Breast Implant Removal

Over 400,000 American women underwent breast implant surgery last year, according to the American Society of Plastic Surgeons When you made the decision to undergo breast augmentation surgery, you may not have considered that the breast implants would need to be eventually removed. However, many women find themselves making this choice for a variety of reasons. Some common reasons for desiring breast implant removal include implant rupture or deflation, infection, or complications like a capsular contracture.

If you are considering a breast implant removal, you likely have a number of questions on your mind that need answering so that you can make a decision based upon sound information.

Breast Implant Removal

What are the reasons for breast implant removal?

Up to 50% of women who underwent insertion of breast implant eventually remove them for various reasons. These include:

  • Deformation of the breast (here you can elaborate on capsular contracture formation and implant rupture)
  • Recurrent breast infections
  • Fear of implant safety (mainly BIA-ALCL and breast implant illness).
  • Complications of implants, including folding or deflation and implant rupture.
  • Personal preference. Women may be unhappy with the shape or size of their breast implants. They may also have shifted into an incorrect position.
  • Complications like capsular contracture, displacement, tension bands asymmetry and silicone leakage due to implant rupture.

Some women have also experienced complications with their breast implants, including capsular contracture or infection. In these cases, Dr. Wiser may recommend the removal of the breast implants.

Common reasons for needing a breast implant removal include:

What is breast implant illness (BII)?

Undergoing a procedure for breast implants can improve your life. However, although a causal association has not been determined, a correlation has been established between silicone breast implants and the development of chronic symptoms found in autoimmune diseases, such as joint and muscle pain and brain fog.

Additional potential risks of breast implants include:

  • Breast pain
  • Scarring
  • late Infection
  • Changes in sensation
  • Implant leakage and rupture

What is breast implant associated anaplastic large cell lymphoma (BIA-ALCL)?

According to the FDA, a rare cancer known as anaplastic large cell lymphoma has been associated with breast implants (BIA-ALCL). BIA-ALCL is a form of non-Hodgkin's lymphoma, which is a malignancy of the immune system.
In the rare instances it occurs, BIA-ALCL is located within scar tissue (the implant capsule) and the fluid adjacent to the implant. In few of the cases reported so far, BIA-ALCL spread beyond the scar into adjacent tissues. Although the risk of developing this condition is low, the seriousness of this form of cancer can prove fatal when left untreated, or treated at a late stage.
BIA-ALCL Is treated successfully for most patients by removing the breast implant together with complete removal of the surrounding capsule (scar tissue).

What is the cause of BIA-ALCL?

It is currently unknown what the precise causes of BIA-ALCL are. Research is ongoing. Early evidence indicates that textured implants are linked to a higher risk of developing ALCL than smooth ones. Some scientists claim this could be because textured breast implants have a larger surface area in which bacterial infections can develop. Any infection in this area could lead to an unhealthy immune system response that causes BIA-ALCL.

What are some symptoms of BIA-ALCL?

ALCL is often localized within tissue near the implant. In some cases, it can move into the lymphatic system and lymph nodes. The most frequent symptoms of ALCL are chronic pain or swelling around the breast implant that occurs long after the initial breast implant surgery.
Fluid collection around the breast implant is another common symptom of breast implant illness. Another is capsular contracture, leading to the development of a skin lump or mass of scar tissue surrounding the implant that causes an abnormal appearance.

What is involved with implant removal?

The three most common reasons for having breast implants removed are capsular contracture, rupture and infection. This can lead to the development of implants that appear asymmetrical or unnatural.

The key point regarding implant removal is whether the procedure involves all, some, or none of the capsule around the implant. Each case is different. For example, an en bloc capsulectomy involves the placement of an incision around the capsule, which remains intact and is removed with the implant.

En Bloc Capsulectomy

This option consists of breast implant removal along with the capsule of surrounding scar tissue as a single piece, or "en bloc." The capsule is removed from the breast tissue surrounding it, and the implant remains inside.

Total Capsulectomy

The breast implant under this procedure is not necessarily removed when remaining inside the scar capsule. It typically involves removing the scar tissue capsule, then later returning for the removal of the total scar tissue capsule.

Because BIA-ALCL usually develops in the capsule, some advocate that removing the capsule lowers the risk of the patient from developing BIA-ALCL and BII.

Is it possible to correct breast deflation and sagginess following implant removal?

If you undergo a breast implant removal, additional procedures may be needed, like a breast lift, implant replacement or fat transfer. In the case of having little to no breast tissue present, combined with proportionately large implants, it may prove difficult to provide breast restoration without natural tissue breast restoration or the placement of another implant.

What should I expect when recovering from breast implant removal?

Dr. Wiser may recommend that you do not return to work for a few days. He may prescribe a pain reliever so that you remain comfortable while you are recovering. It is important to avoid disturbing your surgical incisions while they are healing. You should also avoid vigorous physical activity for four to six weeks following your breast implant removal.