If you're contemplating breast implant removal (explant surgery), you're not alone. Women choose this procedure for various reasons, including capsular contracture, implant rupture, discomfort, or simply a change in personal preference. This guide explores key aspects of explant surgery, including whether you may need a breast lift or reduction, costs, risks, and recovery.
Why Consider Breast Implant Removal?
Patients opt for breast implant removal for several reasons, such as:
- Capsular contracture: When the scar tissue surrounding the implant tightens, causing discomfort and changes in breast shape.
- Implant rupture: If an implant leaks or breaks, removal may be necessary.
- Pain and discomfort: Some women experience ongoing breast pain related to their implants.
- Aesthetic changes: Ageing, weight fluctuations, or personal preference may prompt implant removal.
- Health concerns: Some women choose removal due to systemic symptoms or concerns about breast implant-associated cancers.
Who is a Good Candidate?
Ideal candidates for explant surgery include those who:
- Symptoms of capsular contracture, implant rupture, or discomfort
- Wish to restore a natural breast appearance
- Have concerns about implant safety
- Are in good general health and do not smoke
A consultation with Dr Eddie Cheng, Specialist Plastic Surgeon at AR Plastic Surgery in Brisbane, will determine the best approach for your specific needs. Before your consultation, it is recommended to have a recent (less than 12 months old) breast ultrasound (USS) and mammogram to assess implant integrity and overall breast health.
Will I Need a Breast Reduction and or a Breast Lift After Explant Surgery?
A key concern for many women is how their breasts will look after implant removal. Several factors influence whether a breast reduction and or breast lift (mastopexy) is necessary:
- Personal aesthetic goals: Some women prefer a breast reduction and lift to achieve a youthful size and shape.
- Pre-existing breast appearance: If a double bubble or waterfall deformity already exists then breast reduction and or lift surgery may be required.
- If your breasts are naturally large and sagging, a breast reduction (reduction mammaplasty) may be recommended alongside implant removal
- Skin elasticity: Good skin elasticity may reduce the need for a lift, while poor elasticity increases the likelihood.
- Implant size: Larger implants stretch the skin more, making a lift more likely .
- Duration of implant placement: The longer implants are in place, the higher the chance of needing a lift.
- Age: Younger patients with better skin quality may have more options.
- Weight fluctuations: Significant weight changes can impact breast shape and skin quality.
- Pregnancy and breastfeeding: These can affect skin elasticity and breast tissue.
- Nipple position: Low nipples post-removal may require a lift for optimal results.
- Remaining breast tissue: The volume of natural breast tissue left after removal plays a role.
Capsular Contracture & Capsule Management
Capsular contracture occurs when excessive scar tissue forms around the breast implant, causing firmness, pain, and distortion. Depending on severity, different types of capsulectomy may be performed:
- Partial capsulectomy: Partial removal of the capsule, often sufficient for contracture treatment. Some of the capsule remains.
- Total capsulectomy: Complete capsule removal, not necessarily done as a single unit or in one piece.
- Total intact capsulectomy: The complete removal of the capsule is removed as a single unit.
- En bloc capsulectomy: removal of the breast implant capsule with a margin of uninvolved tissue reserved for cases involving suspected implant-associated cancers after appropriate clinical assessment.
As part of my approach, if the capsule is healthy and there is no clinical indication to remove the capsule, it is sometimes safer to leave the capsule in place. In circumstances where calcified deposits are present on ultrasound and/or there is extracapsular spread of silicone material then this is a carefully considered in dicussions with my patients along with a comprehensive clinical work up. Any capsule material I remove is always sent off for histopathology examination to ensure there is no malignancy or further treatment required.
The Procedure: What to Expect
A bilateral breast implant removal typically involves:
- Surgery time: 1-2.5 hrs - Implant removal +/- any capsule management
- Surgery time: 3-3.5hrs - Implant removal +/- capsulectomy and breast reduction or breast lift
- Anaesthetic: General Anaesthetic
- Hospital: Day hospital or Inpatient stay
- May involve removal of implants/capsulectomy/breast lift or breast reduction
- Reshaping and lifting the breasts by excising excess skin and repositioning the nipple-areola complex
- Refining previous surgical scars for improved aesthetics
- Drains: Yes, removed after 2-5 days on average
- Dressings: outer chest and breasts are wrapped like a mummy to protect the wound, breast incision lines are covered with surgical tape which is kept in place for 3 weeks or as tolerated.
Each surgical plan is customised to achieve the best outcome for each patient.
Understanding Costs & Private Health Insurance
The cost of breast implant removal varies based on a number of factors including:
- Hospital and length of stay
- Surgeon and assistant fees
- Anaesthesia
- Private health insurance (PHI) coverage
Out-of-pocket expenses depend on your personal level of private health insurance cover and eligibility for Medicare/PHI rebates. It is advisable to obtain written confirmation from your health fund regarding specific item number coverage.
Medicare & Private Health Insurance Coverage
In Australia, Medicare and PHI may contribute if the procedure meets specific medical criteria which will be assessed during your consultation. Relevant Medicare item numbers to discuss with you PHI may include:
- 45548 - Removal of implants
- 45551 – Removal of breast implants with at least half of the capsule
- 45523 – Bilateral Breast reduction for symptomatic macromastia (bilateral)
- 45558 – Bilateral Mastopexy (breast lift)
All of the above procedures generally fall under the clinical category of medically necessary breast surgery requiring bronze private health insurance tier. Eligibility depends on clinical indications, and out-of-pocket costs will be discussed during your consultation with Dr Eddie Cheng.
Risks & Safety Considerations
Breast implant removal carries potential risks. These include:
- Skin wrinkling and loose skin – The breast skin may not retract completely after implant removal, potentially requiring a lift.
- Contour deformity: The forces produced by implants between the pectoral muscle and the rib cage, can cause rib cage deformation – this means that there may be an indentation (concavity) left where the implant was removed.
- Delayed healing and tissue necrosis – Some areas may take longer to heal, particularly for smokers or those with medical conditions that affect wound healing.
- Changes in nipple and skin sensation – Sensitivity changes are common but usually temporary. Permanent loss is rare.
- Asymmetry – Natural differences in breast size and shape may become more noticeable, and surgery cannot guarantee perfect symmetry.
- Breastfeeding difficulties – A breast lift may reduce the ability to breastfeed.
- General surgical risks – These include infection, bleeding, scarring, and potential complications from anaesthesia.
Aftercare & Recovery
Acute Recovery (0-6 Weeks)
- Drains & Dressings: Drains are removed within 2-5 days on average, and surgical tape remains in place for 3 weeks to support incision healing.
- Week 3 incision tape is removed and taping of incision lines will continue until week 6.
- From week 6 scar gel applied to incision lines will commence
- Support Garment: A recovery bra must be worn continuously for 6 weeks to aid healing.
- Activity Restrictions: Avoid heavy lifting, high-impact activities, and excessive arm movement.
- Driving & Seatbelts: A seatbelt must be worn when driving. A pillow or soft foam can provide comfort under the shoulder sash.
- Follow-Ups: Regular check-ups with our practice nurse
- Healite to help wound healing
Beyond 6 Weeks & Long-Term Care
- Ongoing review with Dr Cheng and our practice nurses
- Breast Shape Settling: Final shape refines over 3-6 months.
- Scar Management: Silicone gels or laser therapy can improve scar appearance.
- Routine Breast Health Monitoring: Continue regular breast surveillance as per your GP with ultrasounds and mammograms as recommended.
Next Steps: Book a Consultation with Dr Eddie Cheng
If you are considering breast implant removal an in-depth consultation with a qualified Specialist Plastic Surgeon is essential Dr Eddie Cheng and the team at AR Plastic Surgery provide personalised surgical plans to ensure optimal outcomes.
For more information or to book a consultation with Dr Eddie Cheng, Specialist Plastic Surgeon at AR Plastic Surgery in Brisbane, visit: 🔗 Breast Implant Removal & Lift.
📸 Image Disclaimer: These photos are of consented patients of @arplasticsurgerybrisbane and @dreddiecheng and have not been digitally altered, except for nipple covers for social media. Outcomes vary based on individual factors.
All surgical or invasive procedures carry risks and potential complications. We recommend seeking a second opinion from an appropriately qualified medical practitioner before proceeding with surgery.
Individual results will vary from patient to patient and according to factors including genetics, age, diet and exercise. All invasive surgery carries risk and requires a recovery period and care regime. Be sure you do your research and seek a second opinion from an appropriately qualified Specialist Plastic Surgeon before proceeding. Any details are general in nature and are not intended to be medical advice or constitute a doctor-patient relationship.