Explant breast surgery removes breast implants, whether saline or silicone, and the fibrous capsule that forms around them. This procedure is performed for various reasons, addressing both medical concerns and personal preferences. The goal is to safely remove implants and surrounding tissue, supporting patient health.
Reasons for Removal
Individuals choose explant surgery for a range of reasons, often stemming from complications or evolving personal desires. Common medical issues include implant rupture (where the shell breaks) or capsular contracture (hardened scar tissue around the implant), leading to pain, distortion, or an unnatural feeling. Other complications like infection, implant malposition, or persistent breast pain can also necessitate removal.
Many also choose explant surgery for personal preference, seeking a more natural appearance or a return to their pre-implant body. Lifestyle changes or simply no longer wishing to have implants are valid motivations for this decision.
A significant reason for explant surgery is Breast Implant Illness (BII), a term for systemic symptoms some individuals experience after receiving breast implants. These symptoms can be diverse, including chronic fatigue, cognitive dysfunction (“brain fog”), joint pain, hair loss, skin rashes, and anxiety. While not an official medical diagnosis, BII is a recognized clinical phenomenon where patients report symptoms that often improve or resolve after implant removal. Research explores BII’s mechanisms, but patient-reported outcomes frequently highlight significant relief following explantation.
The Surgical Process
Explant surgery is performed under general anesthesia. Surgery duration varies with case complexity, especially regarding scar capsule removal. Surgeons employ specific techniques to address this capsule.
One common technique is total capsulectomy, removing the entire scar capsule along with the implant. This approach is often preferred, especially when there are concerns about capsular contracture or suspected cases of Breast Implant Illness.
An en bloc capsulectomy is a specialized total capsulectomy where the implant and capsule are removed together as one intact unit, without opening the capsule. This technique is particularly sought after in cases of suspected implant rupture or when there is a concern for specific conditions like BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma). While often ideal, en bloc removal may require a larger incision, can be more technically challenging, and is not always feasible due to capsule adherence.
A partial capsulectomy involves removing only a portion of the capsule. This method might be considered in less complex situations but is less common for BII symptoms or severe capsular contracture, as leaving part of the capsule could perpetuate issues. The choice of technique is determined by the surgeon based on the individual patient’s condition and the characteristics of the implant and capsule.
Recovery and Post-Operative Care
Following explant surgery, patients require rest and careful adherence to post-operative instructions. Immediately after, surgical drains may be placed to collect fluid and reduce swelling, usually removed within days. A compression garment or surgical bra is commonly worn to provide support, minimize swelling, and help the breast tissues conform to their new shape.
Pain management involves prescribed medication to control discomfort. Initial healing takes one to two weeks, restricting physical activity. Patients avoid heavy lifting, strenuous exercise, and excessive arm movements for several weeks to allow incisions to heal and prevent complications.
Incision care involves keeping surgical sites clean and dry to promote healing and reduce infection risk. Specific instructions on cleaning and dressing changes are provided by the surgical team. Regular follow-up appointments monitor healing, address concerns, and ensure optimal recovery.
Long-Term Considerations
After explant surgery, breast appearance changes significantly as they adjust to implant absence. New breast shape, size, and firmness depend on original breast tissue volume, skin elasticity, removed implant size, and duration they were in place. Some individuals may notice a flatter appearance or a change in breast projection.
For those seeking to refine breast contour or restore volume, additional procedures may be considered. A breast lift (mastopexy) can address sagging skin and reshape the breasts. Fat grafting, transferring fat from another body part to the breasts, can add natural volume and improve symmetry. These procedures can be performed either at the time of explant surgery or as a separate, subsequent procedure.
Individuals who underwent explant surgery due to Breast Implant Illness often report significant improvement or complete resolution of systemic symptoms. While experiences vary, many patients find substantial relief from issues like fatigue, brain fog, and joint pain in the months following implant removal. Long-term symptom resolution is a consideration for those affected by BII.