For many reasons, more and more women nowadays are having their breast implants removed, either temporarily or permanently, through a procedure known as an “explantation”. In an earlier article, Explantation: Permanent Breast Implant Removal in Breast Revision Surgery, I covered several reasons for the decision to have one’s implants removed. To this list, we can also add two newer and relatively rare reasons: concerns about breast implant illness (BII) and breast implant associated anaplastic large cell lymphoma (BIA-ALCL).
What Does an Explantation Involve?
An explantation involves the removal of either saline or silicone breast implants. If there was a rupture of the silicone implants, removal of the accessible free silicone is typically done as well.
How is an Explantation Performed?
Depending on a variety of factors, an explantation can be performed under general anesthesia, sedation or local anesthesia with general anesthesia being far more common. Your plastic surgeon can provide a recommendation that is best for your particular situation.
Surgery typically involves a relatively limited incision at or by the crease at the lower part of the breast (inframammary fold). If you previously had a breast augmentation or mastopexy-augmentation with an incision in this area, it can be used. If your implants were placed for breast reconstruction, a portion of your previous incision can be employed.
The implants are removed using these incisions. If there is any indication to have a capsulectomy (removal of the scar tissue that forms around the implant), this can be performed at the same time. Drainage tubes are then placed, the incisions closed and a surgical dressing is applied.
For straightforward situations, surgical time can be as short as 30 minutes. If implants are ruptured and/or capsulectomies are performed, the procedure may take an hour or more.
How Much Discomfort is Associated with an Explantation?
Virtually all women undergoing an explantation have little to no discomfort whatsoever and few take any pain medication. Most are up and around later that day. Even when capsulectomies are performed, discomfort is fairly limited.
What Are My Postoperative Limitations?
Your limitations will depend on a variety of factors including the exact procedure done (capsulectomy?) and intraoperative findings. In addition, each plastic surgeon has his/her own protocol for restrictions. Generally, you may be looking at around two to four weeks until you can resume full normal physical activities including working out.
When Can I Return to Work or School?
Depending on how you feel and what your job entails (if relevant), you may be able to return to work or school even as soon as the following day. If you have questions regarding this – ask.
If I Change My Mind in the Future, Can I Get New Breast Implants?
It may very well be possible to have new breast implants placed in the future if you do change your mind. This will clearly depend on your unique situation.
Can an Explantation be Combined with Other Procedures?
An explantation may be able to be combined with other plastic surgery procedures if you so desire. These can be both breast and non-breast procedures. Examples include:
1. mastopexy
2. breast reduction
3. abdominoplasty; liposuction; blepharoplasty; facelift; arm lift; etc.
Patient Example
The following patient, who underwent a breast augmentation several years ago elsewhere, sustained a rupture of her left breast implant as the consequence of significant trauma to her chest due to an accident. She developed pain in both breasts with a substantial deformity and capsular contracture on the left side.
For a variety of reasons, it was determined that an explantation along with a capsulectomy on the left side was the appropriate procedure for her. The photos below show her before surgery and one year later.
Before explantation
One year after surgery
Before
One year after
Before
One year after
The patient was quite relieved with the explantation and was extremely happy with her outcome, decision and the recommendations made.
For more information of explantation surgery or any other plastic surgery procedure that I perform or to schedule your consultation with me, please call the Arizona Center for Aesthetic Plastic Surgery at (480) 451-3000 or contact us by email.
Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona