieces.
The en bloc technique is a variation of the total capsulectomy, where the surgeon removes the implant and the capsule as a single, intact unit. This method is preferred when there is concern about a ruptured silicone implant or certain types of lymphoma, to prevent contents from spilling into the body. This approach is more technically demanding and can require a longer incision than a simple implant removal.
Common Reasons for Choosing Removal
Patients choose implant removal for medical complications or personal preference. A common medical necessity is severe capsular contracture, where the scar tissue around the implant hardens and tightens, causing pain and a distorted breast shape. Implant rupture or leakage is another medical indication for explantation.
Many women seek removal due to symptoms attributed to Breast Implant Illness (BII), which can include fatigue, joint pain, and cognitive issues. While BII is not a formal medical diagnosis, many patients report significant improvement following explantation. Other women desire a return to their natural appearance or experience a change in aesthetic preference. Since implants are not lifetime devices, some patients choose removal to avoid future maintenance or replacement surgeries.
Recovery and Immediate Post-Operative Changes
The initial recovery period typically lasts one to two weeks, often requiring patients to take a week off from work. Pain and discomfort are expected in the first few days, which are manageable with prescribed oral medication. Swelling and bruising are also common post-operative changes.
Surgeons may place temporary surgical drains beneath the skin to collect excess fluid, which are usually removed within a few days. Patients must wear a supportive surgical bra continuously for several weeks to reduce swelling and support the healing tissue. Strenuous activities, heavy lifting, and intense physical exertion must be avoided for four to six weeks to prevent disrupting the healing process.
Long-Term Aesthetic Considerations
The final long-term appearance of the breasts after explantation depends on several factors, including the size of the removed implants and the patient’s existing skin elasticity. The skin and breast tissue, which were stretched by the implant, may not fully contract, potentially leading to a flatter or deflated appearance. For those who had larger implants or poor skin quality, removing the implant alone may result in an unsatisfactory aesthetic outcome.
To address skin laxity and improve the post-removal contour, a concurrent procedure like a mastopexy, or breast lift, is frequently performed. A mastopexy reshapes the breast tissue, removes excess skin, and repositions the nipple and areola to a higher position. For patients seeking to restore some lost volume, fat grafting involves transferring fat harvested from another area of the body into the breast to create a softer, more natural fullness. Combining explantation with a lift and/or fat transfer can significantly enhance the final aesthetic result.