Thinking of having your breast implants removed? Here’s what you need to know about explantation.

woman with back facing us closing bra

Breast augmentation remains the most popular cosmetic surgery procedure in the United States—that said, every year, there is also a small percentage of women who choose to have their breast implants removed. That’s because there have always been cases where breast implants no longer suited a patient’s lifestyle or they needed to be removed for health reasons.

However, with recent news regarding certain implants being associated with a very rare form of cancer (BIA-ALCL), as well as some patients reporting they feel their implants are causing systemic health issues (termed “breast implant illness”), more women are asking plastic surgeons, including me, if they should have their breast implants removed.

Whether or not to have your implants removed for health reasons is a very personal decision you should make with your doctor, having full knowledge of the risks and pros & cons for either choice. I can say that the vast majority of my Reading breast augmentation patients remain very happy with their implants—but the small number of patients who have explantation surgery with me are also happy with their decision.

While this blog post can’t substitute for in-depth consultation with your own physician, I’d like to help you understand more about breast implant removal.

What are the reasons for breast implant removal?

While every patient’s reasons for having their breast implants removed are personal, here are the most common:

  • Personal preference. For some, their aesthetic ideals have changed, while others have comfort-related reasons, such as participating in intense athletics.
  • To address a complication, such as capsular contracture or implant rupture
  • Desire to rule out implants as a possible source of health problems
  • Medical necessity; i.e., when a patient is undergoing breast cancer treatment

Explantation is an appropriate option as long as it is what a patient wants for herself, and the surgery can be performed safely. If you pursue breast implant removal, be sure to choose a reputable board certified plastic surgeon who has specific experience in the procedure.

What is breast implant removal surgery and recovery like?

Explantation is typically performed as outpatient surgery using general anesthesia, although in some very straightforward cases, local anesthesia can be used to remove saline implants. Whenever possible, I will use the same incision site used for the initial breast augmentation procedure. Through this incision, I will carefully remove the implant and surrounding scar tissue (capsule), and then close the incisions.

My patients typically need even less downtime after explantation than they did after breast augmentation. In most cases, five days off work is plenty. However, you will still have to refrain from strenuous exercise and lifting for several weeks while your incisions heal.

Explantation is an appropriate option as long as it is what a patient wants for herself, and the surgery can be performed safely. Just be sure to choose a reputable board certified plastic surgeon who has specific experience in breast implant removal.

What will my breasts look like after explantation?

Obviously, your breasts will be smaller. But, depending on how long you’ve had your implants, how large the implants were compared to your natural breast size, whether or not you have had children, and other factors, your breasts may look similar to—or very different from—how they did before your augmentation. Remember, having breast implants doesn’t freeze the aging process or prevent other tissue changes; whether augmented or not, breasts change over time.

Immediately after surgery, you can expect some post-operative swelling, bruising and soreness, just as you did after breast augmentation. You may feel pleased—or perhaps concerned—with the less-full appearance of your breasts, but in any case, you’ll need to be patient in assessing your results as swelling subsides and the skin gradually contracts to some degree. If, after healing, you find the skin has stretched to the point that you feel dissatisfied with your appearance, you may consider having a breast lift to correct the issue.

Lastly, note that explantation scars will be present, although they should fade over time. To speed incision healing time and minimize the appearance of scarring, be sure to follow all of your surgeon’s post-op instructions to the letter.

Do I need en bloc capsulectomy?

If you’ve been researching breast implant removal options, you’ve probably come across information about en bloc capsulectomy. This is a specific explantation technique that involves removing the breast implant and surrounding capsule of scar tissue as one single piece (en bloc means “all together”). With this technique, the capsule is separated from the surrounding breast tissue without breaking it, and then removed with the implant still sealed inside.

There are a few key benefits with en bloc capsulectomy, particularly if we are removing ruptured silicone implants. Keeping the capsule intact ensures that the silicone gel is contained. We’ll also recommend en bloc capsulectomy if a complication such as BIA-ALCL is suspected.

There is no single “best” breast implant removal technique. An experienced plastic surgeon can help you understand whether en bloc capsulectomy or another method is most suitable for you.

However, the technique is not without its drawbacks. For one, a much longer incision is required with en bloc capsulectomy, as we cannot collapse or squeeze the implant/capsule during removal. Second, it’s not always a safe or practical option, especially if the capsule is very thin or it is closely adhered to the chest tissue.

Moreover, en bloc capsulectomy is not the only technique that allows for complete removal of the capsule and breast implant matter. For most patients, it is actually a better option to open the capsule, carefully remove the implant, close it, and then go back and release the capsule from the surrounding tissue before removing it. All this can be done using the same incision site as the original breast augmentation (assuming an inframammary incision was used).

The moral of the story is that there is no single “best” or “safest” breast implant removal technique. It is also not uncommon for a surgeon to have to adjust their surgical plan as they work, especially with en bloc capsulectomy—if the capsule is too thin, it may be impossible to keep it intact.

In sum, if your implants are intact, and you don’t have BIA-ALCL, en bloc capsulectomy is not likely to be recommended. An experienced, board certified plastic surgeon can help you understand what breast implant method will likely be most suitable for you.

Is there anything else I need to know about explantation?

If you are considering explantation because you are worried about or think you may have “breast implant illness,” I understand. A number of patients who have had their implants removed say symptoms such as fatigue, headaches, and joint pain improved or they generally felt better afterwards. Even explantation patients who do not experience an improvement in symptoms may still be pleased to have eliminated what had been a source of concern for them.

It’s important to know that, because there are not yet scientific studies proving that breast implants can cause systemic issues, we cannot guarantee that removing your implants will improve your health. Be sure you have seen your primary care doctor first to rule out any diagnosable causes for symptoms, such as Lyme disease. If you cannot find an answer, removing your implants is an option to consider, knowing that explantation may or may not have any effect.

In my practice, if a patient wants her implants removed and she is a good candidate for surgery (i.e., her health is adequate to undergo a procedure and she is well-informed), then I am happy to perform explantation. I will work to provide the most aesthetically pleasing result possible, just as I do with any cosmetic procedure.

Have more questions about breast implant removal? Feel free to get in touch.

I hope you have found this information helpful; if you would like to discuss your concerns and procedure options further, I welcome you to contact my office to schedule a personal consultation with me or my colleague, Dr. Lindsay.

26 Comments Posted to "Thinking of having your breast implants removed? Here’s what you need to know about explantation."

  • April 20, 2020 at 12:23 pm • Posted by Taylor Hansen | Reply

    Thanks for mentioning that breast implants don’t freeze the aging process. My sister wants to get an explant surgery since her back has been hurting since her procedure. I’ll be sure to share this with her so she knows what to expect before her explant surgery.

  • September 1, 2020 at 10:39 pm • Posted by debbie tawes | Reply

    ive had my implants for 30 plus years. i want them taken out desperaterly! wish i had never had done!. don’t know how to explain after removal where my breast went! i feel so embarassed! please tell me how to have them removed!
    recently had 3 heart attacks & open heart surgery scared to death to have removed!

    • September 2, 2020 at 7:56 am • Posted by Dr. Brian Reedy |

      Seek out a board certified PS and I’m sure your implants can be safely removed with proper consideration to your medical conditions 🙂

  • September 2, 2020 at 10:53 am • Posted by debbie tawes | Reply

    thank you for the consultation!

  • September 4, 2020 at 5:20 pm • Posted by Luz | Reply

    I would like to know that in the case of Chronic Lymphocytic Leukemia where people develop many lumps could this be a systemic result from breast implants. I like to know if this is the case does the insurance pays for the procedure of removal? Also in cases of much breast pain without knowing the cause and evidence of fluid reaction in the body due to the implants can the insurance will also cover for the removal procedure? Do breast get extra saggy after extracting normal size implants

    • September 6, 2020 at 1:45 pm • Posted by Dr. Brian Reedy |

      I am not aware of Leukemia related to implants. With textured surface implants there are known cases of ALCL anaplastic large cell lymphoma. Most insurances will cover explantation due to a documented complication but it can vary. A very large implant can stretch the tissues and require a breastlift to get back to a youthful shape and form

  • September 24, 2020 at 3:25 pm • Posted by Hope | Reply

    Will your office work with insurance to have implants removed due to illness related?

    • September 24, 2020 at 4:15 pm • Posted by Dr. Brian Reedy |

      Yes. Call to schedule an appointment. However most insurances do not cover explanation, check your individual benifits

  • November 21, 2020 at 2:10 pm • Posted by Christine | Reply

    I had silicone implants for about 1 year and I believe I was developing symptoms of BII. I have lost at least 50% of my hair, scalp eczema, tenderness, joint pain, fatigue. When I got an explant 4 days ago, my surgeon said my capsule was very thin and I could bleed if it was taken out. Do you think this will be an issue with the recovery of symptoms?

    • November 21, 2020 at 2:12 pm • Posted by Dr. Brian Reedy |

      I do not. No worries. I hope your symptoms resolve.

  • December 22, 2020 at 6:21 pm • Posted by Cindy | Reply

    Can the implants be removed without the capsule also being removed? Please explain pros and cons of both. Thank you!

    • December 24, 2020 at 2:56 pm • Posted by Dr. Brian Reedy |

      The capsule only needs to be removed if there is a problem, routine explantation does not require it

  • March 21, 2021 at 2:54 am • Posted by Jody | Reply

    I’ve had my implants for 8 years now. Do not hate them but I have one side that is very uncomfortable I believe due to the scar tissue/capsule ( it feels like it’s getting hung up on my ribs) plus that side is now slightly larger than the other over the years. Can you just remove what I think may be too much scar tissue from that one side to relieve that pain?

    • March 21, 2021 at 8:33 am • Posted by Dr. Brian Reedy |

      Yes you can. And replace the implants. I suggest a consultation with a board certified plastic surgeon that specializes in breast surgery

  • April 22, 2021 at 6:49 am • Posted by Sue Greenan | Reply

    Great information! Thank you! If the implants and capsule are being removed because of possible BIA-ALCL, is an en bloc capsulectomy needed? How do I figure out whether or not to use the same plastic surgeon who put my implants in… to take them out/do the en bloc procedure? Is it always a plastic surgeon who does this procedure? Given that there is no confirmed cancer diagnosis yet, would an oncologist do the surgery/jointly do it with the plastic surgeon or is that premature?

    • May 10, 2021 at 4:31 pm • Posted by Dr. Brian Reedy |

      lots of good but complicated questions. too much to answer here. I recommend an in-depth consultation with a board certified plastic surgeon that specializes in breast surgery.

  • May 14, 2021 at 1:52 am • Posted by Susan | Reply

    I have had breast implants for almost 34 years and do not have any concerns with them for most part. I had MRI recently which indicates breast implants were intact since after pulling over 10 years of mammogram records they indicate otherwise and said chronic rupture occurred years early. How do you know which is accurate? Also just found out my implants are the Replicon textured polyurethane foam silicone ones from 1987. I’m not sure what best options are at time point. I have had chronic joint pain for years but not sure related to implants but if taking them out with possiblity of relieving some of my pain would be a plus. Is best option total capsule and implant removal with replacement or without… if you go with a replacement will they have to be removed again in future in like 20 yrs while in my 80s. Also is drainage tubes required with replacement and no replacement surgery.
    Is leaving implants in and not having surgery a option … I never knew that its recommendation was to remove them… until all my research.

    • May 14, 2021 at 7:40 am • Posted by Dr. Brian Reedy |

      I would recommend explanation and capsulevtomy. Whether you replace or not is completely your choice. Either way you will need drains for a few days. Seek a board certified plastic surgeon that specializes in breast surgery. Good Luck!

  • May 17, 2021 at 12:22 am • Posted by Sylvia | Reply

    Hi, seeing lots of posts in different media platforms about BII has me very concerned, I’ve been feeling like garbage for at least 5 yrs now, I hate to think it’s because of my implants, I’ve had them for almost 15 yrs but have replaced them once to go bigger. I don’t think I have any scar tissue issues because they are very soft and even but some of the symptoms I see people post I have.
    Weight loss, extreme fatigue, exhaustion all day, joint and muscle pain, headaches, blurry vision, and this is all day everyday. I want to believe I feel this way because I’ve been very bad at taking care of my body. I don’t drink water like ever so I want to believe it’s because I’m dehydrated and I don’t exercise. What do you think??

    • May 17, 2021 at 6:52 am • Posted by Dr. Brian Reedy |

      I would seek the advice of a medical doctor to rule out other possible causes first. If after a work up there are no other reasons for your your symptoms then you may want to consider an explanation. The device is fifteen years old and should be replaced at a minimum. But an explanation would rule out the implants as a cause. Remember, you could always have them put back in. Just take your time to rule out other possible issues first. Best of luck

  • June 18, 2021 at 12:12 am • Posted by Barbara | Reply

    My silicone implants are 30 years old. Now at 63, I have gained some weight, my bust size has increased and my breasts droop. I am considering having them removed and also having a breast lift. What does this involve in terms of the surgery and recovery time? Will it be as painful as the initial implant surgery? I’m unsure if I am inviting a problem or should they come out anyway because of how old they are?

    • June 18, 2021 at 8:56 am • Posted by Dr. Brian Reedy |

      They should be removed and recovery will be a little easier. Good Luck

  • June 24, 2021 at 8:36 pm • Posted by Norma varela | Reply

    I have the recalled implants and want to remove them. Do I need to ask foe the capsule to be also explanted? My friend also had them and the doctor didn’t not take the capsule out. Is there a higher percentage of developing a decease if the capsule is left inside?

    • June 24, 2021 at 9:57 pm • Posted by Dr. Brian Reedy |

      With textures implants the capsule should be biopsied but just removing “because” is often unnecessary and can be deforming. Discuss with your surgeon. Good Luck.

  • September 15, 2021 at 12:05 pm • Posted by carolyn onisko | Reply

    Thank you for the thoughtful explanation. My implants are over 30 years old. No health issues but still mulling over removal for appearance.

  • September 22, 2021 at 9:10 am • Posted by Lexi | Reply

    I had breast implants for 32 years and had them removed 8 days ago. WOW! can’t believe I waited this long. If I’d only known my breast would have looked this good, I would have done it years ago. Glad I listened to my PS and didn’t opt for a lift. I’m 56 and figured since there was so much scar tissue and my breast were totally misshaped and sat really high on my chest, Id need to lift because I didn’t want new implants. He suggested to wait and let the breast recover and decide on a lift later. So glad I did! 8 days post op and I don’t even need a lift! Also, i keep reading about drains and i had none of that! He removed my implants and did a capsulectomy. He said both implants were ruptured which I didn’t even know. I truly cannot believe how much better my breast look than they did with those fake, giant, round balls on my chest. They have a natural slope and my nipples are facing out not down, just as they should. My cleavage looks so nice and normal! Sad i didn’t do it sooner, but so glad I did it! I look in the mirror 20 times a day just to check them! lol. I’m so pleased and look like I lost 15 lbs! My pain has been minimal, but I’m being careful. I swap out between support bras, ace bandages and really tight tank with a built in bra. On day 8 my nipple area felt like it was on fire but think its just nerves healing. My scar is the original scar, so it’s not scary. I noticed on day 3 that I was walking down the stairs in the morning without all the creaks and cracks and aches in my feet and ankles. I paid closer attention on day 4 because I thought maybe I’d imagined it… I didn’t. If I had been picking out breast 32 years ago, I would have likely picked the ones I have now! Go figure.

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