The Reconstructive Aspect: How Does Breast Implant Removal Work?

The reconstructive portion of the implant removal is pretty straightforward. The implant itself, whether ruptured or intact, is removed. For subpectoral implants, I strongly recommend that the pectoral muscle is repaired. The pectoral muscle repair not only restores muscle strength but helps to prevent and treat pec flex deformity – where an unattached pectoral muscle moves abnormally, which can look strange. The pectoral muscle repair brings the breast back together from the stretched out position and avoids the flattened out appearance that is otherwise seen after implant removal.

Capsule removal depends on the patient, with most patients with ruptured silicone implants and patients with Bii undergoing capsule removal. Capsulectomy eradicates capsule-enclosed free silicone and biofilms. All capsular contracture patients should have the capsule removed as well, and it should be discussed in other cases based on the likelihood of pathology. Basically, abnormal capsules should not be left in the patient. However, to remove a completely normal capsule in a healthy patient for no reason is not necessary. The capsule is scar tissue, and is not a foreign body.

I prefer to place the incision in the inferior mammary crease regardless of the original incision. Using areolar incisions can lead to dents and divots with implant removal.

The Cosmetic Aspect: What Will My Breasts Look Like After Implant Removal?

Let’s not forget that some patients can spring right back after breast implant removal. Just like those women that look like they were never pregnant after three kids, some bodies are more elastic. If your breasts don’t look droopy with the implant in, and the implant is not that large, it is often worth doing the implant removal without additional procedures, as the result may be great. If you already look droopy with the implant in, though, or your implant size is over 400cc, you may need additional procedures or specialized techniques to help you meet your aesthetic goals.

Breast implant can be combined with two procedures for better aesthetic outcome when needed: mastopexy (breast lift) and fat grafting (filling lost volume with fat). I prefer to use a pocket mastopexy technique and lift the breast back with support. For the fat grafting, the fat can make up for some of the lost breast volume. If you don’t have much breast volume, only some fat can be placed, so remember this technique has its limitations. If you have a lot of real tissue even after removal of the implant, often I can place as much fat as needed to replace the implant. Each scenario is different depending on the patient.

I perform a no scar internal lift on select patients. Sometimes the breast tissue has a hole in it from the implant, and the breast tissue can be restored with internal suturing and support. During surgery, if we can avoid a lift by manipulating and restoring the breast, that is always preferable to a full lift where possible.

I commonly fix other surgeon’s botched implant removals that leave patients with scars, odd-shaped breasts, weird moving and tethered muscles, and too small sizes.

Recovery After Breast Implant Removal

Your recovery experience will vary based on the details of your surgical plan. In general, you can expect some tenderness and swelling in the days after your procedure. The healing process will continue for several weeks, and you will be wearing a special bra. You will be advised to avoid strenuous activity for up to a month after your surgery.