Breast Implant Removal

Breast implant removal, also called explantation, is surgery to remove breast implants without replacing them. The operation may also involve removing some or all of the scar tissue capsule around the implants, depending on the reason for removal and the condition of the capsule. Some patients combine implant removal with a breast lift or fat transfer to address how the breast looks once the implants are gone, while others have removal alone and accept the change in breast appearance that follows.

Removing implants is a reasonable option to consider, and the reasons people choose it are personal. We’ll discuss the implications and what to expect from the procedure honestly at consultation, including the change in breast appearance after removal and the options for addressing skin laxity if that’s a concern.

Reasons fall broadly into two groups. Some are medical, including implant rupture, capsular contracture that’s causing pain or distortion, infection, or a diagnosis of BIA-ALCL. In these situations, removal is a clinical recommendation rather than a personal choice. Others are personal: a wish to no longer have implants, lifestyle changes that make the implants feel less suitable than they once did, symptoms that patients attribute to breast implant illness, or simply a decision that the implants have served their purpose and the patient now wants to live without them.

There’s no judgement about either set of reasons. Some patients agonise over the decision to remove their implants, particularly if the implants have been part of their body image for many years. Others come to the decision easily and want to move forward quickly. Either way, we’ll work through the options with you and make sure the operation that’s planned is the one that suits your situation.

What happens to the capsule of scar tissue around the implants is one of the main decisions in implant removal surgery. The capsule itself is the body's natural response to having a foreign object placed within it, and every implant has a capsule. Whether and how to address the capsule depends on its condition and on the reason for removal.

Implant removal changes how the breasts look, and that change can be more substantial than patients sometimes expect. The breasts will be smaller than they were with implants in place, which is the obvious consequence of removing the implants but is sometimes felt more strongly than anticipated. The skin envelope can be loose, particularly if the implants were large or had been in place for many years and the skin has stretched to accommodate them.

Some patients have a degree of breast tissue thinning over the years, which means the breast may appear flatter or less full than it did before the original surgery. Patients who had small breasts to start with often find the post-removal appearance is less full than their pre-augmentation breasts, because the breast tissue has been thinned by the pressure of the implant over time.

Some patients combine implant removal with a breast lift to address skin laxity, or with fat transfer to add some volume back. We’ll talk about whether either makes sense for you at consultation, including whether to combine the procedures or to perform them in separate stages.

Implant removal is performed under general anaesthesia in an accredited hospital. The operation usually takes between one and three hours, depending on whether and how much capsulectomy is involved. Implant removal alone is at the shorter end of that range, while total or en bloc capsulectomy can take considerably longer.

Most patients stay overnight, with some staying two nights for more complex procedures, particularly total or en bloc capsulectomy where ongoing observation of bleeding and pain control is helpful. Drains are commonly used and are typically removed before discharge or at the first follow-up appointment.

Recovery depends on what’s been done. Simple implant removal has a relatively shorter recovery, with most patients describing moderate discomfort that settles within the first week. Total or en bloc capsulectomy is a more involved operation with a longer recovery and greater early discomfort, because the dissection is more extensive and the tissues are more bruised after surgery.

You’ll wear a surgical bra for several weeks. Lifting, vigorous exercise and overhead activity should wait around six weeks while the tissues heal. For desk-based work, expect to be back after one to two weeks, with longer for more complex removals or for patients in physical roles.

Possible complications include:

Dr Henry Shepherd, BMed MD MS (Plast.) FRACS (Plast.) | Specialist Plastic Surgeon | AHPRA registration: MED 0001860545