Breast implants don't last forever. At some point, they will need attention due to complications, age, or natural changes in body shape. Many patients who previously had breast augmentation are concerned that their breasts will sag or look deflated after breast implant removal. Cassileth Plastic Surgery in Beverly Hills is an industry leader in breast explant surgery, and our surgeons use highly specialized techniques to restore breasts while removing implants.
Browse our photo gallery of plastic surgery results to see the real-life difference it can make.
Dr. Kelly Killeen is not just an outstanding surgeon and artist, she is also an angel. I had 15+ surgeries to correct an ongoing problem for last 10 years, numerous super-famous doctors worked on me, in different parts of the world, including Geneva, Berlin, etc.. So by the time I got into Dr. Kelly's hands the words "total mess" don't even begin to describe the actual condition of what used to be my breasts. Dr. Killeen, just as regular angel performed a miracle and made everything good again. I love you. There is also nurse Dee who is just incredible human being, here level of compassion, love and care is truly rare. Last but not the list there is a Brit called Jade - she is so beautiful, funny and totally awesome, I will find a reason to come again for some facial peeling or something else simple just to see you guys! I am so blessed to have met these beautiful people, they maybe just part of exceptional medical team, but in my heart they will always be my friends...
Some women opt to remove breast implants due to health issues such as Breast Implant Illness (BII). BII is an emerging consideration which may cause some patients to experience autoimmune symptoms such as fatigue, chronic pain, and mood instability.1 Many of our breast implant removal patients with BII find that their symptoms improve as early as one week after surgery.
Other common reasons for removal include complications such as capsular contracture, implant rupture, or possible leaking of silicone or saline implants.2 Another health concern that may prompt you to seek breast implant removal is anaplastic large cell lymphoma (BIA-ALCL). This rare cancer is a type of lymphoma (not breast cancer) that has been linked by the FDA with certain types of textured surface silicone implants. Talk to your plastic surgeon to learn if your breast implants are the type that has been linked to BIA-ALCL and learn if they recommend an explant procedure.
Many women who no longer want implants are concerned about the appearance of their breast shape after removal; they worry about loose skin, asymmetry, or deflation if they have their implants removed without getting new implants. Our surgeons know how to remove your breast implants and then use your own tissue to make your breasts look great. The key to a successful removal is to support the breast internally and add volume, if needed, using your own fat.
Our breast surgeons are highly skilled in a variety of techniques, including capsulectomy and en bloc capsulectomy techniques in which the breast implant is removed in one piece along with the surrounding scar tissue in order to minimize any health risks. Whenever possible, we will use the same incision placement as your original breast augmentation surgery in order to prevent additional scarring.
The breast implant removal procedure is unique and different for every patient. It is typically an outpatient procedure performed with general anesthesia. We address every aspect of what you want from this surgery: do you want to be a smaller size? Do you want the implant (and the surrounding capsule) removed for health reasons? What goals are you hoping to achieve?
Patients tend to fall into three main categories, based on their desired breast size, the current state of their breast skin and tissue, and any existing scar tissue:
1. “You have good breast skin and tissue, and you are happy to have smaller-sized breasts.”
Patients in this category tend to have a simple experience and an uncomplicated treatment plan. We simply have to remove the implant and repair any damage done by the implant. If the implant is under the pectoral muscle, the pectoral muscle should absolutely be repaired in order to treat or prevent pectoral flexion deformity, also called “pec flex” and “windowshading.” This is when an unrepaired pectoral muscle can be seen moving abnormally. When an implant has been in place for years, the breast tissue gets pushed outward from the center, and the area directly adjacent to the implant thins. This is the “doughnut” effect, where a ring of natural breast surrounds the outside of a stretched-out breast. We utilize internal repair sutures to bring the breast back together and “fill in the doughnut.” Finally, the capsule that forms naturally around any implant is often an issue with breast implant removal. In any case where the capsule is abnormal, such as capsular contracture, chronic inflammation, biofilm, Bii, or silicone rupture, the entire capsule should be removed, including its “back wall,” next to the body. We typically send this tissue for PCR testing, microbiology, and pathology, which reveal any underlying problems.
2. “You want more volume than your natural breast tissue.”
Your augmented breast volume is made up of your implants plus your natural breast tissue. When we remove your implants, your breast volume will be provided only by your breast tissue. If you want to get rid of your implants, but you want a larger size than your natural breast tissue gives you, we use fat grafting to bring you to the size you want. The larger your native breast, the more fat that can be grafted. For example, if your breast volume is only half implant prior to implant removal, the whole volume of the implant can be replaced with fat. If your breast is mostly implant, however, we may not be able to replace the implant with a single treatment of fat grafting. We are very careful with our donor sites (the areas on your body where we get the fat from) and the way we fat graft, in order to minimize risks of fat necrosis and get maximal fat retention. Learn more about fat grafting for breasts.
3. “You have stretched-out or droopy breast skin that will be worse when your implants are removed.”
The final category is when the skin is stretched out by the implant, or the skin was already loose or droopy before the implant was placed. In this case, a breast lift or mastopexy may need to be performed. Small lifts may be performed internally, called an “internal lift,” where the breast tissue is moved upward on the chest wall. This can raise the nipple by about one inch and avoid any additional scars. For breasts with more sagging, a true mastopexy must be performed. We believe that the smallest incision should always be used. In some cases, we can perform our “Pocket Lift,” which gives the breast a high and filled look even as the implant is removed. Learn more about breast lift surgery.
We commonly fix other surgeon’s botched implant removals that leave patients with scars, odd-shaped breasts, weird moving muscles, and too small sizes. Cassileth plastic surgeons use innovative, highly detailed techniques during breast explant surgeries to ensure patients’ breasts look beautiful and all breast-implant-related issues are corrected.
If you have cosmetic concerns, medical concerns, or would like to remove your breast implants for any other reason, then breast implant removal surgery may be right for you. Ideal candidates are in good general health, non-smoking, and are at a stable weight.
Women seek implant removal as a cosmetic procedure for a variety of reasons. Some want a more proportionate look after weight loss, some have experienced changes in their breast shape or size after pregnancy or breastfeeding, and some find that breast implants no longer fit in with their lifestyle.
Your recovery experience will vary based on the details of your surgical plan. In general, you can expect some tenderness, numbness, swelling, or bruising in the days after your procedure. The healing process will continue for several weeks and you will be given a compression garment to accelerate recovery. You may be advised to avoid strenuous activity for up to a month after your surgery.
Actress and Little House on the Prairie star Melissa Gilbert opens up on her decision to have her implants removed. Good Morning America asked Dr. Lisa 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 a breast implant removal, making this a very fulfilling procedure to perform.
1The American Society for Aesthetic Plastic Surgery. Breast Implant Illness – Frequently Asked Questions/Talking Points. Available: https://www.surgery.org/sites/default/files/downloads/BII-Talking-Points-FINAL-1.15.19.pdf Accessed February 2, 2020.
2Mayo Clinic. Women’s Health. Available: https://www.mayoclinic.org/healthy-lifestyle/womens-health/expert-answers/breast-implants-and-cancer/faq-20057774 Accessed September 1, 2021
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