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Explant removal surgery

Explant or Breast Implant Removal Surgery


Breast implant removal or explant surgery


Breast implant removal is a personal decision that individuals may make due to various reasons. Some choose to remove their implants for personal preferences or changes in body image, while others may experience implant-related complications or have health concerns. It is important to consult with a specialist plastic surgeon who can evaluate your specific goals and tailor a suitable treatment plan.

I want my breast implants completely removed, also called EXPLANT SURGERY. What options do I have?

This depends on several factors and during your consultation, your surgeon will  evaluate the following with each individual:

  • Your images before breast implant surgery which shows your baseline breast shape and any issues that may present after explant surgery
  • Skin tone and laxity characteristics as this will give me clues about the likelihood that the skin envelope will shrink back down after explant surgery
  • The amount of breast tissue you currently have and where it sits in relation to the breast implant and the nipple-areola complex
  • Nipple-areola position and size
  • Chest wall irregularities
Common reasons why women decide to have explant surgery

Personal Preferences – one of the most common reasons for explant surgery is the timing in a woman's life.   Often in the latter years, some women feel they no longer need breast implants or prefer not to face the prospect of breast implant revision surgery as they age.  Some of our patients have stated that they want implant removal surgery while they are still fit and able to recover quickly.   Patients preferences may also change over time due to natural changes to the body from things like pregnancy, hormones, and weight fluctuations.

Concerns About Breast Implant Safety – Patients experiencing illness or negative symptoms related to their breast implants is a common reason why some women choose to have their implants removed. Some patients have described various symptoms commonly referred to as Breast implant illness,  which may include anxiety, fatigue, and autoimmune issues.  Despite these reports, there is currently a lack of clear scientific evidence linking breast implants to the above symptoms.

Pregnancy and Breastfeeding: Some women remove their breast implants before or after pregnancy and breastfeeding. Hormonal changes, weight fluctuations, and breastfeeding can impact the appearance and feel of the breasts. Women may prefer to have their implants removed to address changes in breast shape or size or to simplify breastfeeding.

Medical Complications  – while breast implants are common, there is a chance of medical complications. For example, ultrasound scans may have confirmed ruptured breast implants.  Other medical complications may include:

  • capsular contracture or development of firm breasts due to scar tissue
  • breast implant rupture
  • Implant Malposition: Implants can shift from their original position over time, leading to asymmetry or an unnatural appearance. If attempts to correct the position are unsuccessful, removal may be recommended.
  • changes in appearance after  pregnancy or weight loss including:

– ptosis or sagging

 - hypertrophy or increased size of natural breast tissue

Whatever the reason for wanting to remove your breast implants, there are several options available and these factors will determine the treatment plan. 

Preparing for Your Procedure

Before undergoing breast implant removal surgery, thorough preparation is crucial. During the consultation, your surgeon will review your medical history, perform a physical examination, and discuss your goals and expectations for the procedure. This consultation is an opportunity for you to ask questions and address any concerns you may have.

Additionally, pre-operative tests may be required to assess the condition of your breasts and implants. These tests may include blood work, mammogram, ultrasound or MRI scans. Your surgeon will provide guidance on lifestyle adjustments, such as avoiding smoking and certain medications, to minimize potential risks and optimize healing.

General Risks of Surgery

Like any surgical procedure, breast implant removal carries certain risks. Although complications are rare, it is important to be aware of potential risks associated with surgery. These risks may include infection, bleeding, adverse reactions to anesthesia, and scarring. However, selecting an experienced surgeon and following post-operative instructions can help minimise these risks. Your surgeon will discuss the risks and benefits specific to your situation during the consultation.

 Risks Specific to Breast Implant Removal Surgery

While breast implant removal surgery can lead to successful outcomes, there are certain risks and potential outcomes to be aware of:

  1. Changes in Breast Appearance: After implant removal, your breasts may appear smaller, deflated, or have changes in shape or symmetry. This is a normal part of the process and will vary depending on individual factors such as skin elasticity, breast tissue quality, and the size and type of implants removed.

  2. Breast Ptosis (Sagging): The removal of implants can result in breast ptosis or sagging. If you have chosen to combine the explant surgery with a breast lift, your surgeon will address this issue during the procedure. However, in some cases, a separate breast lift procedure may be needed in the future to achieve the desired breast shape.

  3. Scar Formation: Incisions made during the surgery will result in scars. The visibility and extent of scarring will vary based on factors such as the incision technique used, the type of capsulectomy performed, individual healing characteristics, and scar care. It is important to follow your surgeon's instructions regarding scar management to minimize their appearance over time.

  4. Dissatisfaction with Breast Appearance: It is essential to have realistic expectations about the results of breast implant removal surgery. Some individuals may experience dissatisfaction with the aesthetic outcome, such as changes in breast shape, size, or symmetry. Discussing your goals and expectations with your surgeon before the procedure can help ensure a shared understanding.

  5. Need for Additional Procedures: In some cases, additional procedures may be necessary to achieve the desired results. This can include revision surgery, fat grafting, or a future breast lift procedure.

    1. Inframammary Incision: If your surgeon chooses the inframammary incision technique for breast implant removal, the incision will be made within the existing inframammary fold. This approach allows for direct access to the implant and capsule, facilitating their removal. After the implants are removed and any necessary capsule management is performed, the incision is closed, and the inframammary fold is re-established.

    2. Alteration of Inframammary Fold: In some cases, the inframammary fold may be affected by the removal of breast implants. The implants themselves may have stretched or displaced the inframammary fold over time or your previous surgery may have lowered the inframamary fold. 

  6. Combined Breast Lift Procedure: If you have chosen to combine breast implant removal with a breast lift procedure, the inframammary fold area may be addressed more extensively. The breast lift involves reshaping and repositioning the breast tissue, elevating the nipple-areola complex, and adjusting the position of the inframammary fold to create a more youthful and lifted appearance. The surgeon will remove any excess skin and may tighten the surrounding tissues to achieve the desired result.

    During breast implant removal surgery, the inframammary fold area, which is the natural crease beneath the breast, may be affected depending on the specific circumstances. Here's what can happen with the inframammary fold area.

    It's important to note that the specific approach and outcome regarding the inframammary fold will depend on various factors, such as the condition of your breasts, the extent of tissue laxity, and your individual goals and preferences. Your surgeon will evaluate your case and discuss the appropriate technique during your consultation. They will explain the potential impact on the inframammary fold and help you understand the expected outcomes based on your specific situation.

    Remember, every individual's experience is unique.

Surgical Procedure

During the breast implant removal surgery, your surgeon will take the following steps:

  1. Anaesthesia: You will be administered general anesthesia. General anaesthesia will keep you completely asleep during the procedure which can take from 1.5 to 3 hours depending on the treatment plan.

  2. Incision and Implant Removal: Your surgeon will make an incision according to the predetermined plan, typically the previous scar in the inframammary fold (under the breast crease),is utilised.  It may need to be a longer incision depending on the removal of the capsule. Your surgeon will explain the most appropriate incision technique based on your specific needs and preferences.

  3. Capsule Management: Depending on your situation, the surgeon may choose to leave the capsule in place if it is thin and not causing any issues. In cases where the capsule needs to be removed, your surgeon may perform a partial capsulectomy (removing a portion of the capsule) or a total capsulectomy (complete removal of the capsule) after the implant is removed or enbloc capsulectomy, the removal of the capsule and implant as a single unit.  

    The decision on which option to choose depends on factors such as the condition of the capsule, the type of implant, associated symptoms, and patient preferences. Your surgeon will discuss these options and their implications with you.

    It is important to note that research and evidence support the safety and effectiveness of different approaches to capsule management. Your surgeon will consider your specific case and guide you toward the most appropriate option.

  4. Additional Procedures: If you have chosen to combine breast implant removal with a breast lift, the surgeon will perform the necessary steps to lift and reshape the breasts to achieve the desired outcome. This may involve reshaping the breast tissue, repositioning the nipple-areola complex, and removing excess skin.

  5. Closing Incisions: Once the implants have been removed, the capsule managed, and any additional procedures performed, the surgeon will meticulously close the incisions using layers of internal sutures and external surgical adhesive to ensure optimal scarring. They may also place drains to collect any excess fluid that may accumulate in the surgical area.  Scarring is an inevitable part of any surgical procedure. The location, size, and visibility of scars can vary depending on the chosen incision technique and individual healing characteristics. Over time, scars tend to fade and become less noticeable. Your surgeon can provide guidance on scar management techniques to optimize healing.

  6. Dressings and Recovery: Your surgeon will apply sterile dressings to the incision sites along with outer bandages to the breast/chest area.  A compression garment or supportive bra will be fitted once your drains are removed several days later.   You will be given post-operative instructions for care and recovery.

Will I need a breast lift with breast implant removal surgery?

There are a group of women who have experienced pregnancy and breastfeeding and/or significant weightless patients where the skin envelope, breast tissue and nipple-areola complex is sagging.  Your surgeon may combine breast implant removal and capsulectomy with a breast lift or mastopexy for this group of patients.  Breast lift surgery is a procedure to lift and tighten the skin envelope, breast tissue and nipple-areola position. This is done by removing and/or tightening the excess skin along with repositioning the nipple-areola and breast tissue to reshape and improve the breast contour. This is common for patients who choose to remove their implants without replacing them. This can give the breasts a firmer and more rejuvenated appearance. For more information on breast lift procedures see our breast lift page.  Some of these women may have developed additional breast tissue after pregnancy and weight gain, hence a breast reduction may also be more suitable for some of these women.

Depending on the severity of the droopiness, a breast lift can also be performed as a stage 2 procedure.

Fat Transfer

This procedure involves removing the original breast implants and using liposuction to harvest fat from other areas of the body to inject into the breasts to improve contouring. This is also referred to as lipoaugmentation, with fat usually taken from the hips, thighs or abdomen region. This procedure is often preferred by patients seeking a relatively small increase in breast size or improving contouring defects after breast implant removal resulting in a more natural look and shape.

Recovery After Breast Implant Removal

Aftercare and Recovery Milestones

After breast implant removal surgery, proper aftercare and allowing sufficient time for recovery is crucial for optimal healing and results. Your surgeon will provide detailed instructions tailored to your specific situation, but here are some general guidelines:

  • Medication Management: Your surgeon will prescribe pain medication and antibiotics to manage discomfort and reduce the risk of infection. It is important to follow the prescribed dosage and schedule.

  • Wound Care: Proper wound care instructions, such as keeping the incision site clean and dry, will be provided. Your surgeon may recommend specific ointments or dressings to aid in healing.

  • Compression Garments and Supportive Bras: you will need to wear compression garments or supportive bras to provide stability, reduce swelling, and aid in healing.

  • Gradual Return to Normal Activities: It is important to follow your surgeon's instructions regarding activity restrictions, including avoiding strenuous exercise, heavy lifting, and certain movements for a specified period. Over time, you can gradually increase your activity levels based on your surgeon's guidance.

  • Follow-up Appointments: Attending scheduled follow-up appointments is vital to monitor your progress, address any concerns or questions, and ensure proper healing. Your surgeon will guide you on the frequency of these appointments.

Recovery milestones vary among individuals. Initially, you may experience swelling, bruising, and mild discomfort, which should gradually subside. It is important to be patient and allow your body sufficient time to heal.

Remember, the information provided on this website is intended to serve as a general guide. It is essential to consult with a qualified healthcare professional for personalized advice tailored to your specific circumstances.

Every patient recovers differently from surgical procedures however in the first few weeks especially, rest and recuperation should be prioritised.  As we always say, recovery is just as important as the surgery itself!!

What to expect during the acute recovery phase week 1

  • All surgical patients have Dr Cheng’s direct mobile contact for any immediate concerns
  • You will wake up from theatre wearing a protective bandage around your breasts immediately after surgery
  • Keep wound clean and dry for 2-3 days
  • Typically this surgery is performed as a same-day discharge with breast drains remaining  for 3-7 days depending on the extent of the surgery.
  • Day 1 review with Dr Eddie Cheng and our Nurse.  Our nurse will progress you to a comfort bra at this stage
  • Sleep with your head elevated for a week or 2
  • Light walking is encouraged around the house to avoid blood clots
  • Gentle range of movement for shoulders and arms are encouraged
  • No lifting heavier than a teacup
  • Take pain relief medications as instructed by your surgeon and anaesthetist

Recovery Week 2-6

  • Drains are typically out by now
  • Dressings on incision lines remain and are changed weekly
  • Driving after 7-10 days for short distances 
  • Office-based workers typically return to work after 2 weeks rest
  • Workers with more physical duties including lifting allow up to 6 weeks or return earlier on modified duties 
  • Recovery bra is worn for 6 weeks – no underwire
  • No sex for 3-4 weeks
  • incision line care involves weekly tape changes until week 6
  • Incision line scar gel is commenced at week 6, 2 times daily.

Recovery Beyond 6 weeks

  • Ease back into normal activities including gym 
  • Incision line care continues for 12 months or as needed
  • Bra fitting to determine your new size
  • Review with your surgeon at 6 months,  where further procedures such as breast lift or fat grafting can be discussed if required to refine breast appearance and shape. 


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Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Are you a candidate for surgery?

Are you a candidate for surgery?