Case #1334 · Pacific Palisades, CA
Breast Implant Removal (Explant)
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This 32-year-old patient from Pacific Palisades, CA had a previous breast augmentation and was experiencing signs of breast implant illness (BII) and grade II capsular contracture. Dr. Cassileth performed bilateral breast implant removal with an inter
Continued care
Recommended aftercare, skincare, and MedSpa services for Breast Implant Removal (Explant).
- Compression bra continuously for 4 weeks
- Lymphatic drainage massage starting week 2 to reduce residual edema
- Sleep elevated for 2 weeks
- Massage breasts gently from week 4 to encourage tissue redrape
- Hyperbaric Oxygen Therapy to support healing when recommended
- Medical-grade silicone sheeting on incision
- SkinCeuticals C E Ferulic for scar healing
- Body hydration protocol while skin retracts
- SPF 50+ on incisions for 12 months
- Indiba radiofrequency for skin tightening as tissue retracts
- Laser or microneedling starting at 3 months if additional tightening needed
- Lymphatic drainage weekly for the first month
- Aftercare
Bilateral HBOT protocol, 10–15 sessions over the first 6 weeks.
Bilateral procedures heal more reliably with sustained HBOT.
- Skincare
SPF 50+ on incisions daily for the first year; younger skin pigments scars more reliably under UV.
Younger skin pigments scars more reliably under sun exposure.
Why this approach
The decisions that shaped this surgical plan.
- Bilateral breast implant removal (explant) performed in one operative session so symmetry, tissue handling, and final shape track between both sides.
Pre-op preparation
What to do before surgery. Specific to this case.
- Discontinue blood thinners (NSAIDs, aspirin, fish oil, vitamin E) two weeks out. Acetaminophen remains safe; the full list is reviewed at pre-op.
- Full nicotine cessation 6 weeks pre- and post-op. This includes vapes and nicotine replacement products; the constriction effect is the same.
- Front-closing clothing only for 3 weeks. Drain holders and supportive surgical bras are issued at discharge.
- A driver is required the day of surgery and a responsible adult should stay with you the first 24 hours.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Both sides healing in parallel means the early phase is quieter, short walks, full rest periods, and no driving until off pain medication.
- Week 2
Patients off prescription pain medication, walking 1–2 miles daily, and back to most light household activity.
- Week 4
Most patients back to gym cardio at 50 percent intensity. Scar massage protocol begins. Driving restored if not already.
- Week 6
Standard clearance milestone. Patients return to most exercise, gym work, and sleeping in any position.
- Month 3
Shape is 80–90 percent of final. Scars are still pink and will continue to lighten through month 12.
