Breast Implant Removal Demystified — Answers to the Questions You Never Knew You Had
Jager Weatherby on 5 Aug 2014 at 4:00pm
Wait, breast implants can be removed? RealSelf caught up with Nashville plastic surgeon Dr. Melinda Haws to find out what really goes down when women decide to undo their breast augmentations.
As breast augmentation becomes more and more popular, so does breast implant removal. (The explant community on RealSelf has grown 27% over the course of the last year, with the procedure earning an impressive 95% Worth It rating.) Women who are bothered by the appearance of their breasts may want implants, but there’s also a chance they’ll want these implants removed as they experience changes in their bodies. Why do these changes occur? With or without implants, our breasts change throughout our lives. Pregnancy, menopause, weight gain, or weight loss can all affect the size, consistency, and shape of our breasts. Sometimes it's just life that changes: What was once an enjoyable D cup now feels too heavy. It's important for women to realize that they chose to get implants, and it's their choice to remove them.
MORE: Why Do Women Remove Their Implants?
When a woman decides she’s ready to get rid of her implants, whatever the reason may be, there are several things to evaluate in her exam. Each of these things will affect the approach and game plan for the procedure.
Are your implants saline or silicone?
The answer will not affect the final explantation, but if the implants are saline, it is possible to deflate them in the office under local anesthesia before any final decisions about replacement or breast lift are made. Once a saline implant is deflated, the patient can see how much of her breast size is her own tissue, as well as whether she has enough extra skin to be a good candidate for a lift. The important thing to remember is that once we puncture an implant to deflate it, it is destroyed and is no longer eligible for any warrantee. If you deflate your saline implant knowing you want to replace it with a smaller one, it is then possible to try on sizers and make your decision about size in an educated fashion.
If you’re dealing with silicone and know the volume of your implant, your doctor can show you an implant the same size to give you an idea of how much volume will be left in breast following explantation.
Do you feel saggy now?
If you feel your breasts are too low and saggy with implants, then you will definitely want to talk about the possibility of a lift after removal of the implant. Removing volume will only make your breasts looser and increase sag.
Do you have a capsular contracture?
Do either of your breasts feel firm or hard? If there is a thickened capsule (scar tissue around the implant), then it may be necessary to remove the capsule in order to ensure that the breast feels normal after implant removal.
PROCEDUREThe implant removal itself may require a general anesthetic or can sometimes be done under local depending on the patient’s personal preference (as well as whether or not the capsule needs to be removed). The approach to this should be decided upon by you and your surgeon.
What are the risks involved in implant removal?
The risks involved in removing your implants are similar to the risks for placing the implant, but less. You could have some bleeding, infection, or scarring. All of these are less scary if you've removed the implant without replacing, because there’s no longer a foreign object inside your body that we’re trying to protect. There’s typically minimal risk of skin or nipple necrosis unless the tissue over the implant is really thin or there’s a very scarred capsule that must be removed. Your surgeon should be able to give you a good risk assessment after your physical exam.
What will my breasts look like after implant removal?
Once the implants are removed, the breasts will initially look deflated with depression in the center, giving a bit of a caved-in appearance. It takes about two to three weeks for the breasts to "fluff" back out. The breasts will actually regain 10-15% of their volume once this central area fills in and the skin retracts. It’s important to remember that the “weird looking” breasts seen immediately after removal will not be your final look.
Can I replace my implant at the time of removal?
If you have a good idea of what volume you want, it is definitely possible to replace your implant at the time of removal. It’s also usually possible to do a lift at that time. If a patient is unsure about either of these, I encourage them to remove the implant and wait for the breast to fluff back out before making any decisions.
POST-IMPLANT REMOVALWhat happens to the implants after removal?
Occasionally a patient asks to keep her implants after they’ve been removed. (In a recent episode of Botched, porn star Kimber James revealed that not only did she take her implants home, but she sold them to a fan for $5,000!) Common sense would dictate that you paid for them, so they should be yours. However, the implant companies track these devices and usually want them back. Many surgery centers and hospitals have also set policies which maintain that anything removed from your body, whether it’s a breast implant or a gallbladder, is considered medical waste and should be disposed of or returned to the manufacturer. Your surgeon should be able to provide guidance on specific policies.
What if I decide I want implants again after removal?
The biggest thing to know is that while the removed implants can never be used again, it doesn't mean you can't have implants again in the future. Some women remove implants while having children and then choose to replace them once they’re done with pregnancy and breastfeeding. Some women simply have times in their lives where a B cup works better than a C cup. It's possible for the C cup times to come again.
Dr. Melinda Haws is a plastic surgeon based in Nashville, Tennessee. Learn more at ThePlasticSurgeryCenterofNashville.com.