Having your breast implants removed is a deeply personal decision that requires careful consideration. It’s a decision that should be heard and respected, just like a breast augmentation, reduction, or lift. The women I see at my clinic have a variety of reasons for wanting to have their implants removed.
Some women decide they dislike the way their breasts look and want to go back to having a smaller bust or a more proportional silhouette. The body they wanted at 25 might no longer match what they view as feminine or the image they currently want to project. Their breasts may have thickened with time, requiring their implants to be removed and repositioned (lifted). This category also includes women whose implants need to be replaced—either because of their age or a problem like capsular contracture or a fissure—and who decide to simply have them removed.
For other women, the decision is motivated by physical or psychological discomfort. Sometimes patients dislike the “feel” of their implants or have trouble getting used to having a foreign object in their bodies. In some cases, this discomfort is related to the onset of a variety of symptoms or pain that are collectively referred to as “breast implant illness,” a condition that is still poorly understood and is garnering increased media attention. The most commonly reported symptoms include chronic fatigue, brain fog, muscle pain, hair loss, and impaired vision. These physical symptoms sometimes lead to stress, anxiety, difficulty sleeping, and even depression.
While the studies that have been conducted thus far have been unable to establish a clear link between breast implants and the symptoms described, I think more research needs to be conducted. I believe that these women, who think they have this condition, are expressing valid concerns. As a plastic surgeon, it is my duty to listen to them and to walk them through the process by explaining the risks, benefits, ramifications, and potential complications of removing their breast implants.
Another medical reason for removal includes implants with textured surfaces. A link was recently discovered between textured implants and a rare form of cancer called BIA-ALCL, which has prompted many women to replace their implants or have them removed. While the incidence of BIA-ALCL is very low, some patients decide not to live with the risk and have their implants removed as a precautionary measure. Click here for more information about textured implants and BIA-ALCL.
The procedure involves making an incision along the inframammary fold, which is likely where the implants were initially inserted. The resulting opening allows the surgeon to delicately detach and remove the implant and breast capsule (scar tissue surrounding the implant). If the procedure is being paired with a lift, the incision line will take the shape of a lollipop, vertically up from the breast crease and around the areola.
The “en bloc” removal method is when the implants and capsules around them are removed at the same time. This type of removal avoids potential contamination of the rest of the body when there is a suspected problem. Total capsulectomy is the method I recommend and perform whenever technically feasible. If the patient is experiencing unusual symptoms, the implants and capsules are sent for analysis. Photos are taken at various stages to document the procedure.
Many patients are concerned about how their breasts will look post-operation. The removal procedure can result in breasts that appear saggy and deflated. A mastopexy helps remove excess skin and give the bust a more attractive shape and height.
Regardless of what’s behind the decision to have your implants removed, it is important to call on an experienced surgeon to perform the procedure. This type of surgery, especially when it involves a total capsulectomy, requires a highly skilled and experienced surgeon. Make sure you choose a surgeon with excellent references, one whom you’re comfortable with, and who is able to provide clear, complete, and candid explanations.