Breast implants will need eventually to be removed due to implant rupture, possible leaking, age, texture1 of implant or health issues such as Breast Implant Illness (Bii)2. Many women who really don’t want their implants anymore are concerned that their breasts will look unattractive and deflated 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.
Browse our photo gallery of plastic surgery results to see the real-life difference it can make.
Your surgical expertise, concern, artistry, and true listening to my desires have left me happier. The breast augmentation results I received are more natural-looking and beautiful than I ever hoped. Thank you for all of it, and for your compassion and time. I am so truly grateful.
Breast implant removal surgery is unique and different for every patient. 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 and the current state of their breast skin and tissue.
These women are the easiest to treat. 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 deformity3, also called “pec flex,” “pec animation deformity,” or “windowshading.” This is when an unrepaired pectoral muscle can be seen moving abnormally and occurs when the pectoral muscle is cut to place an implant underneath. If you have pec flex when your implants are in, you will most likely continue it when they are removed, and it usually worsens as the muscle is looser on removal. The breast tissue, as well as the muscle, also needs to be addressed. 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.
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. You can find more information about it here.
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. You can learn more about the Pocket Lift here.
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.
2 The 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 7, 2021.
3 Gland Surgery. An overview of animation deformity in prosthetic breast reconstruction. Available:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378247 Accessed February 7, 2021.
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