Breast Breast Implant Removal/Explant

After several years with breast implants, some women end up wanting them removed for various reasons. When this occurs, few plastic surgeons are more qualified than Dr. Rady Rahban to carefully remove your implants while simultaneously doing what is necessary to the breast tissue in order to sculpt a beautiful and natural breast shape. This may include procedures such as a breast lift or a breast reduction.

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Breast implant removal, otherwise known as explant, is a surgical procedure done to carefully remove implants and aesthetically restore the breasts whether through fat grafting or a different size or style of implant as desired. Breast implants are safe and long lasting, but aren’t lifetime devices.

At some point, they may need to be removed or replaced, whether by personal choice or, less often, medical necessity or for peace of mind. The first step in breast implant explantation is a personal consultation from an experienced and open-minded cosmetic surgeon, eager to hear your concerns, evaluate the possibilities and clinical data, and help you achieve the relief you may be looking for.

I am SO very happy and relieved with the results of my surgery and I owe my piece of mind to Dr. Rady Rahban. If you are seeking an EXTRAORDINARY, talented surgeon who has your best interests at heart, please visit Dr. Rady Rahban and his staff. You will be in stellar hands!

L.T.

What is breast implant removal?

Explant is a straightforward but exacting procedure performed under local or general anesthesia. The procedure starts with a reopening of the initial incision. The implant is then carefully removed and any scar tissue that surrounds it (called the capsule) can then also be excised. Removal of the capsule is a more invasive procedure but remains an option for our patients after their careful review and consideration of the risks and benefits. In most cases, removing the implant itself is sufficient. The incision is then stitched closed and covered with a surgical dressing and drains may be placed to prevent the buildup of fluids while healing. The patient is then given post op instructions that will usually include the use of compression garments for about a week for optimal healing. Pain and discomfort can be managed by prescribed pain medication, as the patient stays home and recovers.

Reasons for breast implant removal

While breast implants are not rated as life-long devices, even the instance of contracting something like capsular contracture can be as low as 4-8% over one’s lifetime. Nevertheless, local or systemic pathology, as well as a shift in one’s beauty or personal goals, occasionally indicates the potential benefits of removing breast implants. A host of conditions may present that could signal the need for explanation. Some of the most common ones include:

Aesthetic issues

If you’re unhappy with the appearance of your new chest, or you feel as though your breast implants are too large or look artificial, you may want to have them removed.

Capsular contracture

A serious breast augmentation complication, capsular contracture develops when scar tissue hardens and contracts around the breast implant, causing a distorted appearance. When this occurs, the implant needs to be removed or replaced to correct the issue along with removal of the scar tissue also known as the capsule.

Infection

An infection is a rare breast augmentation complication, but it can happen. And when it does, you may need to have your implants removed temporarily or permanently in order to treat it.

Breast cancer

If you’ve been diagnosed with breast cancer, it may be necessary to remove your implants so your surgeon can reach and successfully treat any tumors,

Ruptured implant

If you have implants, there’s always a chance that they can rupture, causing breast pain, shape changes and contour irregularities. When this occurs, the only way to treat the issue is to remove or replace the implants.

Change in cosmetic preference

In many cases, women simply tire of their appearance with breast implants, and this is as valid a reason as any to get them removed.

Schedule A Consultation

When Dr. Rahban does a consultation with a prospective patient, he wants it to be two things above all others: thorough and honest. He will find out from you just what you want from cosmetic surgery. And he will tell you honestly if you can get the result you want, and how he can best help you do so.

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Total Capsulectomy, En Bloc Capsulectomy

If you suspect you are experiencing the effects of Breast Implant Illness (BII) or you have capsular contracture, En Bloc Capsulectomy removes the breast implant and all of the surrounding scar tissue, or “capsule” that forms around a breast implant. En Bloc Capsulectomy is done during breast implant removal in order to address all breast implant related complications, minimizing health risks. While En Bloc Capsulectomy is advised for patients with free silicone, biofilms and other conditions, it can be much more stressful on the body and is best decided upon after a personal consultation with an experienced cosmetic surgeon who can help you weigh its pros and cons. Nevertheless, should a patient demand it, Dr. Rahban is well suited to perform the surgery. What he will never do, however, is operate at the risk of his patients, no matter how demanding, if clinical data and pathology contraindicate it.

Conditions Indicative of the Potential Necessity to Explant

Capsular Contracture

Capsular contracture can occur for reasons that differ from patient to patient. It begins asymptomatically and may first become noticeable as one or both breasts begin to feel tight and firm, and become painful particularly when lying facedown. Visually, the breasts may appear misshapen or high-riding. Capsular contracture can occur within 4-6 weeks of surgery (thus the importance of gently massaging the breasts for 5 minutes, 2 to 3 times daily the first two months after surgery) and is unlikely to develop after 6 months of the surgery. Capsular contracture is divided into four grades, from mildest to most severe. Surgery becomes a necessity in Grade 4 (hard, misshapen, soreness, tender and painful to the touch), and much can be done before then to prevent it, including Aspen therapy.

Rippling

Rippling is an uncommon condition in breast implants that can occur for reasons such as: poor tissue coverage over the implants, over- of under-filled saline implants, or when the natural scar capsule around the breast implant causes the implant to droop. This can become evident in “rippling” of the breast skin. In most cases, correcting this requires a surgery of some kind, whether it be replacing the implant with a larger or different type implant, adding or removing silicone from an over- or under-filled implant, or a fat graft.

Implant Rupture

The outer shell of a breast implant can potentially tear or develop a hole from such things as aging of the implant, trauma, or accidental needle insertion during a medical test. It can also occur iatrogenically due to damage by surgical instruments in the initial breast implant surgery. Rupture in saline implants are often quickly noticeable to the patient as a deflated breast, as the saline solution is absorbed by the body. In silicone implants, the gel may slowly leak out over time and can spread to other areas of the body. Correcting implant rupture requires surgery.

Breast Implant Illness (or BII)

Breast Implant Illness (or BII) is a growingly popular term used to describe a host of usually non-diagnosed symptoms that patients have come to feel are due to breast implants. BII may present to each individual uniquely and some of the common symptoms associated with it include chronic fatigue, foggy memory, difficulty concentrating, headaches, depression, anxiety and headaches. Following a thorough consultation, Dr. Rahban will advise the best method of treating it.

BIA-ALCL

BIA-ALCL (or Breast Implant Associated Anaplastic Large Cell Lymphoma) is a rare and easily treatable lymphoma that can develop around both silicone and saline breast implants. Women with breast implants have about a 1 in 2,500 to 86,000 chance lifetime risk of contracting BIA-ALCL. Symptoms of BIA-ALCL include breast enlargement, pain, and hardening of the breasts or a lump in the breast.

Malposition

Breast implant malposition occurs when implants are incorrectly placed or when they migrate out of correct placement slowly due to capsular contracture, trauma or other conditions. This unsightly condition can affect the lateral, medial or inferior positioning of the breast or breasts and can be corrected in a number of ways, one of which is explant, although malposition alone is usually not treated with explant.

Preparing For Your Breast Explant

Prior to your procedure, you will spend a considerable amount of time talking to Dr. Rahban about the breast implant removal process.

After evaluating your chest and assessing any aesthetic issues, deformities or problems you’re having with your implants, he will talk to you about what your natural chest will look like once the implants are removed.

The reality is that removing your implants will definitely reduce your volume, and it may also cause your chest to appear droopy. Therefore it is crucial that your surgeon is honest with you and lets you know whether you have sufficient breast tissue that will allow an aesthetically pleasing result. Many patients want their implants taken out, but once they realize they may be left with a less-than-desirable aesthetic outcome, they reconsider.

If you are a good candidate, Dr. Rahban will perform a simultaneous breast lift to counteract any sagging effects following a breast explant. Some women may not need a lift—it all depends on your anatomy. During your pre-surgery appointments, he will discuss his surgical plan with you and make sure you’re comfortable with the expected outcome. Once Dr. Rahban is confident that you’re fully prepared for surgery, he will schedule your operation.

What to Expect During Your Breast Implant Removal

To perform your breast implant removal, Dr. Rahban will begin by re-opening your prior incisions. If your breast implants are comprised of silicone, he will first inspect the area for any signs of a rupture. From there, he will carefully remove the implant, along with any scar tissue and leaked silicone, from your body. If your breast implants are made of saline, Dr. Rahban will deflate the implant first, which allows for an easier removal.

If any scar tissue has developed in the area, he will remove that as well. Once both implants are no longer in your body, Dr. Rahban will sit you up and assess the appearance of your breast. Many times the breasts are saggy and appear unattractive, so he will generally perform a breast lift to ensure a supple and perky chest. This portion of the procedure will be completely customized based on your anatomy, skin quality and the severity of your sagging.

With Dr. Rahban’s vast experience of revision breast surgery, he has learned that until the implant is removed, you will often not know what kind of lift you need. Hence it is crucial that your surgeon be able to adapt in the moment and execute a well-designed lift. However, in most cases it will involve removing excess skin, reducing the size of the areola and elevating the breasts to a more desirable position on the chest. Once your breast lift is complete, Dr. Rahban will close the incisions in multiple layers to ensure that the resulting scars are minimal and able to fade from view over time.

Recovery After Breast Explant

Most people who undergo breast implant removal experience a recovery period of about one week, during which they need to stay home from work and wear a surgical bra and bandages. At the initial post-operative appointment, Dr. Rahban will remove the bandages, assess progress, and provide detailed care instructions. Although each patient's experience is unique, most can resume their usual activities in about six weeks. Post-surgery, the breast shape is usually still pleasing, though smaller, with a natural loss of volume where the implant provided fullness. If the implants were large, the volume loss will be significant, and a breast lift may be recommended after healing and settling.

Safety that never compromises beauty

Rahban may also use fat grafting to naturally lift the breasts after the artificial explants have been removed. Where warranted, Dr. Rahban may combine breast implant removal or explant with an internal breast lift to restore a more optimal angle and degree of lit in the breast. By repositioning skin tissue, moving it from the lower half of the breast to the mid breast, he can restore that optimal angle and degree of lift, filling up the once-depleted portion of the breast.

An Exacting Procedure for a Precision Surgeon

Breast implant removal is a more exacting procedure than the initial implanting was and there are several reasons for this. For instance, your surgeon will now be dealing with tissue that has already been manually manipulated, scar tissue will have formed, and care must be taken to ensure the implant isn’t ruptured or damaged during the explant, dangerously leaving pieces of it behind. Each of these and more can eventually result in further complications cropping up after the explant surgery — something we want to avoid at all cost. However, exacting does not mean impossible.

Rather, it means your choice of cosmetic surgeon is crucial. You’ll want to find a surgeon who is very well versed in explant procedure and all of its variations and potential complications; someone who has performed this surgery many, many times before and can call on a vast library of experience, options and education. Dr. Rahban is unarguably such a surgeon. As a world-renown board-certified cosmetic surgeon known for professional integrity and a highly refined aesthetic edge, his hundreds of patients have put their body and health into his caring and experienced hands and come out very satisfied with the outcome.