For many, breast augmentation can be a life-changing procedure. It can restore volume, symmetry, and general aesthetic quality to the breasts, as well as a profound sense of confidence in one’s new breasts. Because breast augmentation is a major surgery, it is important to choose an experienced, reputable surgeon to perform the procedure. That being said, some women eventually choose to get rid of their implants for a variety of reasons. These patients can benefit from a procedure known as “breast explant surgery” or “breast implant removal”.
Dr. Andrew Cohen, our board-certified plastic surgeon, has worked with many patients who wish to have their implants removed. They inquire about cosmetic concerns, but also about potentially serious medical conditions that can be eased with the help of explant surgery.
Patients seek breast explant surgery for a plethora of reasons, not limited to:
In rarer, more serious cases, a patient interested in explant surgery may be suffering from breast implant illness (BII). While there is currently no concrete scientific evidence that links breast implants to systemic illness, symptoms such as fatigue, anxiety, and muscle pain are sometimes suspected to be the result of an autoimmune reaction to breast implants. There is still much research to be conducted on this issue, but the best-known remedy at this time is explant surgery.
Even more rarely, a patient may develop breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a cancer that affects the tissue surrounding the implant. Although fewer than ten women per year are diagnosed with BIA-ALCL, and the condition is primarily associated with Allergan®’s textured breast implants (which have been recalled and are not offered by Dr. Cohen), it is a serious concern that needs professional medical care.
Dr. Cohen is happy to communicate with oncologists in the event this condition appears, and is certainly able to remove the implants placed by another surgeon in order to eradicate the issue.
Ideal candidates for breast implant removal are often those who no longer desire their implants for personal or aesthetic reasons, or are experiencing complications such as implant rupture, capsular contracture, or discomfort. Candidates should be in generally good health, be non-smokers, and have realistic expectations about procedure results. Breast implant removal may also be appropriate for those experiencing symptoms of breast implant illness or wishing to return to a more natural breast appearance. A consultation with Dr. Cohen can help determine if you are a candidate for breast implant removal.
While different surgical strategies exist to remove implants, Dr. Cohen has found that en bloc capsulectomy is the most effective, especially for those with concerns of breast implant illness. “En bloc” means “as a whole” or “all at once” in French; as such, an “en bloc capsulectomy” is meant to remove the entire implant and capsule at once. Any remaining scar tissue is generally also removed, and the “all-in-one” nature of the approach leaves less opportunity for leakage during surgery. Sometimes it is not possible to do an en bloc removal as the tissue can be stuck to the rib cage. In those cases we remove the scar tissue in pieces but make all attempts to remove the entire capsule. Doing an en bloc capsulectomy will mean a larger inframammary scar. We now have scientific data published in a peer-reviewed journal showing that “en bloc” capsulectomy is not necessary for symptom improvement for women with self-described BII.
During an en bloc capsulectomy, you will be administered general anesthesia. Incisions are either made along the inflammatory fold on the lower side of the breast, or near the areola, depending on the size and location of the implants. The capsule and implant are detached from the surrounding tissue and extracted.
The en bloc method is usually performed to treat patients with BII and BIA-ALCL, but has proven successful for those who need explant surgery for several other reasons, as well, leading Dr. Cohen to make it his method of choice for implant removal. Some may not be eligible for en bloc, and may be better suited for partial rather than total capsulectomy. In any case, Dr. Cohen will discuss your options during your consultation.
The recovery period for breast implant removal surgery depends on the extent of surgery done, the method performed, and any underlying health conditions. Expect to take about a week off from work in order for the incisions and sutures to heal properly. Drains will likely also be used to remove any fluid buildup during your initial recovery. You may be prescribed a special bra for your recovery period. During your consultation, Dr. Cohen will go over recovery instructions specific to your needs.
The cost of breast implant and capsule removal can vary depending on several factors. It’s important to keep additional expenses in mind, such as hospital or surgical facility costs, X-rays, anesthesia, medications, or other related fees.
We always strive to make your payment process as stress-free as possible, and offer several financing options for your convenience, including third-party financing and even specialty cosmetic insurance. Feel free to ask about financial options at your consultation.
If you are interested in breast implant removal surgery, please contact our office today. Additionally, if you believe you are exhibiting symptoms of BII or BIA-ALCL, please contact your general practitioner immediately.
