Can Breast Implant Removal be Carried Out Under Twilight Sedation?

I have saline, smooth, round, high profile 300cc implants. they are 12 years old. No problems with them just want simple explant. Without capsulectomy or En Bloc. can removal be done with anethesia? Just local and maybe twilight?

Do all explants need drains? I had a Tubal done with twilight and remember nothing about the procedure so I think I could handle saline bags taken out. Does the Dr. have to have an OR suite in his office to do twilight sedation? Thanks

Doctor Answers 10

Can Breast Implant Removal be Carried Out Under Twilight Sedation?

Hello! Thank you for your question! It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capsule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. If minimal contracture is seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from rutptured implant vs pain vs simple pocket adjustment, etc).  Typically this is performed under general anesthesia, but may be able to be done with sedation, depending on your surgeon's comfort with this as well as your ability to withstand the procedure. 

Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies (in an en bloc fashion) in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you. Hope that this helps! Best wishes!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 14 reviews

8900 E. Raintree Dr.
Scottsdale, AZ 85260

Anesthesia for Simple Explantation (Implant Removal)

Simple Explantation or implant removal without capsulectomy can be performed in many cases under local anesthesia alone or with Twilight anesthesia especially for calm patients without significant medical problems.  Not all explants need drains. Many Plastic Surgeons use either an Office OR, free standing outpatient surgical suite or a hospital OR.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 72 reviews

3991 MacArthur Boulevard
Newport Beach, CA 92660

Breast Implant Removal under Local Anesthesia?

Thank you for the question.

If all that is being done is removal of the implants ( no capsule work)  then they may be safely and comfortably removed under local anesthesia for  a relatively calm patient. I generally individualize the type of anesthesia to be used based on the specific patient's  personality and  situation.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,051 reviews

8851 Center Drive
San Diego, CA 91942

Removal of saline implants.

Removal of saline implants can be done under twilight or even local anesthesia if necessary. A full capsulectomy and drains are not always necessary, but there is a higher risk of a seroma or fluid collection. A partial capsulectomy or even scoring of the capsule with compression can significantly lower this fluid collection risk.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 13 reviews

660 Glades Road
Boca Raton, FL 33431

Breast Implants can easily be removed with Twilight Anesthesia

Yes, your implants can easily be removed under twilight anesthesia.  Drains should not be needed.  You should have this done in the usual operating suite - which could easily be an office-based facility.

Randy J. Buckspan, MD
Austin Plastic Surgeon
5.0 out of 5 stars 8 reviews

630 W. 34th Street
Austin, TX 78705

Breast Implant Removal Under Local Anesthetic - Beverly Hills

Hello and thank you for the question. 

In uncomplicated cases as you are describing, breast implants may be removed under a local anesthetic and/or twilight, if that is preferred. Drains are typically not required in these cases. 

A retained capsule may lead to a seroma later on down the line. Hence, it should ideally be removed or plicated. I recommend making a consultation with a Board Certified Plastic Surgeon to discuss your case in detail.

Kindest Regards,

Glenn Vallecillos, M.D., F.A.C.S. 

Glenn Vallecillos, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 21 reviews

436 N. Bedford Drive
Beverly Hills, CA 90210

Twilight Sedation and Local Anesthesia for Breast Surgery

It is quite feasible to perform uncomplicated explantation under twilight sedation and local anesthesia.  You should also discuss with your surgeon the removal of the capsule around your implant.  Even if there was no issue with contracture, leaving the capsule in place could lead to fluid accumulation (seroma) down the line.  Dr. Marc DuPéré, Toronto.

Marc DuPere, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 50 reviews

209-179 John Street
Toronto, ON M5T 1X4

Removing implants

Certainly implants if unc omplicated can be removed under sedation. I have even taken them out under straight local for some patients.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

1049 Fifth Ave
New York, NY 10028

Removal of Implants Under Local Anestheisa

If you had implants placed years ago and just want the saline implant removed, this can be performed under pure local anesthesia if you are tough.  One could take oral sedation ( a Valium) or get some intravenous sedation to take the edge off if you want.  Drains are usually not necessary.  Good Luck

Richard Greco, MD
Savannah Plastic Surgeon
5.0 out of 5 stars 17 reviews

5361 Reynolds St
Savannah, GA 31405

Saline implant removal

What you are describing, removal of uncomplicated saline implants without capsule removal can be done under strainght local anesthesia and with no drains.  If you want, you could take some sedative pills, or if you are a really nervous type, IV sedation might be needed.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.5 out of 5 stars 57 reviews

1135 116th Ave. NE
Bellevue, WA 98004

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.