Definition & Overview
Breast augmentation with implants remains to be one of the most popular cosmetic surgical procedures in many parts of the world. Although safe, the FDA has warned that breast implants are not meant to last a lifetime and must be removed within 10-20 years due to the possible development of serious complications.
Aside from medical purposes, breast implants can also be surgically removed for personal reasons such as when the woman no longer desires breast implants or her initial expectations were not met.
However, due to the invasive nature of the procedure, women who seriously consider undergoing breast implants removal go through an extensive preoperative process and consultation to help them carefully weigh the procedure’s risks and benefits.
Who Should Undergo and Expected Results
Breast implant removal is often recommended in cases of:
- Capsular contracture, or when the breast tissue around the implant hardens
- Rupture or deflation, or when a hole or tear develops on the surface of the implant, resulting in the leaking of the filler material
- Ptosis, or when the breasts sag
- Displacement or malposition, or when the implants move out of their correct position
- Implant wrinkling or rippling
- Calcification, or when calcium builds up in the breast tissue
- Chest wall deformity, or when the chest wall or rib cage becomes deformed due to the implants
- Extrusion, or when the implant breaks through the skin due to skin breakdown
- Hematoma, or when a blood clot forms around the surgical site
- Seroma, or when fluid collects around the implant
- Breast tissue atrophy, or when the skin thins or shrinks
- Breast pain
- Delayed wound healing
Patients may also decide to have their implants removed for personal reasons such as when their bodies are unable to adjust to the increased breast size or weight or if their initial expectations were not met. In such cases, patients are typically provided with two options: (1) to have their implants removed and replaced with new ones or (2) to have their implants removed permanently.
In the event that a complication arises due to a breast implant, the removal procedure is the first and most important step towards the patient’s recovery. Unless the implants are removed immediately, the patient may continue to suffer from symptoms and may be at risk of more serious threats to her health. Records show that complications of breast implants can lead to serious illnesses and even premature death, especially if treatment is delayed.
Following the procedure, patients can expect to experience a general improvement in their condition although their symptoms may linger for a certain period as the body first undergoes a detoxification and healing process. However, in the majority of cases, patients are fully recovered a year or two after the operation.
How is the Procedure Performed?
Depending on the goal of the procedure, breast implants can be removed using one or a combination of these methods:
- Implant removal – This refers to the straightforward removal of breast implants.
- Implant removal with replacement – This is appropriate when a woman is not satisfied with the size or shape of her implants and wants to replace them with new ones.
- Implant removal with breast lift – Patients may elect to combine the procedure with a breast lift so their breasts will not sag once the implants have been removed.
- Capsulectomy – This procedure becomes necessary if scar capsules need to be removed. In many cases, the body is able to absorb these capsules, especially those that are soft and thin, without any complications. In others, however, the capsules become thickened or calcified. In such cases, surgeons recommend the removal of scar capsules to help with the patient’s overall recovery.
Prior to undergoing any of the above procedures, candidates for breast implants removal go through a consultation and pre-operative process, wherein they discuss their concerns and goals with their surgeon. This is crucial in setting the right expectations and weighing the pros and cons of the procedure to help patients make well-informed decisions.
On the scheduled date, the patient is admitted to the hospital or cosmetic surgery centre for the surgery. Breast implants removal, which is typically performed on an outpatient basis, can be straightforward or very challenging depending on the condition of the implant, the patient’s anatomy, and the presence of scar tissue. In the absence of complications, a straightforward implant removal can be completed in an hour but may last longer if implant exchange replacement, breast lift, or scar capsule removal will also be performed.
During the procedure, the patient is placed under general anaesthesia or intravenous sedation while an anaesthesiologist monitors the patient’s vital signs all throughout the entire length of the procedure to ensure safety. It is a general practice for surgeons to remove breast implants through the original incisions made when they were placed to prevent additional scarring. The surgeon will begin by removing scar tissue or the capsule that surrounds the implant before the implant is removed. Meanwhile, saline breast implants are deflated first before they are taken out. The surgeon will then proceed by either performing additional procedures (implant replacement or breast lift) or by placing a surgical drain to prevent excess fluid from leaking during the recovery period before the incisions are closed.
To facilitate prompt and proper healing, patients are given post-operative instructions, such as how to care for the surgical wound. It is also often helpful for patients to wear a support bra during the first few weeks following the procedure.
Possible Risks and Complications
While patients seeking breast implants removal sometimes do so in response to implant-related complications, it is also possible for them to experience some complications due to the removal procedure, including the following:
- Breast distortion
- Severe skin scarring
- Scar tissue
- Excessive bleeding
- Reduced breast or nipple sensation – This usually occurs in cases that involve extensive dissection, often as a result of scar tissue removal or a ruptured implant
Proper planning and post-operative care can help minimise or even prevent these complications. Patients who are worried about scar tissue should plan ahead and undergo a capsulectomy to have scar capsules removed. They should also inform their surgeon if they are suffering from any illness or are taking any medications, especially those that have blood-thinning effects. It is crucial for patients to closely follow their surgeons’ post-operative instructions, especially with regards to taking their antibiotics, which are often prescribed as a preventative measure against the risk of post-surgical infection.
Leduey A., Mazouni C. et al. (2015). “Comparison of the Explantation Rate of Poly Implant Prothese, Allergan, and Perouse Silicone Breast Implants within the First Four Years after Reconstructive Surgery.” International Journal of Breast Cancer. http://www.hindawi.com/journals/ijbc/2015/519497/
Woo Yeol Baek, Dae Hyun Lew, Dong Won Lee. (2014). “A Retrospective Analysis of Ruptured Breast Implants.” Arch Plast Surg. 2014 Nov; 41(6): 734-739. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4228218/