Breast implant removal or explant surgery can be done for a variety of reasons but our intention today is to explore the pros and cons of having your breast implants removed as well as to look at the results and recovery process after the surgery.
Statistics for 2018, published by the American Association of Plastic Surgeons, show that in the United States 313,735 women had a breast augmentation procedure. During that same time frame, 29,236 women had their implants removed.
Breast implants are not lifetime appliances and last an average of 10-15 years before needing to be removed or replaced.
Some are removed or replaced to increase or decrease breast size. Women who have been diagnosed with breast cancer have had their implants taken out to undergo treatment. Others have experienced breast implant illness (BBI), an implant rupture, scar tissue around the implant becomes hard and painful (capsular contracture), or their vision of what they want for themselves changed.
If you have been considering breast implant removal, then this information should help you decide if breast explant surgery is the right thing for you. As with anything else, there are pros and cons to explant surgery. No matter the reason for removal, being prepared for what to expect after breast implant removal can make for a smoother experience.
The Positive Aspects Of Breast Implant Removal
When looking at the pros of removing breast implants please consider the following:
1. Mammogram Accuracy
Breast implants, either saline or silicone, can obscure the images on a mammogram and reduce the radiologist’s ability to accurately read them. The placement and type of breast implants you received both play a part in how difficult it is to obtain an accurate reading. The inability to monitor breast health could be potentially dangerous, especially for those women who have a family history of breast cancer.
Some women have also experienced implant ruptures during mammograms. Having breast explant surgery will eliminate any issues in obtaining a clear image from a mammogram so accurate breast health can be determined.
2. Goodbye Expensive MRI’s
The fact that mammograms are inconclusive for most implant recipients coupled with the possibility of implant rupture, women who have had breast implant surgery must get an MRI every two years. An MRI is an expensive test and can be $2,000 on average. Having breast explant surgery means no longer being required to have scheduled MRIs.
3. No More Anxiety Regarding Potential Ruptures
Women who have implants have been made aware of the possibility of implant rupture. Implants can rupture due to intense physical pressure, defects in the implant, weakening implants due to their age (need to be replaced), or stress on the implant because of capsular contracture.
Women with implants need an MRI every two years to ensure the implants are still intact and no rupture has occurred. Removing breast implants also removes the worry over potential ruptures.
4. Elimination of Pain
If you have chronic pain, resulting from your breast implants, then undergoing breast explant surgery should alleviate it. Often women who have opted for larger implants experience pain in their shoulders, necks, and back. Sometimes a condition called capsular contractures can occur causing the scar tissue, that results from breast implants, to harden and can cause significant pain as well as misshapen implants.
In recent years there has been more information available regarding breast implant illness (BII) that can result from breast implants. Some women have experienced a wide array of systemic illnesses after receiving breast implants. The symptoms caused by their bodies’ reaction to the implants are so widely different for each woman, can mimic other illnesses, and are often misdiagnosed.
If you have pain or symptoms resulting from your breast implants, then removing them should provide relief. Schedule a personal consultation with a triple-board certified cosmetic surgeon, Dr. Angelina Postoev, to learn more about breast explant surgery.
5. No Need For Replacements
Since breast implants age over time, they need to be replaced every 10-15 years. Some doctors advise every 10 years to err on the side of caution. Breast implant surgery is not normally covered by your insurance and can be quite costly. Breast explant surgery removes the need for replacements each decade.
6. Short Recovery Time After Explant Surgery
If you decide to undergo breast explant surgery, you will be pleased to hear that the standard recovery time is only two weeks. Your surgeon will provide you with aftercare instructions and a list of dos and don’ts pertinent to your recovery such as lifting heavy things, or driving, etc.
7. Celebrate The New You
Women receive breast implants for several reasons and one is a sense of self-confidence. They desire to “feel” a certain way about themselves and believe that this alteration will bring them that feeling. The same holds true for breast explant surgery. Some find that feeling free enough to “just be who they are” how they were made, gives them a great sense of self-love.
Some women who have breast implants find it challenging to find clothing to fit them properly. A stylish article of clothing may not button up over their breasts but it fits in all the other places. They end up having to buy something 2 sizes too big just to fit their chest. Shopping may become more enjoyable because they may have an easier time finding cute things that fit correctly.
The Downside Of Breast Explant Surgery
When looking at the cons of removing breast implants please consider the following:
1. Sagging Breasts
Depending on the size of implants you are removing, as well as the size you were before you had the implants, you can experience a certain amount of sagging. If you originally were a B cup and increased to a DD, you will likely experience more sagging than someone who went from an A cup to a B cup.
The number of years you have had your implants, coupled with gravity will also play a part in the degree of sagginess. You can talk to your surgeon and see if you might be a good candidate for a breast lift which usually can address sagging as well as loose skin.
2. Excess Loose Skin After Explant Surgery
Having larger implants can stretch out your skin as well as factors such as aging, genetics, weight gain and loss, and gravity. For many of the same reasons breasts sag also cause the skin to loosen and hang down. As mentioned above, you might be a good candidate for a breast lift after implant removal to address loose skin or sagging.
3. Significant Loss Of Breast Tissue
In some cases of breast explants, it is necessary to remove a significant amount of breast tissue. This could be due to a silicone gel rupture that spread or scar tissue that has formed making removing the implant alone impossible. For your continued safety, the surgeon may need to remove a good deal of breast tissue causing it to appear as if you had a full or partial mastectomy.
4. Risk Of Infection
Just as with implant surgery, breast implant removal surgery comes with the associated risk of possible infection. If you did experience an infection it would likely occur at the incision site or where the implant was previously located. An infection would lengthen your recovery time and require antibiotics and possibly drainage tubes.
5. Complications From Anesthesia
As in any surgery, being under anesthesia comes with its risks. Some women experience nausea, vomiting, headaches, backaches, and in rare cases anaphylaxis, hematoma formation, and more.
6. Additional Scarring
Despite a surgeon’s best efforts, scarring at the incision site is unavoidable. Breast implant removal surgery would most likely be done through the same incision sites as your original implant surgery however, breast explant surgery scars may be more noticeable.
One of the most common areas a surgeon will access the breasts to insert an implant is around the bottom of the areola or periareolar incision. If your original augmentation was done in this manner, you may have already experienced a reduced amount or loss of sensation in your nipple area.
There are tiny nerves all around that area that signal sensations and feelings to your nipple. Sometimes those nerves are damaged or severed by the surgery because they are so tiny and hard to detect. When removing breast implants and using the same access point, there is a risk of those nerves being further damaged or severed.
7. Decrease in Self Esteem
If having your implants removed is something you have to do for medical or safety purposes, then you are likely to experience some issues in the way you feel about yourself. Many women have breast implants to give them feelings of confidence and boost their self-esteem. Removing the implants may cause you to revert to those old feelings. If this is the case, speak to your surgeon about options you may have to alleviate these feelings.
8. Reconstruction After A Breast Explant
What do breasts look like after implant removal? This is a question that most women who are contemplating the procedure ask. Most patients have questions about what they can expect regarding their breasts after the surgery. Understanding that there will be a significant difference in the look of your breasts before and after explant surgery will help you be prepared.
Each case will vary depending on factors such as:
- Your initial breast size;
- The size of the implants that were installed;
- How long the implants have been in place;
- If there are any current issues with the implants;
- Your overall health.
Generally, after removing breast implants, the breasts are saggy and have lost their shape. The greater your cup size increases during your initial breast implant surgery, the more your breast skin will be stretched out and will hang down.
Most women decide to undergo some form of reconstruction surgery so they have natural-looking breasts that are more aesthetically pleasing. They choose to have breast explant surgery with a fat transfer or with a lift.
A breast lift can eliminate loose skin that remains on the breast after explant surgery. The breast lift will also recontour the shape and lift the breast and nipple to place them in their rightful position where they will look youthful and natural.
Sometimes, breasts can be enhanced with a fat transfer. Fat is taken from one location in the body, processed, and then injected into another location. If a small amount of extra volume is needed to create a natural-looking shapely breast after explant surgery, the breast lift may be enhanced using a modest amount of fat that is transferred to the targeted location on the breast to achieve the desired result. In most circumstances, they add more fat during the transfer than is needed because not all of the fat injected will be sustained.
When discussing the look of your breasts after the surgery with your cosmetic surgeon, you can ask to see before and after pictures as well as explant surgery with a lift before and after pictures to help you determine if you would like to undergo reconstruction during your implant removal.
9. The Cost
Breast augmentation surgery is considered a cosmetic procedure in most cases and is not covered under insurance. Removing breast implants, unless medically necessary, comes under the same category and is often not paid for by insurance. Comparing the costs of maintaining breast implants vs. the cost of explant surgery should be taken into consideration.
Deciding to undergo a breast explant is something to be carefully considered. Either way, the decision may be life-altering just as it was when you had your breast augmentation. Choose a surgeon that is board-certified and one you feel totally comfortable with. Keep an open and candid dialog with your surgeon and ensure you have all your questions answered before making your choice.
For more information about breast explant surgery please contact our offices to set up a consultation.
Angelina Postoev, MD, FACS, a triple board-certified cosmetic surgeon, and Christopher Ibikunle, MD, FACS, offer explant surgery in Atlanta, GA, and the surrounding areas of Lawrenceville, Suwanee, Johns Creek, and Buckhead.