"You don't have to live with unwanted breast implants because you fear how your natural breasts will look after having your breast implants removed. Breasts don't need to be flat or deflated–-they can be put back together from within." -Dr. Lisa B. Cassileth, Board Certified Plastic Surgeon
Age: 43, from Venice, California. Patient originally had a breast augmentation in 1994. Now she is a little older she felt like her implants were too big and wanted them removed. Dr. Cassileth performed a breast implant removal with an internal lift.
Dr. Cassileth will work with you to decide on the right surgical procedure. If your breast implants are ruptured, or if you have capsular contracture or capsular calcifications, you may also need your implant capsule removed, which is a surgery called "capsulectomy." This is often performed with breast implant removal or replacement. Whether the removal of the capsule is necessary or not is determined by your physical exam, radiological studies, or both.
Most patients also need internal breast work done. Dr. Cassileth uses an innovative "auto-augmentation" technique to put the hanging breast tissue back where it belongs, central to the breast itself. This is critical to having a full, high breast after breast implant removal surgery. Finally, depending on the amount of loose skin that you have, you may also need a mastopexy, or breast lift. The scar for mastopexy varies from patient to patient, depending on the degree of excess skin. In all cases, however, the scar is kept to a minimum, and the skin is never used to hold or lift breast tissue.
Actress and “Little House on the Prairie” star Melissa Gilbert opens up on her decision to have her breast implants removed. Good Morning America asked Dr. Cassileth to discuss why breast implant removal, also known as an explant surgery, is becoming a growing trend among women. Dr. Cassileth sees many patients who want to go back to their natural breasts. Her patients regularly report feeling like they have their own body back again after having their breast implants removed, making this a very fulfilling procedure to perform. We wish Melissa a very happy recovery!
Breast implants unfortunately don’t last forever. At some point they will need to be replaced or removed due to breast implant rupture, age or suspicion of leaking breast implants. Many women are concerned that their natural breasts will look unattractive and deflated if they don’t replace their implants, yet at the same time, they don’t really want implants anymore. Feeling forced to have implants is not necessary when the explantation is done by a world-class Beverly Hills breast surgeon with over a decade of experience.
Dr. Cassileth sees patients traveling from such distant countries as Japan and Saudi Arabia for breast implant removal explantation at her private Beverly Hills surgical center. She has perfected an internal breast lift technique which gives her patients beautiful, full, natural breasts, with the option of using fat grafting instead of silicone or saline implants. For patients who want to decrease the size of their breast implants or need to replace ruptured implants, Dr. Cassileth utilizes her internal breast lift technique in her breast implant revision surgery to ensure the implants are correctly positioned creating natural, lifted breasts.
During every procedure, Dr. Cassileth always performs surgery through the smallest incision possible to leave her patient's with little, to no scarring. Dr. Cassileth usually combines the breast implant removal procedure with an internal breast lift, which is done through a very small incision in the lower breast, usually at the bottom edge of the areola where the scar will be virtually invisible. The skin of the lower breast is first separated from the breast tissue, allowing the breast to be lifted without cutting the skin. Depending on the degree of the lift, a central mound of tissue is taken from the lower half of the breast and tucked under the central breast to create an "auto-augmentation" of the breast. This fills up the depleted upper half of the breast. Then the lower half of the breast is brought together, creating a neat breast that is pulled up above the level of the natural crease under the breast. This is just one of the methods Dr. Cassileth uses to leave her patients with little to no scarring, and beautiful, natural results.
To help you prepare for and understand what to expect from breast implant removal surgery, Dr. Cassileth will explain the process in detail during your personal consultation and pre-surgery appointments in our comfortable Beverly Hills office. Dr. Cassileth will thoroughly evaluate your specific needs, make specific recommendations, and work closely with you prior to your explant surgery to ensure that you understand both what to expect and what the end result of your procedure will be. A summary of the process and brief explanation of various incision techniques is also described at this time.
Plan on relaxing at home the first two days after your explant surgery. You will be in a comfortable surgery bra that has adjustable straps. You may take pain medication during this period of time. After the first few days, most people are up and around, off all prescription pain medication, and usually have resumed basic activities. However, it is important to avoid all exercise, heavy lifting, and other more strenuous activities for the first three weeks. If you go to work, expect to be more tired during the first week and sore by the end of the day. If your work involves a lot of moving of your upper body, take the entire first week off.
Dr. Cassileth insists that all patients undergo a six-month scar treatment regimen after breast implant removal surgery to minimize all scars. During the healing period, the breasts often have tight or small lumpy areas where the internal sutures are located. This is common and is most prominent 4-8 weeks after surgery. These sutures are absorbable and any lumps caused by them will resolve. Your breasts need up to 2 months to fully heal and take their final shape. Our team will discuss with you what kind of support and activity you will need during this time.