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.

1. Prepare like a pro

The first secret to gorgeous results is having a productive, in-depth personal consultation with your plastic surgeon. And you’ll get the most out of that meeting if you prepare ahead: read about others’ breast augmentation experiences, look at before and after photos of patients who look like you in the ‘before’ images, and get a basic understanding of breast implant and surgical options.

Take notes, save examples, and write down the questions you want to ask. This will empower you to ask more detailed questions and help you receive personally relevant information. Patients who have prepared for their consultation are better able to clearly communicate their goals, helping them to get on the same page with their surgeon more easily.

As you research breast implants, take notes, save photos, and write down the questions you want to ask your plastic surgeon.

2. Pay attention to the details

Your surgical plan has a big impact on your results. Whether you want a subtle boost or notably bigger breasts, my goal is to create a volumetric look that perfectly suits your frame. Here are 3 key elements of the plan that I am thinking about when I meet with you:

• Breast implant options: There are a range of breast implant options, with variations in size/volume, profile, and material. During the consultation, you will have the chance to try on sizers and feel implant options for yourself. We’ll recommend a range of sizes and profiles of implants that we know will look good on you, and help you narrow down your options from there.
• Breast lifts: If your breasts sag, you may need a breast lift in combination with your breast augmentation. This is not always the case, as a little visible “lift” can be achieved with implants. But if your breast sagging is more than just mild, we may have to incorporate a lift in order to achieve your vision.
• Add-on procedures: You may desire add-on procedures (such as liposuction) to get ideal, comprehensive results.

Excellent surgeons customize the procedure for your anatomy, and discuss the details of the surgery with you. The best surgical outcomes happen when the surgeon and patient are collaborating—you bring your expertise about your body and goals, and I bring my expertise about breast surgery.

3. Optimize your health for a smooth recovery

The secret to an optimal recovery? It starts well ahead of surgery! Go ahead and start investing in your health to support your body’s ability to heal during recovery:

• Strictly abstain from smoking and vaping.
• Fuel a healthy recovery by eating a nutrient-rich diet full of protein, fruits and vegetables, healthy fats like nuts and seeds, and whole-grain carbohydrates.
• After breast augmentation, you will need to sleep on your back. So that you’ll be comfortable getting quality rest in this position after surgery, practice ahead of time! You may want to place pillows along your sides to support this position at first.

After recovery, follow these tips that are a key part of the secret to gorgeous results:

• Continue to refrain from smoking—and, ideally, don’t pick it back up! Smoking ages your skin prematurely, and therefore contributes to breast sagging.
• Continue to eat a nutrient-rich diet.
• Don’t do too much, too soon after surgery. Embrace this chance to rest and allow your body to do the work of healing!
• Wear soft, supportive surgical bras—no underwires until your surgeon gives you the OK.
• Sleep on your back.
• Take care of your incisions per the scar care instructions that we provide.
• Avoid the sun, which will darken your healing scars and contribute to early skin aging.

4. Do it for the right reasons

Breast augmentation is one of most genuinely confidence-boosting procedures available. Yet choosing breast implants is a personal decision, and the happiest patients we see post-op decide to have this procedure to feel like a stronger, more confident version of themselves—not to please someone else. Check in with yourself before booking your consultation to make sure that you are seeking breast augmentation as a gift of confidence to yourself rather than to make others happy.

Breast augmentation should be a gift of confidence you give yourself—not something you do to make others happy.

5. Choose a qualified plastic surgeon who gets you

Good rapport with your plastic surgeon may be the most important secret to your results. Look for someone who listens to you and works with you during the consultation to make sure they 100% understand what you want out of surgery. Find a surgeon who is board certified, has years of experience, has glowing reviews, and shows you stellar before-and-after results that resemble the look you’re going for. Trust your intuition, and if you don’t feel that your plastic surgeon gets you, get a second opinion!

Schedule your consultation with Dr. Cat at Swan Center in Atlanta

Female board certified plastic surgeon Dr. Cristen Catignani wants her Atlanta breast augmentation patients to feel empowered, safe, and listened to every step of the way. If you are ready to schedule your consultation and learn what breast augmentation with Dr. Cat can do for you, call 770-667-0904 or contact our practice online.

You are smart to do your research, as some basic principles of breast implant sizing will help you as you talk with your surgeon about the look you want. Here is everything you need to know to help you get gorgeous breast augmentation results in proportion with your figure.

How do you choose a breast implant size?

In collaboration with your board certified plastic surgeon, you will choose a breast implant size based on a number of factors. First and foremost, you and your surgeon will discuss the “look” you want. Do you want buxom breasts, or do you want a modest, more natural-looking augmentation? Before and after pictures of patients who resemble you can help at this stage. Then, your surgeon will examine you, considering a number of factors about your body:

• The measurement of your breast base (breast width)
• How wide-set your breasts are
• The width of your shoulders and hips
• Your height, weight, and overall shape
• Your current breast volume
• The quality of your natural breast tissue

Other considerations may come into play during this consultation, too. For example, athletes may want to choose more modestly sized implants for their comfort while active. Or, you may want a certain incision placement or type of implant that will affect your choice of size.

Finally, you will try on breast implant sizers in our office to get a sense of what different sizes look like on you. Once you and your surgeon reach an understanding of the result you want, they will still typically bring a small range of implant sizes into your surgery. This minor amount of leeway allows your surgeon to observe the specifics of your tissues during surgery and, based on that, select the most appropriate implants to achieve your desired look. This also helps surgeons to achieve greater symmetry between the breasts; often, one side will need a slightly larger implant.

What implant is best for broad shoulders?

If you have wide shoulders or a larger frame, you will most likely be happiest with low-profile implants. “Profile” refers to how much projection the implant has: high-profile implants are shaped more like gumdrops (a bit more “pointy”), with more volume projected out from the chest wall. In low-profile implants, volume is evenly distributed throughout the implant, filling out the breasts at the center and edges. Low profile implants tend to create a nice fullness in all directions for women with a wider chest, without needing to add so much volume that they are uncomfortably heavy; high profile implants, on the other hand, typically look more natural on patients with narrow or petite frames. Moderate profile implants are also an option that is ideal for many patients with wider chests.

The key to gorgeous breast augmentation results is breast implants that are in proportion with your figure.

Tall or broad-shouldered women also often find that they are surprised by the high implant volumes we recommend for them. This is normal; if you are tall, you will need a higher breast implant volume (measured in cc’s) to achieve a proportional look.

What should I consider before breast augmentation if I have a larger frame?

The most important choice you make before breast implants is your surgeon; if you have a wide frame, look for a surgeon who has patients who look like you in their before and after gallery—with results you like! Note that surgeons’ online galleries may be limited, but in your initial consultation, your surgeon should be able to show you many more patients with the kind of results you’re looking for. If their aesthetic is not right for you, there is no harm in scheduling a second consultation with another surgeon. Your results are (literally) in your surgeon’s hands, so make your decision with no less than 100% confidence they can give you the results you desire.

How many cc’s is equivalent to a breast cup size?

Bra cup sizing is not scientific, nor is a single “breast cup” on a 42 band size going to hold the same amount of volume as that on a 32 band size. This makes it difficult to use breast cup size to determine the implant volume in cc’s that will be right for you. While you can try to estimate your implant size ahead of time, it’s key to schedule your consultation with a board certified plastic surgeon and try on implant sizers. Each implant has a certain diameter, projection, volume, and fill material, so the best way to get a sense of how all these factors interact in a certain breast implant is to handle real implants and try them out!

Does my weight before breast augmentation matter?

If you are at a stable weight you expect to maintain, your weight before breast augmentation usually doesn’t matter. (You just need to be under a BMI of about 30 to safely undergo surgery.) However, if you are actively losing weight, or expect your weight to fluctuate by more than 15-20 pounds, hold off on surgery until your size and proportions are stable so that your surgeon can give you a gorgeous, proportional result that continues to look stellar far into the future.

Schedule your breast augmentation consultation at The Swan Center in Atlanta

You are not alone in choosing your breast implant size at The Swan Center! Our board certified plastic surgeons take their time and work with you to find the perfect breast implants for your body. From initial consultation to post-operative check-ins, we are on your team every step of the way. To schedule your consultation, call 770-667-0904 or contact us online today.

If you are a little confused, or perhaps even worried, you are not alone. Word of the recall spread quickly, and as often is the case, the news raised more questions than it answered.

Your being confused is the last thing we want! Our board certified plastic surgeons have put together the following Q&A about the Allergan breast implant recall to help you understand what’s really going on, why, and what (if anything) you need to do.

First, a note to our patients: as a rule, we use Mentor implants at The Swan Center and have done so for years. If you had your breast implant surgery with us, it is highly unlikely that you are affected by the recall. Please see your Mentor Warranty Card or view warranty info here for more information.

• What breast implants have been recalled?
• What does a breast implant recall mean?
• Why were these breast implants recalled?
• Should I have textured implants removed?
• What should you do if you have implants affected by the recall?
• Will Allergan pay to have my implants replaced?

What breast implants have been recalled?

Only BIOCELL textured implants from Allergan have been recalled. This includes:

• Natrelle Saline textured breast implant styles 168, 363, 468
• Natrelle 410 anatomically shaped highly cohesive and 410 Soft Touch breast implants
• Natrelle INSPIRA textured breast implants
• Natrelle 133 (with or without suture tabs) and 133 Plus tissue expanders
• Other Natrelle silicone-filled textured breast implants. See a full list here.

Smooth-shelled breast implants of any kind are not impacted by the recall.

What does a breast implant recall mean?

When we hear the word “recall,” we automatically think of automobiles or toys—you take your car to the dealer or toy back to the store to replace the faulty part. The breast implant recall works differently. It means that BIOCELL implants may no longer be sold to or used by doctors and that any of these implants on the shelves must be sent back to the company. It may help to instead think of it as immediate discontinuation, or recall of unused BIOCELL products.

The recall does NOT mean that all patients who currently have these implants need to have them removed. This is because BIA-ALCL is such a rare condition. You simply need to be aware of breast symptoms that can be cause for concern and continue with routine follow-up care as recommended by your plastic surgeon.

Why were these breast implants recalled?

While the risk of developing BIA-ALCL is very rare (an estimated 1:2,207 to 1:86,029 if you have textured breast implants), BIOCELL implants have been shown to have the strongest association with the disease. In fact, the incidence of BIA-ALCL has been reported to be over 14 times higher in patients with BIOCELL implants vs. patients with other types of textured implants.

Importantly, the research indicates that it is the specific BIOCELL texturing method, not the presence of a breast implant itself, that raises the risk of BIA-ALCL. 

The texturing method of BIOCELL implants results in a very high implant surface area that can harbor significantly more bacteria than other types of textured implants. Studies show that a “chronic biofilm infection” results in heightened immune cell response. As BIA-ALCL is a cancer of the immune cells, it is believed that that the BIOCELL texture creates a more favorable environment for BIA-ALCL to develop compared to other types of implants.

Should I have textured implants removed?

It is currently not recommended that patients have BIOCELL or any other textured implants removed if they are not experiencing symptoms, such as breast pain or late-onset seroma (fluid accumulation in the breast 6 months or longer after implant placement).

If it seems odd to you that they would recall breast implants but say it’s okay for those who already have them to keep them, here’s the reasoning: the lifetime risk of developing BIA-ALCL, even for those with the recalled implants, is extremely low, about 1 in 2200, or 0.045%, at most. Worldwide, there are only 573 confirmed cases of BIA-ALCL out of tens of millions of women who have breast implants, and undergoing surgery carries its own risks. Additionally, if you are happy with the way your breasts look and feel with implants, having them removed may negatively affect your self-confidence.

All that said, if you would like your implants removed for personal reasons, we encourage you to discuss your options with an experienced, board certified plastic surgeon.

What should you do if you have implants affected by the recall?

The most important thing is to follow through on your recommended follow-up care after breast augmentation or reconstruction. Keep your appointments with your plastic surgeon, and get routine MRI or ultrasound imaging as recommended. Additionally, monitor your breasts for any changes or symptoms and report anything unusual or of concern to your primary care physician and your plastic surgeon.

Additionally, educate yourself about BIA-ALCL, including the risks, symptoms, and treatments. Here are a few resources to help:

• Breast Implant-Associated ALCL: The Facts About Your Risk (from the Swan Center)
• Questions & Answers about Breast Implant-Associated Anaplastic Large Cell Lymphoma (from the FDA)
• BIA-ALCL Resources: By the numbers, and what they mean (from the American Society of Plastic Surgeons)

Will Allergan pay to have my implants replaced?

Allergan is offering a partial replacement warranty for patients who currently have BIOCELL implants. If you choose to have your implants replaced, Allergan will provide you with smooth Allergan implants for free. This covers the cost of the device only; you will still have to pay surgeons’ fees, operating room and anesthesia costs, and any other costs associated with surgery. This offer is valid for 24 months, from July 24, 2019, until July 24, 2021, and applies to U.S. based patients only.

If you choose to keep your BIOCELL implants, you will still be covered under the Natrelle ConfidencePlus® warranty program, which includes up to $1,000 in diagnostic costs and up to $7,500 in surgical fees in the unlikely event you need to be tested and/or treated for BIA-ALCL.

Please reach out if you have any questions

We hope reading this has helped you better understand the breast implant recall, but if you have more questions, or would like to discuss your safe options for breast augmentation, reconstruction, or revision, please reach out to us! Our Atlanta plastic surgeons will be happy to help. Call 770-667-0904 or contact us online.

At The Swan Center, helping people feel amazing is what we love most about our jobs. We also pride ourselves on prioritizing our patients’ safety, health, and happiness, and believe in discussing the potential risks of any cosmetic procedure openly and honestly.

Today we want to talk about a phenomenon called breast implant illness. Several high profile patients have spoken out about health problems they have experienced after undergoing breast augmentation, and many more women across the U.S. have joined the conversation on social media, sharing concerns about symptoms ranging from headaches to hair loss, which they believe may be related to their implants.

As physicians, we believe it’s our duty to help answer your questions and discuss the issue frankly and fairly. Below, we’ve addressed the top questions about breast implant illness, based on the current information we have.

• What is breast implant illness?
• What are the symptoms of breast implant illness?
• How common is breast implant illness?
• Have breast implants been linked to chronic inflammatory symptoms?
• What should I do if I think I have breast implant illness?
• Should I have my breast implants removed?
• Is en bloc capsulectomy the best implant removal option?

What is breast implant illness?

Breast implant illness is a term used to describe systematic symptoms that a patient believes relate to her breast implants. If this sounds like a vague definition, that’s because defining breast implant illness is challenging.

Unlike many diseases, such as chicken pox or diabetes, breast implant illness does not have consistent symptoms or a certain known cause. The common denominator is that the patients have breast implants, they have developed one or more symptoms after having implants placed, and they feel their symptoms are linked to their breast implants.

It’s worth noting that breast implant illness is not the same as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), which is a specific, very rare, and treatable cancer that has been determined to be linked to breast implants. (You can learn more about BIA-ALCL on this post from our plastic surgeons.)

What are the symptoms of breast implant illness?

Patients have reported a wide variety of symptoms they believe are associated with breast implant illness. These include: headaches, chronic fatigue, body aches, generalized pain, hair loss, increased sensitivity to light, depression, anxiety, sleep problems, rashes, unusual body odor, and more.

These symptoms are also commonly experienced by men and women who have never had breast implants, which makes it difficult to narrow down breast implants as the definitive source or cause of the symptoms in a specific patient. However, we must consider the possibility that any of these symptoms could be related to the breast implants.

At the Swan Center, we continue to keep close tabs on all research and testing related to breast implants (as we have since our founding), and detail all scientifically proven risks in our patient materials.

If you are concerned that your breast implants may be causing symptoms, share your concerns with your doctor and your plastic surgeon. Your doctor can suggest testing or treatment and, if desired, your plastic surgeon can detail your breast implant removal options.

How common is breast implant illness?

Breast implant illness is a relatively new concept in the medical community. We have witnessed an increase in patients reporting suspected breast implant illness symptoms in recent years, in large part thanks to social media groups, which have raised awareness of the concept of breast implant illness, as well as provided a platform for patients to report and discuss their symptoms. We don’t point this out to diminish concerns, but rather to help explain what may seem like a sudden increase in patients asking if symptoms they experience could be related to their breast implants.

Because symptoms are subjective and vary widely, and there has yet to be consensus in the medical community that breast implant illness is a definable condition, we cannot specify the exact risk of developing symptoms after breast augmentation. Moreover, there is no existing means to test specifically for and definitively diagnose breast implant illness. Plastic surgery societies such as The American Society for Aesthetic Plastic Surgery (ASAPS) have begun initiatives to better track and examine reports of breast implant illness, including a scientific study and surveys to help plastic surgeons and patients document any symptoms.

Our plastic surgeons believe the women who are reporting symptoms and pledge to help each woman who visits our practice consider all possible sources and solutions (including the possibility of implant removal), to help them find the best course of treatment to feel better. In short, we support each individual woman’s personal choice, whether it is to keep or remove her implants for any reason.

Have breast implants been linked to chronic inflammatory symptoms?

Earlier we mentioned BIA-ALCL, which is thought to result from chronic inflammation in the biofilm, or natural microbial layer, surrounding a breast implant. However, the scientific studies we have to date show that this is only a factor in BIA-ALCL, and the symptoms have only been linked to textured implants, which have a greater surface area on which microbes can gather. Symptomatically, this inflammatory response usually presents as seroma (fluid buildup) and/or pain that is isolated to the breast.

To date, there is no known link between systemic inflammatory symptoms (i.e., rheumatoid arthritis, chronic fatigue, digestive problems, etc.) and breast implants, although many women with such symptoms suspect their implants play a role. As mentioned earlier, patient/doctor survey initiatives and further scientific research are currently underway to help identify any possible patterns.

What should I do if I think I have breast implant illness?

If you are experiencing symptoms that concern you, see your primary care physician or other appropriate specialist. Your doctor may recommend further tests to identify or rule out other possible causes of your symptoms, and they can help you manage your symptoms while you consider options.

If you believe your breast implants are a contributing factor, share your concerns with your doctor and with your plastic surgeon. While there isn’t yet means to medically confirm or disprove a specific association, they can share their professional knowledge and help you understand your options if you wish to pursue breast implant removal.

Because there is no way to confirm that symptoms are related to breast implants, there is no guarantee that breast implant removal surgery will relieve symptoms.

Should I have my breast implants removed?

With some complications, such as capsular contracture, undergoing breast implant removal and/or replacement is a clear option and path to relief. However, it’s not so cut-and-dried with breast implant illness.

First, because there is no way to confirm that symptoms are related to breast implants, there is no guarantee that breast implant removal surgery, or explantation, will relieve symptoms for an individual woman. The patient must undergo surgery and see if her symptoms are relieved afterward, knowing that the additional surgery also carries some risks and requires recovery time. That said, in the hands of an experienced, board certified plastic surgeon, risks are low and many women who have had implants removed are glad to eliminate them as a source of concern, even if they continue to experience symptoms.

For our patients who are unhappy with their implants for any reason, we offer explantation surgery as an option. If both the patient and the plastic surgeon believe the potential benefits of removing breast implants (whether for health, lifestyle, or aesthetic reasons) outweigh the risks, that is what truly matters.

Is en bloc capsulectomy the best implant removal option?

Many breast implant illness websites and social media forums advocate for en bloc capsulectomy—an explantation technique that removes the breast implant and surrounding scar tissue capsule in one single unit. It is thought by some doctors and patients that leaving the breast implant “sealed” inside the capsule most effectively removes all the matter that may be causing symptoms.

Indeed, for some patients, en bloc capsulectomy is the right approach; for example, if a known complication or disease such as BIA-ALCL is suspected. However, en bloc capsulectomy has some drawbacks to be aware of. First, the incisions required to remove an implant en bloc are usually much longer than those required for other types of breast surgery, and this results in additional scarring in most cases. Additionally, if there is not enough natural tissue between the capsule and the surrounding muscles, rib cage, or other vital organs, en bloc capsulectomy cannot be performed safely.

If you are considering en bloc capsulectomy, make sure the plastic surgeon you choose is highly experienced in the technique and that you fully understand the incision plan, risks, and differences in results vs standard breast implant explantation before moving forward.

We welcome your questions about breast implant illness

At The Swan Center, we remain dedicated to providing the highest standard of safety and care. Whether you are considering your options for Atlanta breast implants and want to be sure you are making the right choice for yourself, or you are concerned about the possibility of breast implant illness, we are here to listen and help you make safe, considered choices. Please call us at 770-667-0904 or contact us online anytime.

We recently took a look at the current shift in aesthetic preferences towards smaller breasts and smaller breast augmentations on our blog. Since then, we’ve had several questions about what it takes to achieve a more modest breast size increase. More specifically, many patients ask, “what size implants do I need to go one size bigger?”

The answer is different for everyone, depending on what breast size and shape you’re starting out with, what bra you use as a yardstick, the size of your torso, and more. Given all this, you many need larger or smaller implants than another patient to achieve a single cup size increase. Let’s delve into the topic right now.

How breast implant sizing works

Breast implants are sized by volume, in units called “cc’s,” which stands for cubic centimeters. Every implant manufacturer offers a wide range of sizes, typically beginning at around 100cc, and increasing in 10 to 20cc intervals all the way up to 800cc or more. Considering there’s only about 1 Tablespoon per 15cc of implant filling, having so many options allows us to achieve very specific breast augmentation size goals. However, this doesn’t make it any easier for you to know what size implant you might need to go from an A cup to B cup, for example.

In an effort to simplify sizing estimates, some surgeons give a rule of thumb of 150 to 200cc per bra cup size increase; however, some of our patients need a 300cc implant to achieve one cup size increase, while for others something as large as a 340cc implant is more appropriate. You can see the wide variation in implant sizes our patients with similar goals by using the search tools in our before and after gallery.

In other words, there is no accurate “rule” for a one cup size increase and we discourage fixating on a certain number for several reasons.

Getting natural looking, beautiful breasts requires thinking about more than size

First, there are multiple factors influencing the actual size increase a breast implant will provide other than volume, including:

• Implant profile (projection) and base width
• Implant shape (i.e., classic round, teardrop shaped, extra upper pole fullness)
• How much natural breast tissue you have
• The width and contour of your rib cage
• Your natural breast shape and dimensions (i.e., do you have a wider breast base, or more narrow or tuberous breasts, or any asymmetry or sagging to address?)

For example, a 200cc high profile/narrow base width implant placed on a petite patient will usually create a more dramatic breast size increase than a 200cc low profile/wide base width implant placed on a patient with a larger stature. Additionally, as implant size goes up, it takes more cc’s of volume to achieve a full cup size increase, meaning that you’d probably need a larger implant to go from a B to C cup than you’d need to go from an A to B cup.

Second, there is almost zero consistency in bra sizing; the cups of a 34C bra in one brand or style will fit differently than a 34C in a different brand or style. (No doubt you’ve experienced this already when bra shopping!)

With our own patients, we hone in on an implant size range by having them try on different implant sizers during a consultation and see which size will give them the look they want. Additionally, our plastic surgeons use sizers during your breast augmentation surgery to confirm that the actual implants you receive provide just the right boost in your proportions.

Is it worth it to only go up one cup size with breast augmentation?

As often as we’re asked what it takes to achieve a certain breast size increase, we’re asked whether it’s worth it to have breast augmentation to bump up just one cup size. It can be totally worth it if any of the following is true for you:

• You’d like to improve the shape of your breasts or correct tubular (“Snoopy”) breasts
• You want larger breasts but don’t want others to notice you’ve had an augmentation
• You hope to correct breast asymmetry (i.e. one of your breasts is smaller than the other)
• You want more fullness in the upper part of your breasts but don’t really want your breasts to be much bigger
• You’re an athlete and going too big might hamper performance
• You simply want a very subtle size increase

As our many patients who chose to have smaller breast augmentations will tell you, a skilled plastic surgeon can achieve what no padded bra ever will: improved breast symmetry, a beautiful shape, and breasts that look and feel natural in any type of clothing (or no clothing at all)! Peer-reviewed studies have show that cosmetic surgery leads to higher self-esteem and a better mood, so even a small change can have a big impact.

We’re North Atlanta’s choice for tastefully natural breast augmentation results

As we tell our Atlanta breast augmentation patients, choosing the right implant size is part art and part science—and all something an experienced plastic surgeon can help you with. If you’re considering breast augmentation, whether you want a dramatic size increase or a more modest boost, our board certified plastic surgeons at The Swan Center can help you achieve the look you’re wishing for. Contact us today to request your consultation.

Considering we’ve been one of Atlanta’s top plastic surgery practices for over 20 years in large part due to our surgeons’ reputation for achieving beautiful breast augmentation results, you may wonder what our surgeons think of this current shift in trends. They embrace it! Our surgeons pride themselves on their ability to achieve a very natural size, shape and feel for our patients through breast augmentation. This has long been an area of special expertise and interest at The Swan Center. That’s because we’re here to help each woman get the shape that feels just right for their own body—a shape which will look fabulous now as well as years down the road.

The goal of a natural breast augmentation has always been shape over size

While fashion trends—and the breast aesthetics they favor—come and go, our plastic surgeons have always prioritized shape, symmetry and proportion over size. Their skill for enhancing a patient’s overall figure with the appropriate size breast implants—whether small, average, or large—is something that our patients have long valued, ever since we opened our doors back in 1993.

It’s never too late to change your shape…

The other side of the “less is more” coin with regards to breast augmentation is that we are seeing more returning patients who want to refresh their silhouette by downsizing breast implants. While changing fashion trends may have some influence, more often than not it’s a personal shift in aesthetic preferences—how many of us have the exact same taste at age 40 as we did at age 20?

For these patients, a revision procedure to replace older, larger implants with smaller ones is often the answer. In some cases, a breast lift is also necessary to address excess skin that cannot contract to the new, smaller breast size. In all cases, the patient enjoys a fresh start on her breast augmentation with brand new implants.

Ultimately, breast augmentation remains one of the most popular cosmetic surgeries for women despite shifting fashion trends, and an experienced, board certified plastic surgeon will tailor the procedure to achieve the breast contour that suits your needs best, regardless of size.

Smaller breast implants can make a big difference, while maintaining a natural look

We specialize in meeting your goals with Atlanta breast augmentation

If you’re looking for a subtle breast augmentation in Atlanta, make an appointment with one of our board certified plastic surgeons at The Swan Center. They will help you understand what’s involved with breast augmentation surgery, and you’ll get to try on different implant sizes to see how you might look with a small breast size increase—or a dramatic boost, if you prefer. Start your breast enhancement journey by contacting us today. We look forward to meeting you!

As board certified plastic surgeons specializing in breast augmentation, our days are literally filled with news, discussion, and practice of this popular cosmetic procedure. When we are not performing surgery, consulting with a patient, or helping her choose breast implants, we are either furthering my research, attending surgeons’ conferences, or leading seminars about the latest techniques in breast surgery.

There are many facts about the procedure that we take for granted but that our Atlanta breast augmentation patients are often surprised to learn. We thought we’d share a few of the more interesting bits of info with you now. If you’re considering breast augmentation for yourself, we hope you’ll find this insider information helpful. If you’re not, perhaps these fascinating facts about breast implants will come in handy for trivia night. Enjoy!

1. Today’s “5th generation” silicone implants can withstand up to 300 lbs. of pressure

Many patients ask us what it would take to break a breast implant: can contact sports, a car accident, a mammogram, or an overzealous partner cause a rupture? If your implants are in good shape—that is, the shell is not compromised due to age of the implant—the answer is probably no. Today’s breast implants are extremely durable, and can withstand tremendous amounts of pressure before rupturing: about 175 pounds for saline, and up to 300 or so for silicone gel. This is far more pressure than a mammogram comes even close to applying.

If you do experience a rupture, the good news is it is not usually a medical emergency. Saline filling is safely absorbed by the body, and today’s silicone gel implant filling is designed to remain in the implant shell and almost never migrates outside the breast capsule. Just be sure to contact your doctor, and they’ll be able to guide you.

2. We may never even touch your breast implants during surgery

“How is that possible?!?,” you may ask. Here’s how: the Keller Funnel. This deceptively simple device looks like a pastry bag—and also works somewhat like one, in that we will squeeze a silicone gel implant out the small end into the breast pocket during surgery—but it offers multiple benefits for your safety, comfort and results:

• Dramatically reduced infection risk. The implant can go straight from its sterile packaging, to the sterile Keller Funnel, to your breast without anyone touching it or the inside of your breast. Even though a reputable plastic surgeon changes gloves multiple times during surgery, eliminating glove-to-implant contact further reduces risks.
• A quicker, more comfortable recovery. A hands-off approach also means there’s less poking and prodding of breast tissue during surgery, which can reduce post-op swelling, bruising and tenderness and help you heal more quickly.
• Smaller incisions, smaller scars. Squeezing the implant through the smaller opening of the Keller Funnel allows us to place the implant more precisely through a shorter incision compared to surgery without this tool.

Despite these benefits, not every plastic surgeon is trained in the Keller Funnel, so it’s worth asking during your consultations if that surgeon uses it. Additionally, it’s only an option for silicone gel implants—saline implants and gummy bears must be placed by hand.

3. Breast augmentation has gotten over 200%* more popular over the last 20 years

Breast augmentation isn’t going out of style any time soon. In fact, more patients each year choose to have the procedure, regardless of changing trends for the “ideal” body shape. A likely reason why: most women who have breast augmentation do so for personal reasons that have nothing to do with looking “perfect” or keeping up with fashion.

The top reasons my patients state for wanting breast augmentation are (in no particular order):

• To balance out their upper and lower body proportions
• To help them feel more like themselves
• So clothing will fit them better
• To correct significant asymmetry

The moral of the story is that breast augmentation can improve more than one’s outward appearance—it can improve a patient’s self-confidence and quality of life.

4. It’s fairly easy to have breast augmentation and keep it a secret

The only people who ever need know about your procedure are: your plastic surgeon, your operating room team, and yourself. While you will need a trusted adult to drive you to and from the surgery center for your procedure, and care for you the first 24 hours, this can be a hired home-care nurse if you prefer.

If you’re worried about your boss and coworkers finding out, consider this: most patients return to an office job within 3 to 5 days after breast augmentation. That’s a long weekend or short vacation—and all your employer needs to know is that you are taking a few days off for R&R. When you return to work, a stylish scarf or high-necked, relaxed-fit blouse is usually all that’s needed to avert unwanted attention (a new haircut can work wonders as a distractionary tactic too!) Just keep in mind that before you drive anywhere, you’ll need to be completely off prescription pain meds.

Want more breast augmentation facts? Come in for a consultation.

We hope these facts have been interesting and helpful to you! If you have questions about breast implants or are considering your options for breast augmentation in Atlanta, please contact us at The Swan Center! We offer consultations for cosmetic surgery patients, and we will be glad to help you learn more about your options to enhance your breasts.

*Source: https://www.surgery.org/sites/default/files/ASAPS-Stats2016.pdf

You may have heard on the news or through social media that breast implants have been linked to a rare form of cancer called Anaplastic Large Cell Lymphoma (ALCL). Patient health and safety is our utmost concern for our plastic surgeons and staff at The Swan Center, and this is important news that may concern many of our patients. However, sensationalized media headlines can lead to confusion about what actual risk breast implants carry for women. Let’s look at the facts in context.

What is Anaplastic Large Cell Lymphoma (ALCL)?

ALCL is not breast cancer. It is a type of non-Hodgkin’s lymphoma that affects cells in the immune system. It can occur anywhere in the body, and it occurs in women and men who have never had breast implants as well as those who do have implants. Breast implant associated ALCL, or BIA-ALCL refers to cases of ALCL that developed in patients after they received breast implants.

The FDA has been monitoring the possibility of an association between breast implants and ALCL since 2011, after a small number of cases were reported in women who had breast implants. Likewise, the Plastic Surgery Foundation (PSF), a research organization founded by the American Society of Plastic Surgeons, established PROFILE (Patient Registry and Outcomes for Breast Implants and Anaplastic Large Cell Lymphoma, Etiology and Epidemiology) registry in 2012 to track any possible link.

Since this time, the FDA and PSF have gathered enough data from clinical incidence reports and statements from health regulatory organizations to declare a statistically significant association between having breast implants and developing ALCL. In other words, the FDA does believe that women with breast implants have a higher chance of developing the disease than the general population. How high? Let’s look at the numbers.

Your lifetime risk of getting struck by lightning is 1 in 13,000, or 0.007%, nearly twice your risk of getting ALCL

What is my risk of getting BIA-ALCL after breast augmentation?

If you are among the millions of women in the United States who have breast implants, the risk of ALCL remains extremely low. A recent epidemiological study estimates a 33 in 1 million lifetime chance of developing ALCL if you have textured breast implants—that’s a .003% chance. (Your lifetime risk of getting struck by lightning is 1 in 13,000, or 0.007%, nearly twice your risk of getting ALCL). Data indicates the risk is even lower if you have smooth breast implants. More facts:

• Since 2010, 660 total medical device reports (which are different from confirmed cases) of BIA-ALCL related adverse events have been made to the FDA, including 9 deaths. Nearly 300,000 women get breast implants every year in the U.S., and an estimated 11 million women worldwide have breast implants.
• As of September 2018, the FDA estimates 457 unique cases of BIA-ALCL in the US have been reported to the Patient Registry and Outcomes for Breast Implants and Anaplastic Large Cell Lymphoma Etiology and Epidemiology (PROFILE) database, which is maintained jointly by the American Society of Plastic Surgeons, the Plastic Surgery Foundation, and the FDA.
• There is no apparent difference in the risk of developing ALCL for silicone implants than for saline
• There appears to be a higher risk associated with textured implants vs. smooth implants.
• On July 24, 2019, the FDA requested that Allergan voluntarily recall BIOCELL textured implants, which have been shown to be closely linked to confirmed cases of BIA-ALCL. This includes: Natrelle Saline-Filled breast implants, Natrelle Silicone-Filled breast implants, Natrelle Inspira Silicone-Filled breast implants, and Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Filled breast implants.

Is BIA-ALCL treatable?

The majority of breast implant-associated ALCL are treated by removing the patient’s breast implants, as well as the surrounding scar tissue, or capsule. Chemotherapy and/or radiation has been used in some cases. According to the MD Anderson Cancer Center and Plastic Surgery Foundation, most patients who receive appropriate treatment for ALCL have a good prognosis, with implant removal surgery fully treating the disease in most cases.

There is no need to abandon your plans to get breast implants if you would like to enhance your breasts, or if you are facing breast reconstruction. The overall risk for complications after breast augmentation remains very low when performed by an experienced, board certified plastic surgeon.

What to do if you have breast implants

Neither the FDA nor the medical community recommends that patients have their breast implants removed if they are not experiencing any problems. In fact, the normal risk of complications from undergoing a second surgery to remove implants, while very low when performed by a qualified plastic surgeon, are likely greater than your risk for developing ALCL.

The best thing to do is to continue with routine recommended screenings, including mammograms (if applicable) and MRI if you have silicone implants.

Do see your plastic surgeon as soon as possible if you are experiencing any of the following, as these are potential symptoms of BIA-ALCL:

• You develop persistent pain in one or both breasts
• You notice swelling in one or both breasts later than 6 months after surgery, when normal post-op swelling should have subsided

Additionally, you should contact your plastic surgeon if ever you have a concern or question about your breast implants.

If you have been considering breast augmentation…

There is no need to abandon your plans to get breast implants if you would like to enhance your breasts, or if you are facing breast reconstruction. All surgery carries some risk, and the overall risk for complications after breast augmentation remains very low when performed by an experienced, board certified plastic surgeon.

In its statement, the FDA recommends that patients educate themselves about breast implants before having surgery—we have always encouraged our patients to research their options and learn about the benefits and potential drawbacks of each implant type. In fact, we spend a considerable amount of time with each patient discussing implant options.

Given the current information we have about BIA-ALCL, it is reasonable to consider smooth implants if you are concerned about further reducing the small risk of developing the disease.

Please don’t hesitate to contact us

If you have questions or concerns about the news regarding BIA-ALCL or any other issue related to plastic surgery, our board certified plastic surgeon and staff at The Swan Center will be happy to assist you. Please call our office at 770-667-0904 during office hours or contact us online anytime.

Article updated with new FDA report numbers on February 12, 2019.