Breast implants removal may be required or desired for a variety of reasons, and involves the surgical removal of previously inserted implants. The FDA recommends that breast implant removal only be done when the risks of leaving them in outweigh the risks of removing them, which include:
- Capsular contracture
- Ruptured or damaged implant
- Fears of future health consequences from silicone implants
- Aesthetic concerns (such as changing implant size)
During this operation, the original incisions are reopened and the implant – along with any accompanying scar tissue – is removed. The implant is then either replaced or the breast is reconstructed with a breast lift to ensure that internal structure and shape of the breast are maintained.
Procedure Walk-Through
- Preparation: It is important that patients follow all of Dr. Vallecillos’ pre-operative instructions prior to breast implant removal. This might include limiting any medications, vitamins, or herbs that can cause thinning of the blood for two weeks before surgery. Depending on the individual, Dr. Vallecillos might also prescribe a round of antibiotics to be taken as a measure to prevent infection. If you smoke, you should abstain for at least two weeks before and after surgery, and if you are over the age of 45, you may need to obtain medical clearance from an independent physician prior to undergoing breast implant removal.
- Anesthesia: Breast implant removal is usually done under general anesthesia. A local anesthetic with IV sedation may also be an option.
- The Surgery: In most cases, Dr. Vallecillos will utilize the same incisions from the initial breast enhancement surgery. Once access to the breast pocket has been established, the implant and any accompanying tissue (such as scar tissue, in the case of capsular contracture) will be removed.
Depending on the reason for breast implant removal and the patient’s wishes, several variations can be implemented within this framework to best accommodate the patient’s situation. In some cases, implant replacement is the best way to move forward, as this option circumvents any safety or health issues without sacrificing the aesthetic enhancement.
Instead of or in addition to replacement, other approaches include capsulectomy, fat grafting, and full breast implant removal.
Breast Implant Replacement
In cases such as capsular contracture and implant rupture, the implant will be replaced with a new implant. During your consultation, Dr. Vallecillos will discuss with you the option of replacing the implant with one made of a different material or make (silicone gel vs. saline, smooth shell vs. textured), or moving the placement of the implant (submuscular vs. subglandular).
For context, capsular contracture is a post-operative complication in which scar tissue around the implant becomes tight and hardened. It’s normal for the body to develop a capsule of scar tissue around the implant after the procedure. Still, when this excessive tightening occurs, it can affect the texture and location of the implant while causing pain in many cases. Sometimes, capsular contracture may be alleviated with massage or medication, but surgery is required if the issue persists or is more severe.
Breast Implant Removal
When the patient has elected not to replace the implant, Dr. Vallecillos will often recommend reconstructing the breast’s original size and shape using a breast lift technique.
Once the surgery is complete, the incisions are closed and bandaged.
Common reasons for complete implant removal include, but are not limited to, the following:
- Aesthetic preferences – Over time, some breast augmentation patients come to embrace a more minimalistic approach to aesthetics.
- Lifestyle factors – Athletes who have received breast augmentation in the past may seek implant removal to improve athletic performance and/or to improve comfort when training or competing.
- Health and wellness factors – Breast implant illness (more information below), autoimmune sensitivities, and other health-related motivations drive some patients to seek implant removal.
- Age-related factors – Natural aging processes can cause the natural breast tissue surrounding the implant to increase in laxity over time, causing an unwanted visual contrast.
Dr. Vallecillos will carefully tailor each patient’s breast implant removal or replacement treatment to reflect their goals, expectations, and reasons for seeking treatment. Our team encourages patients to be open about their reasons for considering breast implant removal, as this is an important part of the foundation that guides Dr. Vallecillos’ approach to the treatment.
How Is Breast Implant Removal or Replacement Tailored to Each Patient?
No two patients follow the same path when it comes to breast implant removal or replacement; everyone has unique goals, motivations, and backgrounds. This is why patient-centered plastic surgeons like Dr. Vallecillos rely on a full palette of surgical techniques. How you present to treatment, including your input throughout the consultation and planning process, will inform Dr. Vallecillos’ careful approach to your procedure. Capsulectomy, fat grafting, and downsizing or upsizing are three key approaches that can be used on their own or combined to deliver the results you’re looking for while addressing medical and safety considerations.
Capsulectomy
As mentioned, when scar tissue hardens and tightens around breast implants, the location and shape of your implant may change, and you may experience discomfort. A total, partial, or en bloc capsulectomy may be recommended in more severe cases.
A total capsulectomy involves surgically removing all the scar tissue surrounding the implant. This is the most invasive approach and is generally reserved for more severe and/or complicated cases (implant rupture, calcified implant, etc.).
As the name implies, only a portion of the capsule is removed in a partial capsulectomy. This is often the preferred option for patients with less severe capsular contracture. The remaining scar tissue is left to be absorbed by the body or removed later in surgery.
Finally, an en bloc capsulectomy refers to simultaneously removing the implant and the capsule. This approach is often relied upon in high-risk cases, or when there are complications that make the removal of scar tissue unsafe.
Fat Grafting
Patients who opt for breast implant removal without replacement often turn to fat grafting to restore lost shape and volume in a way that mirrors the natural contours and symmetry of the breasts. Fat grafting offers a simple, safe, and elegant solution that restores the patient’s confidence after a breast implant removal procedure, avoiding a hollow or sunken appearance.
Typically, living fat from another area of the patient’s body will be transferred (autologous fat transfer) to the breasts, where it is then carefully contoured to provide a subtle volume boost. Common donor sites include areas along the abdomen, flanks, or thighs. The fat is extracted via liposuction, purified, and then injected into the breast area with surgical precision and planning.
The amount of fat transferred, where it is placed, and other key dimensions of this treatment vary based on each patient’s anatomy, previous implant size, expectations, and more. Because the transferred fat becomes living tissue, it yields natural, long-term results with a low risk of infection or other adverse reactions.
Downsizing or Upsizing
Changes in the patient’s physique, expectations, comfort, or lifestyle, among other factors, may lead them to consider downsizing or upsizing their implants. This also presents an opportunity to recontour the breasts if needed.
Breast implant downsizing is a popular option among patients who have changed their aesthetic preferences in favor of a more minimalistic, athletic silhouette. With time and physique changes, larger implants may cause skin issues or back pain. In any case, Dr. Vallecillos may perform a breast lift to ensure that the downsized implants do not negatively impact the shape or positioning of the breasts.
Upsizing, on the other hand, not only helps in the apparent sense (increasing the fullness of the breasts), but can also be an opportunity to enhance breast symmetry.
Breast Implant Removal Downtime and Recovery
Because Dr. Vallecillos precisely tailors each breast implant removal procedure to each patient’s unique set of circumstances, everyone will experience the recovery process differently. Whether or not you have a replacement, whether or not capsular contracture is an issue, and other factors can all significantly impact the recovery process. The best practice is always to defer to your personalized aftercare instructions, carefully monitoring the treatment area and reporting any unusual developments.
The Recovery Timeline: A General Outline
The first few days following your breast implant removal procedure will be accompanied by routine soreness, swelling, and a sensation of tightness affecting the treatment area. Typically, this acute post-op period lasts five or six days at the most. You will either be prescribed pain medication or use over-the-counter medications to manage any discomfort. Dr. Vallecillos will provide instructions regarding proper sleep positioning, incision care, and more. Early follow-ups will ensure that your body is progressing through the healing process appropriately.
Once you’ve passed the first week, you may be able to return to light work (as for an office job). However, more vigorous activities, including weightlifting and high-intensity cardio, will likely still be discouraged at this point. Patients are often instructed to wear a compression garment or support bra during this time to facilitate the settling in of the newly contoured breasts while minimizing swelling. Bruising and swelling will likely be present, but fading.
From the third week through the sixth, activity restrictions will likely be relaxed if your body is healing appropriately. Light exercise may be approved, swelling and bruising should be significantly or totally resolved, and your results will continue to progress towards the final stage. Beyond the six-week mark, you should be cleared to return to full activity, and full results will become visible. Incision lines will continue to fade and flatten. Follow-up visits will be spaced farther apart, but will continue every few months to ensure proper healing.
Long-Term Considerations Following Breast Implant Removal
Many patients are reasonably curious about how a breast implant removal may affect the look and feel of their breasts in the years or even decades to come. The surgical technique used, the age of the patient at the time of the surgery, and other factors can all shape this long-term aesthetic outcome. The following provides a simple overview of typical long-term outcomes by procedure type.
Breast Implant Removal Without Replacement
While the breasts may appear hollow immediately after the procedure, patients who opt for a breast lift and/or fat grafting alongside implant removal will notice the breasts settling into a more youthful contour over the following weeks. Whether or not these additional techniques were incorporated, skin elasticity plays a pivotal role in how well the skin accommodates the change in volume and shape. Greater skin elasticity allows for a smoother, more youthfully taut appearance and vice versa.
Breast Implant Replacement
Modern implants are designed to last a decade or even two in many cases. After the brief settling period, patients who opt for breast implant replacement enjoy stable results for years after the fact. However, pregnancy, aging, and weight fluctuations can all adversely impact your results over time. For patients who choose to upsize their breast implants, aging and weight fluctuations may increase the need for a breast lift in the future.
Monitoring Changes Over Time
Regularly following up with your surgeon after a breast implant removal procedure is essential to monitor for:
- Implant integrity (if applicable)
- Changes in breast tissue
- Scar healing and aesthetic refinement
Consistent monitoring that combines regular self-checks and ongoing communication with your surgeon will allow for early intervention if any issues arise.
Schedule Your Breast Implant Removal Consultation With Dr. Vallecillos
If you’re considering removing or replacing your breast implants, but are nervous or unsure about how to proceed, Dr. Vallecillos will be your advocate as you navigate this process.
Along with the rest of our team, Dr. Vallecillos is committed to providing industry-leading care and educating and informing patients so they are empowered to make the best decisions for themselves.
Contact us for a breast implant removal consultation today.
“At its fundamental level, every surgery is deeply rooted to a person’s sense of well-being and sense of self-confidence. We partner closely with our patients and strive to establish strong relationship with them.”
– Dr. Vallecillos
Frequently Asked Questions
Am I a good candidate for breast augmentation surgery?
Breast augmentation surgery may be a reasonable option for you if you would like to enhance the shape and volume of your breasts, or if you’ve recently given birth and are suffering from postpartum breast volume loss. Dr. Vallecillos will confirm your candidacy for breast augmentation in a one-on-one consultation.
What are the most common risks and side effects from breast augmentation?
Complications from breast augmentation surgery are rare, but can include scarring, bleeding, infection, and loss of sensation in the nipple or breast. Capsular contracture, or the hardening of the tissue and skin around the implant, can occur and would require an additional surgery to correct. It’s essential to monitor for complications immediately following and after your surgery, reporting any issues to the appropriate provider as early as possible to prevent further damage.
Are breast augmentation results permanent?
Although breast implants typically yield long-term results, it is important to understand that over time, changes in your breasts may make later procedures necessary. While it is rare, implants can leak and sometimes require replacement. Women who receive large implants may later need a breast lift to reduce drooping. Regular follow-up visits with your surgeon are an important part of your post-procedural routine.
What is breast implant illness?
Breast implant illness, or BII, refers to a wide-ranging and largely unexplained set of symptoms that some people with breast implants experience. These symptoms include fatigue, brain fog, joint and muscle pain, sleep disturbances, and others. Breast implant illness does not currently have an official medical diagnosis, but more doctors are beginning to recognize this issue. BII symptoms have been reported among people with ruptured and unruptured silicone or saline implants. If you notice these symptoms, report them as soon as possible.
What happens to your breasts when you remove implants?
The answer depends on several factors, including whether or not any adjunct procedures were performed (like fat grafting), the size of the implants, the patient’s age, and more. In most cases, the breasts may present with a more hollowed or deflated appearance at first, but then settle into their new contours within weeks or months.
At what age should breast implants be removed?
There is no hard age limit delineating when breast implants must be removed. Rather, the decision should be guided by individual factors. If the reason for the removal relates to medical concerns, for example, then patients will typically want their breast implants removed as soon as the risks of keeping the implants in place outweigh the risks of removing them. When the motivations are more preferential (i.e., aesthetic reasons), patients can elect to have their breast implants removed whenever it is convenient.
Can I have my breast implants removed and replaced in the same procedure?
In many cases, yes. When possible, both patients and surgeons tend to prefer this approach, as it limits downtime and the number of surgeries. However, there are several scenarios in which breast implant removal and replacement must be spaced apart. Severe capsular contracture requiring en bloc capsulectomy, for example, may necessitate a gap as the surrounding tissues heal. Similarly, ruptures, infections, and other problems may require a gap.
Is breast implant removal painful?
Most patients are surprised to discover that breast implant removal is not as painful as initially expected. Though this is a surgical procedure, since it does not require creating a new pocket in the tissue or inserting a device, post-operative discomfort is generally kept at a mild or moderate level. In the vast majority of cases, prescription or over-the-counter pain medications are enough to manage discomfort without issue.