Explant surgery involves the removal of breast implants, often including the surrounding scar tissue capsule, in a procedure known as a capsulectomy. People choose to undergo this surgery for various reasons, including the development of complications like capsular contracture or the presence of systemic symptoms associated with Breast Implant Illness. This procedure represents a significant physical and emotional transition, and setting clear expectations for the post-operative period is essential for a smooth recovery.
The Immediate Post-Operative Period
The first week following explant surgery focuses on pain management, wound care, and initial stabilization. Patients are placed in a compression garment or surgical bra immediately after the procedure to minimize swelling and support the breast tissue. While some discomfort is expected, it can often be managed effectively with a combination of prescribed pain medication and over-the-counter options like acetaminophen. Narcotic use is generally kept to a minimum to avoid side effects like constipation.
Surgical drains are placed in the breast pocket to prevent the build-up of excess fluid and blood, which can lead to complications such as a seroma or hematoma. Patients or their caretakers must monitor and record the fluid output from these drains, often twice daily, and keep the suction bulb compressed to maintain proper function. The drains are typically removed in the surgeon’s office when the fluid output drops below a specific threshold, often 25 to 30 milliliters per 24-hour period, which usually occurs within three to seven days of surgery.
Activity during this initial period is limited to light movement, such as short walks, which promotes circulation and reduces the risk of blood clots. Patients must avoid heavy lifting, pushing, or pulling anything over five to ten pounds. For the first week, sleeping in an elevated position on the back, such as in a recliner or with pillows, is recommended to decrease swelling and protect the surgical site.
Managing the Physical Recovery Timeline
Physical recovery begins with the removal of initial dressings and drains. Once drains are removed, patients can usually shower, but incisions must not be submerged in water for approximately four to six weeks. The incisions should be kept clean and dry according to the surgeon’s instructions to prevent infection.
Patients with desk jobs or non-physically demanding work can often return to their professional duties within five to ten days after surgery. Driving is restricted for at least one week, and longer if prescription pain narcotics are still being used, as they can impair judgment and reaction time. Light exercise, such as walking, remains encouraged, but the patient must continue to avoid strenuous activity and anything that significantly raises the heart rate or blood pressure for at least four to six weeks.
Around the four- to six-week mark, most patients are cleared to resume moderate activities, including light weight lifting and non-impact cardio, provided the incisions are well-healed. Scar care protocols, such as massage or silicone sheeting, are typically initiated at this time to encourage optimal scar maturation. Full return to strenuous activities, like heavy weight training or impact sports, usually occurs by six to eight weeks post-operation.
Changes in Appearance and Sensation
The final aesthetic outcome of the explant procedure often requires six to twelve months for the breast tissue to fully settle and soften. Immediately after implant removal, the breasts may appear flatter, deflated, or misshapen due to the sudden loss of volume and the skin having been stretched. This initial appearance is temporary, as the skin and remaining breast tissue will gradually contract and reshape over the following months.
Many patients opt to combine the explant with a lift (mastopexy) to address excess skin and reposition the breast for a more contoured result. For those who do not, some degree of ptosis (sagging) is common, especially if the original implants were large or had been in place for a long time. Scars often remain pink or raised for several months before beginning the process of flattening and fading, which can take up to a year or more.
Changes in sensation are a frequent experience following the procedure due to the manipulation of nerves during surgery. Patients may notice areas of numbness, hypersensitivity, or a tingling feeling in the breast and nipple area. While sensation often gradually returns, complete restoration may not occur for all patients.
Systemic and Emotional Adjustment
Explant surgery often leads to the resolution of systemic symptoms in patients who have experienced symptoms associated with Breast Implant Illness (BII). Studies show that a significant reduction in self-reported symptoms, such as fatigue, anxiety, and brain fog, can be observed as early as 30 days post-surgery. This improvement is often sustained, with patients reporting better physical and mental health scores at follow-up periods of up to one year.
The body’s healing process benefits from nutritional support, including a diet rich in whole foods and adequate hydration, which aids in tissue repair and energy restoration. The psychological impact of the surgery can be complex, involving a mix of relief from symptoms and potential emotional vulnerability. Some individuals may experience temporary emotional shifts, sometimes referred to as “post-op blues,” due to the physical stress of surgery and hormonal changes.
Adjusting to a new body image is a significant part of the emotional recovery, especially after living with implants for an extended period. This process can involve a period of grief or acceptance concerning the change in appearance. Seeking support from a therapist or support group can be helpful during this time to navigate the psychological dimensions of the transition.