Breast Implant Removal
What You Need to Know about Breast Implant Removal
Breast augmentation is the most popular procedure performed by cosmetic surgeons. No one who is having their first breast enhancement thinks about a time down the line when they would actually want them removed and NOT replaced. But for many women, there comes a time when they want to get rid of their implants completely. Implant removal, sometimes called breast explantation, is an important decision. Read on to find out more about reasons why women remove breast implants, what the procedure involves, and options for your breasts after implant removal.
Reasons for Implant Removal
There are many reasons why women might want to have their implants removed. Those who are having some complications or issues with their implants (like firmness or contracture) may be tired of attempts to fix the issues without success. Perhaps a saline implant has deflated, or a silicone implant has failed. I’ve known many patients who have had implants for a long time, and they’re at a time in their lives when their implants simply aren’t as important to them as they used to be.
Sometimes weight gain later in life can result in breasts that appear matronly and unflattering. Patients who develop a medical condition that they believe is related to their breast implants may want them removed for peace of mind (please note, there is no evidence that breast implants cause medical issues). Other patients become frustrated with overly large breasts that have interfered with their daily living and inquire about breast implant removal to get them “out of the way”.
Making the choice to get a breast augmentation does not mean that you need to have the implants for life, and you can always make the choice to take your breast implants out. The questions then become:
- What will my breasts look like after I remove my implants?
- Will additional procedures be necessary to ensure that my breasts look their best?
- Will I be happy with my decision to remove my implants?
- How will implant removal impact my life?
As with any big decision, we encourage you to be informed and explore your options. For instance, you can view our gallery of patient photos, showing how they look before and after breast implant removal. Below, we’ll go into more detail about what is involved with an implant removal procedure.
What Is Breast Implant Removal Surgery?
The breast implant removal procedure will depend on your individual situation. An example of a simple removal is a patient with saline implants that are soft. Removal is as simple as a small incision with implant removal using local anesthesia. This can take 30 minutes or less. A more complicated case is a patient with ruptured or contracted silicone breast implants who request removal of their implants and the implant capsules as well (the layer of scar tissue around all breast implants). In this case, the incision is larger, full anesthesia is necessary, drain tubes are common and the procedure is more involved and complicated. You can read more about breast implant capsule removal, or capsulectomy, here.
When considering breast implant removal in Austin or anywhere else, there are three main issues that need to be taken into consideration:
- the quality of the breast skin and tissue
- the position of the chest muscle
- the breast implant capsule
Removing Saline Implants Versus Removing Silicone Implants
Saline breast implants are filled with saltwater and silicone implants are filled with silicone gel material. A ruptured saline implant will deflate and the solution is absorbed by the body so the breast will become smaller in a short period of time. The silicone variety will maintain its volume as the silicone material is contained inside the implant capsule (scar tissue that surrounds all implants).
Women with saline implants can opt to have the saline removed with a needle as an in-office procedure so they can see how their breasts retract over time. After 4-6 weeks, they can then decide to remove or replace the implant and determine if they would like a breast lift as well.
Silicone implants require more careful consideration when deciding how to remove them. If they are intact, the procedure is straightforward and performed under local anesthesia. If ruptured, this silicone material will need to be cleaned from the implant pocket and this often requires anesthesia services for your comfort and safety. The problem is that it is difficult to determine if a silicone breast implant is intact on examination. Radiology scans are helpful but often not performed. Therefore your surgeon has to make his or her best guess based on the age of the breast implant and examination findings.
Do I Need a Breast Lift After Breast Implant Removal?
An important consideration in this procedure is whether your breasts will retract back well once the implants are removed. Perky breasts with good quality skin, younger age, and no history of pregnancy or weight fluctuations often result in excellent retraction. Those patients with poor skin elasticity, sagging breasts prior to augmentation, history of pregnancy, and major weight loss may need to consider a breast lift after implant removal. This can be done at the same time as implant removal or as a “staged” procedure months after implant.
When you decide to wait for a second surgery, you can see how well your breasts have done and whether you are happy enough with your appearance. An experienced surgeon can be very helpful in making a good decision. When in doubt, it’s always best to keep your options open and elect for a secondary surgery down the line. The excuse that it’s cheaper to do it all at once is not a good basis to choose how your breasts are managed. At Westlake, we will always be there to help you make the best decision for your situation.
The benefits of a breast lift (mastopexy) are an improved shape with tighter skin and smaller, better-placed nipple-areola complexes. A breast lift is not inexpensive and will result in permanent scars on the breasts. I recommend that you visit with several surgeons if you are considering a breast lift. Experience and maturity matter in the quality of your results.
Removing Breast Implant Capsules
All breast implants develop a thin layer of scar tissue around the implant capsule as part of the normal healing process. This capsule can become thicker and even develop calcifications and become brittle as they age. In some cases the thicker capsule can be the cause of firm, tender breasts – this is known as capsular contracture.
A decision must be made about what to do with the implant capsule based on the age of your implants, whether or not you have a capsular contracture or implant rupture, and if you have rippling and ridges around your implant. While a capsule should shrink considerably after removal of the implant, a capsule will not necessarily be resorbed by the body. Some or all of it can remain. A thick, calcified breast implant capsule may interfere with mammography of the breast, although this is uncommon. A firm capsule with sharp edges can cause pain and even visible irregularities of the breast.
Sometimes mistakenly called “en bloc” implant removal, a capsulectomy is a tedious procedure that requires a knowledgeable and experienced surgeon. It’s a more complicated procedure than just removing the breast implants and leaving the capsules in place. Drains and full anesthesia are needed. In general, I recommend leaving the implant capsules in place for those patients with soft breasts with implants not older than 10-15 years. Of course, the ultimate decision is made on a case-by-case basis.
Effects of Breast Implant Removal
The psychological impact of breast implant removal is not to be taken lightly. It’s perfectly normal to ask, “What will my breast look like after implant removal?” Many of my patients need time to adjust to their new breasts. Some have no regrets, while others may miss the benefits of breast implants and the impact they make in their lives. It’s important to know you always have future options to replace your breast implants if that is your wish. It’s important to choose a surgeon who can discuss these issues with you before you elect to remove your breast implants.
Changes To The Chest Muscles After Breast Implant Removal
The status of the chest muscle after breast augmentation is poorly appreciated or understood. During the breast augmentation procedure, surgeons will often cut the muscle along the breast fold as well as for a short distance along the breast bone. The consequence of this can be significant displacement of the muscle upwards towards the clavicle so that very little of the muscle actually covers the breast implant (when it was placed under the muscle to begin with). This can cause, among other things, a dynamic muscle deformity whereby the breast appears oddly shaped when the chest muscle is flexed. It can also cause lateral displacement of the breast and bottoming out.
The chest muscle works best when it is in the position that mother nature intended it to be in. Excessive pocket dissection, overly large breast implants, and aggressive muscle release can all lead to displacement of the chest muscle causing visible deformities and probably some weakness of the chest muscle in general.
When removing breast implants, it is best to access the muscle location and if it is displaced significantly to secure it to its natural, normal position on the chest wall while the muscle is soft and expanded. Timing is important here because this retracted muscle will heal shorter in the weeks and months to follow implant removal and it will not be possible to move or stretch the muscle to the ideal location in a future operation if desired.
Get an Expert Surgeon’s Opinion about Implant Removal
Breast implant removal can be a simple procedure performed under local anesthesia or it can be a much more involved procedure requiring full anesthesia depending on each patient’s individual circumstances. You shouldn’t always just ask, “Is there breast implant removal near me?” It’s generally worth traveling to work with the surgeon you want. Your surgeon must be aware of your goals, review your history, and examine your breasts so the most appropriate procedure is performed.
The most important factor in breast implant removal is choosing an experienced surgeon. With a surgeon who has performed a variety of successful implant removal surgeries, you are much more likely to get the results you want and deserve. The right surgeon will know which procedure is best for you and whether you will require a breast lift. If you’d like to speak with an expert in breast implant removal, please schedule a free consultation with me today.