If you’re considering breast implant removal, you likely have numerous questions! The answer to the question of whether or not an explantation procedure is right for you is certainly a personal one—but it’s best to make the decision with counseling from a board-certified plastic surgeon. 

Our Swan Center plastic surgeons have decades of combined knowledge on the subject and are here to explain some of the most critical things to consider when making this important decision about your body. Below, we’re covering the reasons certain patients may choose to reverse their “boob job,” plus what happens during the surgery and after, to help you decide if it’s time to speak with a plastic surgeon.

What are some reasons to have breast implants removed?

Patients may seek out breast explantation (another term for implant removal) because of personal preference, a change in their breasts’ appearance, to treat a complication, or for other health-related reasons. 

Following are some of the specific scenarios that may lead you to want to have your breast implants taken out:

• Personal preference or lifestyle
• Rupture and/or deflation
• Capsular contracture
• Health concerns
• Cosmetic changes
• Aesthetic irregularities
• Time since your implants were placed

Personal preference or lifestyle

Many breast implant removals boil down to personal choice. It’s completely normal to have your breasts implants out because they aren’t a good fit for your lifestyle, or you prefer to have your natural breast size and/or shape again! Some patients feel their breasts are too heavy, or their tastes have changed and they want a more natural aesthetic.

Rupture and/or deflation

A ruptured breast implant is an implant that has torn or developed a hole in the outer silicone shell. With saline-filled implants, you will typically notice that your implant has deflated: the saline (salt water) leaks out and is safely absorbed by the body. This is a common reason patients decide to have a breast explant since deflated implants change the appearance of your breast(s).

With the modern cohesive silicone gel-filled implants, however, a rupture can be asymptomatic—it usually doesn’t change your breasts’ appearance, and therefore can only be detected with an MRI or ultrasound scan, which (as of 2022) are recommended by the FDA after 5-6 years, with check-ups every 2-3 years thereafter. If a rupture is detected, then the compromised silicone implant should be removed or replaced because the silicone inside the implant is not meant to be exposed inside the body, and may interact with lymph nodes or surrounding tissues.

Capsular contracture

Capsular contracture develops when the capsule of scar tissue that naturally forms around an implant irregularly tightens and hardens, distorting the shape of your breast(s). There are several Baker grades of capsular contracture severity, and some scientists believe it may be caused by a bacterial biofilm that forms on the implant. To treat capsular contracture, some patients may choose explantation with capsulectomy (scar tissue removal), while many patients opt to replace their implants in order to restore their breasts to their previous augmented look (this option comes with a risk of recurrence, but surgeons have various techniques to help minimize the risk).

Health concerns

Breast implants have been the subject of ongoing studies exploring their connection with certain health conditions. Breast implant illness, or BII, refers to the experience of systemic symptoms like hair loss, memory loss, rash, brain fog, or fatigue that are thought to be caused by breast implants. BII is a diagnosis of exclusion, meaning that patients work with their providers to eliminate other possible causes of their symptoms before arriving at a diagnosis of BII. Research is currently underway to better understand BII, but currently BII is not a diagnosable condition. To alleviate symptoms, explantation surgery may be chosen as a treatment option. 

Nothing is more important than our commitment to the safety of our patients. We proudly offer  MENTOR® implants for our breast augmentation patients, which have an extensive warranty program and a high standard of quality and safety. MENTOR® has conducted decades worth of clinical studies to closely monitor long-term breast implant complications, which is why we trust using these implants for our patients.

Cosmetic changes

With aging, childbearing, and weight changes, the breasts’ appearance is likely to change. You may decide you want a change in the shape or size of your breasts with a revision cosmetic surgery, or simply to have your implants taken out—we understand! Whether you want to add a breast lift to your breast implant removal for a perkier appearance or you opt for a simple removal surgery, cosmetic change is a normal reason to seek an explant.

Aesthetic irregularities

Aesthetic complications include visible implant rippling, implant malposition, or asymmetry of your results, and any of these may lead you to decide to remove your implants. An experienced cosmetic breast surgeon can also help you to restore a natural-looking breast shape and size with a customized combination of procedures like breast lift to address breast ptosis and fat transfer to the breasts to add a small amount of volume and upper pole fullness, as needed. 

Time since your implants were placed

Time passed since getting your implants is another reason: according to the American Society of Plastic Surgeons (ASPS) and other experts, breast implants are not lifetime medical devices and may need replacement or removal after 10-15 years. That said, if you are happy with your look and aren’t experiencing a complication, there is no need to have your implants out within a specific time frame.

Alternatives to breast implant removal

As an alternative to explantation, breast implant revision with implant replacement is an option if you still want the look of implants: many patients switch to newer-generation silicone gel breast implants which are very durable, safe, and natural-feeling. You can also choose implant revision surgery instead of removal if you have a complication, such as capsular contracture, that needs to be treated.

It’s completely normal to have your breasts implants out because they aren’t a good fit for your lifestyle, or you prefer to have your natural breast size and/or shape again!

Most explants involve more than just removing implants 

Breast implant removal is performed under general anesthesia, and uses the same incision or incisions (if possible) used during your initial breast augmentation. However, implant removal typically involves more than just taking out the implants: depending on the state of your implants and any complications you may have, the capsule of scar tissue may need to be removed partially or completely in a procedure known as “capsulectomy.” Here are the capsulectomy options to discuss with your board-certified plastic surgeon during your consultation:

En bloc capsulectomy

In an en bloc capsulectomy, your surgeon removes the implant and the surrounding capsule of scar tissue in one unit. This technique may be necessary if the implant poses a health risk if exposed to the surrounding tissues. Still, it should only be used when critical to the patient’s health as en bloc capsulectomy can notably increase the risk of damage to surrounding tissues.

Total capsulectomy

A total capsulectomy involves first opening the implant capsule and removing the implant, then removing all of the capsule tissue second to that (sometimes in separate pieces). This is a somewhat less risky procedure than en bloc capsulectomy, yet still requires the surgeon to be vigilant working around surrounding tissues.

Partial capsulectomy

A partial capsulectomy involves removing any problematic portions of the scar capsule tissue  that could inhibit a good outcome. The surgeon will leave any part of the capsule that is deemed risky to remove.

Ultimately, which type of capsulectomy is best suited to treating your anatomy and concerns can only be determined in an in-person consultation. Your plastic surgeon will explain which options will be effective and safe based on your reasons for seeking an explant surgery.

You may also want a breast lift or fat transfer—here’s why

A breast lift is a plastic surgery that tightens stretched tissues, removes any excess skin that is contributing to sagging or drooping, and creates a firmer, lifted breast shape. It can also move the nipples higher on the breast mound, if needed, to help your breasts look more youthful. 

Since having large breast implants, pregnancy, weight changes, and aging can all contribute to stretched breast tissues, it’s fairly common to need a breast lift to restore an aesthetically pleasing breast shape after breast implant removal. We can perform a breast lift in the same surgery, under the same anesthesia as your explantation procedure, in most cases. Including a breast lift adds 1-2 hours to the total procedure time.

Additionally, a fat transfer to the breasts is a procedure that can add a modest amount of volume and shape, as well as help to provide volume where needed in a customized fashion. Fat transfer may even be able to help you to restore some degree of cleavage or upper-pole fullness.

That said, patients with minimal stretching of breast tissue can take a “wait and see” approach, having their breast implants removed first, then deciding later if they are happy with their breast shape. Our surgeons will be sure to educate you on any options that may provide a pleasing outcome and will support your ultimate decision, developing a tailored procedure plan.

Your breasts’ appearance after explantation

Your breast will lose volume and fullness after your implants are taken out, but they will likely still have a familiar shape to you. It’s common for patients to be worried about their breasts’ appearance after an explant, but for most, there is some amount of “bounce back” that you can expect to see over time as your breast skin adjusts to not having implants. Talk with your surgeon about these concerns, and based on your own anatomy, they can help you decide if an additional procedure like breast lift may truly be necessary (or not!) to help you see a result you love after surgery.

About The Swan Center for Plastic Surgery in Atlanta

The board-certified plastic surgeons at The Swan Center for Plastic Surgery are here to help you achieve peace of mind as well as your aesthetic goals. We understand that the decision to remove breast implants is a highly personal one, and we make it our goal to be here for you each step of the way. To learn more and meet with a board-certified plastic surgeon at our luxurious accredited private surgery center and medical spa, schedule your consultation today by calling 770-667-0904 or filling out our online form.