Breast Implant Removal Surgery (Explant)

Considering Breast Implant Removal – What do you need to Know?

About 20,000 breast augmentations are performed in Australia each year. Many young women choose to undergo this surgery for a variety of personal reasons, including aesthetic preferences and self-confidence. However, it is essential to keep in mind that all breast implants may eventually need to be removed at some point in time, which is a significant decision to contemplate, similar to the initial choice of getting the implants. There are several reasons you might consider for removing your implants, along with important factors to weigh carefully before proceeding with this type of surgery. Here is some general information that aims to help you make a well-informed choice that aligns with your personal needs and situation.

What are the common. Reasons people want their implants removed for?

Reasons for considering breast implant removal can vary and are personal.

Capsular Contracture: A condition where scar tissue tightens around the implant, causing discomfort, pain, and changes in appearance.
Implant Rupture or Leakage: Damage to the implant that can result in deflation (for saline implants) or changes in shape or firmness (for silicone implants).
Changes in Aesthetic Preferences: A desire to change breast size, shape, or appearance, or a preference for a more natural look.
Health Concerns: Worries about potential health risks, including conditions like Breast Implant Illness (BII) or Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).
Aging of Implants: Implants don’t last a lifetime; as they age, the risk of complications increases, leading some people to remove or replace them.
Pain or Discomfort: Chronic pain or discomfort associated with the implants, particularly during exercise or daily activities.
Weight Changes or Pregnancy: Significant body changes that can alter breast appearance, prompting some to remove or adjust implants.
Breast Sagging (Ptosis): Age-related changes or gravity can cause breasts to sag, leading to dissatisfaction with implant appearance.
Financial Costs of Maintenance: The potential long-term costs of monitoring, replacing, or repairing implants can prompt removal.
Lifestyle or Physical Activity: Some people find implants interfere with certain activities or feel they affect comfort during exercise or physical work.
Many people opt for implant removal as a personal decision based on a combination of these factors. Careful discussion with yuor local doctor and Dr Green is advised. Take time to think over the decision and consider second opinions if you are unsure.

Ruptured Breast Implant

What is Implant Associated Lymphoma (BIA-ALCL)

Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare type of non-Hodgkin's lymphoma that can develop in the tissue surrounding breast implants. Although not a form of breast cancer, BIA-ALCL is a cancer of the immune system and is most often associated with textured breast implants. Symptoms may include persistent swelling or pain near the implant, typically occurring years after the implant surgery (Onset between 1-8 years after insertion). Most appear as early stage 1 or 2—only fluid buildup or early capsule invasion—and can be completely treated by removing the implant and capsule. In rare cases, the lymphoma may be more advanced and need chemotherapy. Early detection and treatment, involving removal the implant and surrounding scar tissue (capsule), can lead to good outcomes. While the risk of developing BIA-ALCL is low, it’s important for individuals with breast implants to be aware of this condition and consult their healthcare provider if they experience any unusual symptoms.

Are my Implants at risk of BIA-ALCL?

BIA-ALCL is linked to textured breast implants, with no cases found in smooth implants. The risk of BIA-ALCL depends on the type of textured implant you have.

Allergan – 1 in 3000
Slimed – 1 in 10000
Mentor – 1 in 14000 – 64000

I have developed a complication from my breast implant, what are my options?

If there is a problem such as a rupture or contracture, it may be necessary to remove the implant to address the issue effectively. At this juncture, you will need to carefully decide if you want the implant to be replaced with a new one or if you prefer to simply have it removed altogether. If you choose to proceed with the removal without opting for a replacement, it’s important to consider that a breast lift might be necessary to maintain the overall appearance and contour of your breast. If you are looking at implant replacemtn Dr green advises contacting your original plastic surgeon. Dr Green does Does not perform Primary breast Augmentation (Breast implant insertion)

My implants have been in place for 10-years do I need to change or remove them?

You don't need to remove your breast implant if it is not causing any significant issues or complications. However, it is important to remember that after a period of 10 years, the chance of rupture may gradually increase, so it becomes crucial to monitor its condition closely. As long as the implants remain intact and there are no problems, they can continue to stay in place safely and effectively. Regular check-ups can help ensure that everything is functioning as it should.

My health has been deteriorating and I think I have Breast Implant Illness (BII), what should I do?

There is no specific test to determine if the implants are causing your symptoms. Removing the implants may not improve your symptoms. Start by discussing your symptoms with your GP to ensure the necessary tests have been done. If no cause is found and you remain concerned, talk to your GP about referring you for a discussion on implant removal surgery related to Breast Implant Illness (BII). Dr. Green has significant experience in implant removal surgery and can address your concerns openly and respectfully.

My health has been deteriorating and I think I have Breast Implant Illness (BII), what should I do?

There is currently no specific test available that can definitively determine whether the implants are the source of your symptoms. Furthermore, it is important to note that removing the implants may not necessarily lead to an improvement in your symptoms. To begin, it is advisable to discuss your concerns and symptoms with your general practitioner (GP) to ensure that all necessary medical evaluations and tests have been conducted. If, after thorough investigations, no underlying cause is identified and you still feel apprehensive, consider discussing with your GP the possibility of a referral for an in-depth conversation on implant removal surgery, especially in relation to Breast Implant Illness (BII). Dr. Green possesses extensive experience in performing implant removal surgeries and is committed to addressing your concerns in a manner that is both open and respectful.

What is involved in Breast Implant removal surgery?

Explant surgery is performed under a general anaesthetic, which typically necessitates an overnight stay in the hospital for monitoring and recovery. The important aspects of this surgical procedure include not only the careful removal of the implant and the surrounding capsule that encases it but also the meticulous reformation of the breast to ensure a natural shape and aesthetic appearance after the implant's removal.

Will the capsule be removed?

Breast implant surgery, a procedure that involves the careful removal of both the implant and the surrounding capsule, is an essential step in ensuring the health and safety of patients. This process is of particular importance when dealing with textured implants, as there is a slight risk associated with Breast Implant-Associated Lymphoma (BIA-ALCL). The primary objective is to remove both the capsule and the implant in a manner that is often referred to as 'en-bloc,' effectively minimizing any potential complications. Dr. Green is dedicated to meticulously performing this technique in every surgical case and will take the time to explain the procedure in detail during your appointment. Following the surgery, the capsule will be sent for testing to check for any abnormalities, ensuring thorough monitoring of your health. Additionally, photos of the implant and capsules will be taken, and these images can be made available to you upon request, should you wish to have them for your records.

Will my ribs need to be scraped? No, they won't. The capsule can stick to the chest wall, making it hard to remove. Dr. Green understands the importance of getting rid of the capsule, especially with textured implants. Efforts will be made to fully remove it. If part of the capsule is stuck on the chest wall, it will be lifted and removed using a technique called hydro-dissection. If any capsule remains, you will be informed, and the leftover tissue will be treated to destroy it. However, this is not common, and usually, the capsule can be removed completely.

Total capsulectomy “en bloc”

Will I need drains?

Drains are placed at the time of surgery for an important purpose. They help prevent the buildup of any fluid, blood, or surgical wash that may be left behind or potentially develop after tissue removal. Typically, the drains are removed the following morning if there is minimal output. However, in some cases, there may be an excessive amount of fluid, and as a result, the drains may need to remain in place for a few additional days. When the time is right, they can be safely removed by our experienced breast nurse or by Dr. Green himself.

Do I need a mastopexy breast lift?

After the removal of breast implants, it is common for the breast to experience a collapse due to the prior stretching that occurred while the implants were in place. To address this issue, a certain amount of skin reduction is typically necessary to prevent this collapse and to effectively restore the lost volume of the breast, a process that often involves performing a breast lift, also known as mastopexy. This surgical procedure cleverly utilizes the excess tissue to fill the void that is left behind by the removed implant, ultimately resulting in a smaller, more aesthetically pleasing breast shape. There are various techniques available, each presenting unique scar patterns; however, the most commonly used methods tend to leave either an ‘anchor’ scar or a scar that encircles the nipple. Dr. Ben Green will carefully assess your individual circumstances and recommend the most suitable option to achieve a neat and favorable outcome. It is important to remember that while scars do have a tendency to fade over time, the process of reshaping the breast becomes significantly more challenging in the future if a lift is not performed initially. In the absence of a lift, the lower portion of the breast may begin to sag, resulting in the nipple pointing downward, which can complicate subsequent corrective procedures later on.

No Lift - Ridging and nipple pointing to the floor

What does a mastopexy lift look like post surgery?

A mastopexy breast lift is a surgical procedure that effectively tightens the skin envelope following the removal of breast implants. This procedure aims to prevent a collapsed or deflated appearance of the breast, which can often occur after implant removal. By performing a lift, we may be able to preserve some projection and fullness, ensuring that the breasts maintain a natural and aesthetically pleasing shape, while specifically designed to prevent any empty or sagging look that may otherwise arise. A full and projected can not be guaranteed, especially if there is minimal natural breast tissue.