Women choose to have breast implants removed for as many reasons as they choose to have them placed. While women usually choose breast augmentation to feel better about their bodies, they typically choose explant so their bodies may feel better and heal.
Why Opt for Breast Implant Removal
Even though most women are generally happy with the appearance of their augmented breasts, they typically seek implant removal for reasons including the implants are too large making daily activities and exercise difficult, improving the accuracy of mammograms, the desire for a more natural appearance, decreasing anxiety over implant leakage, and, more significantly, breast implant-associated illness.
Despite historical and continuously growing evidence, there are many in healthcare who do not recognize breast implant-associated illness as a potential complication of breast augmentation. Moreover, many surgeons refuse women’s requests to remove their breast implants. Seemingly, the surgeons’ reluctance to remove breast implants revolves around their own perception of how their patients will feel about their breasts following implant removal. They fail to consider how their patients may be suffering as a result of the implants.
Options Following Removal of Your Implants
Although a woman’s breasts may not look as aesthetically pleasing to them following implant removal, there are procedures and techniques that can be utilized to improve what would be an otherwise poor outcome including breast lift (mastopexy) and/or fat transfer to the breast. Some patients have a good amount of natural breast tissue and relatively small implants whereas others have little to no breast tissue and very large implants. The latter patient is obviously more challenging than the former and, in many situations, the aesthetic outcome is limited.
It is critical that a patient be educated about the entire process of breast implant removal so they can feel more comfortable about the process, have realistic expectations, and anticipate any issues that may arise following surgery. Patients are often confused about what a capsule and capsulectomy are. A capsule is a layer of scar tissue formed around any foreign body (e.g. pacemaker, joint replacement, breast implant) to wall it off. If a patient simply has their breast implants replaced, the old implant will be removed and a new implant placed within the existing capsule or layer of scar tissue. In this case, there is no reason for the body to form another capsule. However, if a patient has her breast implants replaced in a new pocket (e.g. moved from on top of the muscle to under the muscle), a new capsule will form because the new implant is not placed inside the old capsule. Ideally, in those situations, the old capsule would be removed at the time the new pocket is made for the new implants. If not, those patients will have two capsules in each breast requiring removal during the breast implant removal with capsulectomy procedure. Indications for capsulectomy include but are not limited rupture of a silicone implant, breast implant associated illness, and significant capsular contracture with calcifications that would otherwise cause discomfort for the patient.
As mentioned above, removal of breast implants can leave breasts appearing saggy with excess skin and deflated. In an effort to provide women with the most aesthetically pleasing outcome, there are several procedures that can be performed at the same time as explant or months following. The most common adjunct cosmetic procedure with breast implant removal and capsulectomy is a mastopexy. The mastopexy procedure will raise the nipple, if necessary, to a more aesthetically pleasing location and tighten the skin envelope of the breast after the volume of the implant is gone. However, a mastopexy is not indicated in all patients. If a woman has relatively small implants, the nipples are already well above the inframammary fold, and she has no droopiness of the breasts, a mastopexy may not be indicated and this determination would be made on examination during the consultation process. A common misconception with a mastopexy is that the nipple is removed and put back on during the procedure. This is referred to as a free nipple graft. While a free nipple graft is sometimes indicated in the most extreme of circumstances, it is not typical of a mastopexy procedure. The mastopexy procedure does not add to the overall recovery time or activity restrictions. It simply lengthens the time of surgery and the extent of the incisions or scars. The recovery process following this combination of procedures involves some early discomfort that may require pain medication for the first 1-3 days, resolution of the majority of discomfort at approximately 10 days, four weeks of activity restrictions including no heavy lifting and no strenuous activity, only showers for the first 3-4 weeks beginning the day after surgery and no submerging in water, and return to light daily activities including driving and work within 3-7 days.
Another adjunct cosmetic procedure to consider with breast implant removal and capsulectomy is fat transfer to the breast. Fat transfer, also referred to as fat grafting or fat injections, is the surgical process of transferring fat from one area of the body to another. The procedure involves liposuction of one or more areas, most commonly the abdomen and love-handles, and reinjection of the fat into the tissue of the breast. The amount of fat that can be transferred will be limited by the thickness of the donor sites (amount of fat that can be obtained) and the original thickness of the patient’s breast tissue. The more breast tissue a patient starts with, the more fat that can be added. Fat transfer to the entire breast can be considered for those patients who do not require a full anchor pattern breast lift. In patients that do require a full anchor pattern breast lift, fat transfer can be considered and is often very beneficial in the upper pole in order to reduce the concavity or ski-slope appearance that results following implant removal.
There is Hope
Most women who have their breast implants removed feel that they made the right decision. In many cases, they are not only pleased with how they feel without their implants, but tend to also be pleased with how their breasts look. If you think you are ready for breast implant removal surgery, set up an appointment with Dr. Tarola at Tarola Plastic Surgery. He and his team of professionals will guide you through the process with utmost care.
