Each year, thousands of patients undergo successful breast augmentation surgery, experience no major problems and are very happy with the results. However, there are some cases in which a patient may choose to have their implants removed by undergoing a procedure called explantation.
There are a variety of reasons why a patient may seek explantation, including but not limited to:
- A patient feels like they’ve come to a new stage in their life, and they no longer desire implants or the aesthetic that the implants provide.
- Patients may have chosen implants that were ill-suited to them (e.g. too large of a size) and are now encountering complications from those choices.
- Rarely, clinically significant capsular contracture has occurred, causing pain or cosmetic issues.
In addition to explantation, your surgeon may also deem it necessary for you to undergo a breast lift. The reasons for this could include:
- After having children, breast tissue has expanded and deflated, causing aesthetic changes.
- Very large implants have stretched the skin, often necessitating a breast lift after the implant removal.
- A significant amount of time has passed, and as a result age and gravity has naturally caused the breast tissue to descend.
Just like choosing to undergo breast augmentation, explantation is a big decision with many important elements and options to discuss with your surgeon. The process can seem daunting, but there are a few common surgical options:
If the existing implants are positioned above the muscle…
We usually perform a procedure called “en bloc capsulectomy”, which includes the removal of the scar tissue capsule and breast implant all at once, without opening the capsule. Following this procedure, we often recommend a breast lift to remove any excess skin and reposition the remaining tissue (coined a “you-flap”) into a more aesthetically pleasing position. We’ll also often do a touch-up with fat grafting, which includes collecting fat via liposuction from another site and injecting it into the breast in an effort to increase volume where it may be needed.
If the existing implants are positioned under the muscle…
In this case, an en bloc capsulectomy is less likely to be possible—it is much more difficult and can be unsafe. This is because the scar tissue or capsule is usually closely adhered to the muscle and/or the ribcage, which can cause significant complications when removal is attempted. When this is the case, we recommend removal of as much scar tissue as possible (partial capsulectomy). After the scar and implant removal, we then reposition or reconstruct the pectoralis muscle back to its original anatomical position and perform the same breast lift and tissue repositioning coupled with fat grafting mentioned above.
If capsular contracture has occurred….
When breast implants are placed into the body, our defense mechanism reacts—as it would to any other foreign body—by developing scar tissue or a “capsule” around it. In rare cases (approximately <3% of the time), patients will develop excess scar tissue around the implant which can make the breast hard or distort its shape, sometimes causing discomfort. This is known as capsular contracture, and in cases where it does occur it can usually be corrected surgically, though some patients will choose explantation as a result.
If a patient is unsure whether or not they want to keep their implants in…
If a patient with saline implants is unsure whether or not they want to keep their implants or undergo explantation, we can deflate the saline implants and allow them to go about their daily lives for 3-6 weeks. This way, they get a sense of whether they want to keep their implants, potentially exchanging them for a different shape or size, or if they would be more comfortable removing them. Deflation is a very simple procedure (comparable to getting your blood drawn) that can be performed in-office. Deflation is not possible with silicone implants.
If you’re looking to learn more about your explantation options, contact the team at FORM Face + Body today.
