Explant surgery is the removal of breast implants without replacement. Women seek this procedure for various reasons, including medical concerns such as capsular contracture, implant rupture, or systemic symptoms often referred to as breast implant illness. Others choose explantation due to a shift in personal preferences, a desire for a more natural figure, or to avoid the ongoing maintenance and potential future surgeries associated with implants.
Surgical Steps and Capsule Management
The physical process begins with the surgical removal of the implants, typically performed under general anesthesia. The management of the fibrous capsule, the layer of scar tissue that naturally forms around every implant, is a crucial component of this operation. The decision of how to handle this capsule is determined by the patient’s medical history and the surgeon’s recommendation.
Capsulectomy
A capsulectomy involves removing the scar tissue capsule along with the implant. This is often preferred for patients with health concerns or complications like capsular contracture, where the capsule has hardened and tightened. A complete capsulectomy removes the entire capsule.
En Bloc Capsulectomy
The en bloc capsulectomy is a more technically demanding variation. Here, the implant and the surrounding capsule are removed together as a single, intact unit. This technique aims to prevent any potential contents, such as ruptured silicone or fluid, from contacting the surrounding tissue during removal. This approach is often recommended for patients concerned about implant integrity or those with systemic symptoms.
Immediate Post-Operative Healing
Following the procedure, the initial recovery phase generally spans the first two to six weeks. Patients can expect immediate effects such as swelling, bruising, and soreness in the chest area, which can be managed with prescribed pain medication. The use of a surgical support bra or compression garment is often required to help reduce swelling, minimize bruising, and provide support to the newly reshaped tissue.
Many surgeons will place small surgical drains beneath the skin to collect excess fluid or blood that accumulates in the space where the implant once was. These drains are typically removed within three to seven days, once the fluid output decreases. Patients are usually advised to take at least one week off from work and must avoid strenuous activities and heavy lifting for four to six weeks to prevent strain on the incisions and healing tissues.
Long-Term Changes in Breast Appearance
The primary long-term effect of explant surgery is the loss of volume, resulting in a smaller breast size. Immediately after removal, the breasts often appear flattened or deflated, as the skin and tissues had been stretched to accommodate the implant. The final aesthetic outcome takes time to develop, with the breasts continuing to settle and reshape over a period that can last up to 12 months.
A primary change is the presence of skin laxity, or sagging, a condition known as ptosis. The degree of sagging depends heavily on the original size of the implant, the patient’s skin elasticity, and the length of time the implants were in place. Younger patients with better skin elasticity may see more skin retraction, while those with larger implants are likely to experience more significant drooping.
The ultimate shape and projection will be determined by the patient’s remaining natural breast tissue. Over the year following surgery, the compressed natural tissue gradually expands and repositions, a process sometimes called “fluffing.” Scarring will be present, typically following the original incision lines, and will fade and soften over many months. Some women whose skin laxity causes significant ptosis may choose to undergo a mastopexy, or breast lift, either concurrently with the explant or as a separate procedure later, to remove excess skin and reshape the breast mound.
Emotional and Body Image Adjustment
The journey after implant removal is an emotional experience. For many women, the removal brings profound relief, particularly if the decision was driven by the alleviation of chronic health concerns. This feeling of relief is often linked to a sense of reclaiming one’s health and embracing an authentic self.
Despite the potential for improved physical well-being, the adjustment to the new body contour can be complex. Some individuals may experience a period of grief over the lost volume or struggle with dissatisfaction regarding their smaller or more deflated appearance. The difference between the expected result and the reality of the post-explant body can lead to a challenging adjustment period. Connecting with a strong support system or seeking professional guidance can be beneficial during this transition to help integrate the physical change with a positive self-perception.