Question 1

Why do people have breast implant removal surgery?

Accepted Answer

When you had breast augmentation, you probably didn’t imagine that you’d ever remove your breast implants. According to the latest statistics from the American Society of Plastic Surgeons, 37,679 women underwent breast implant removal (aka explant surgery) in 2022.

“Women want their breast implants removed for as many reasons as they want them placed,” says Dr. Melinda Haws, a board-certified plastic surgeon in Nashville.

Common reasons for explant surgery include a desire to address health concerns, implant failure, or complications—though some women simply want a more natural aesthetic or smaller breasts.

Breast implant removal might be a good choice for you if:

1. You’re unhappy with the way your breast implants look. “The majority of women who have their breast implants removed do so because they’d like to see some type of aesthetic change to their breasts,” says Dr. Camille Cash, a board-certified plastic surgeon in Houston.

Some women want to correct shifting, sagging, or changes due to age, weight fluctuations, or pregnancy.

Others simply want to return to their natural cup size. “Many women feel that their breasts, with implants, no longer match their body or their lifestyle,” says Dr. Haws. “They may have gained weight, had a baby, gone through menopause, or taken up marathon running.”

2. The scar tissue (or capsule) around your implants hardens or tightens. “Sometimes the capsule can harden, become calcified, or shrink down around the implant, causing it to become firm, painful, or misshapen,” says Dr. Cash. This complication, known as capsular contracture, is the most common complication of breast implants.

3. One or both of your implants has leaked or ruptured. Studies of silicone gel implants, the most popular type, suggest that most implants last 7–12 years. However, some break during the first few months or years, while others may last more than 15 years.

Reported rates of implant rupture vary by implant type, from 3.9% to more than 16%. The likelihood of rupture increases every year you have your implants.

4. You’re experiencing other symptoms you associate with your implants. While the FDA says it doesn’t have definitive evidence suggesting breast implants are associated with these symptoms, it does say that “Some women experience systemic symptoms that may resolve when their breast implants are removed.” Women with pre-existing autoimmune conditions seem especially prone to implant-related symptoms.

Many women who undergo a breast implant removal procedure also choose to have a breast lift (mastopexy), fat transfer, or a combination of both to address sagging skin and volume loss. It all depends on your preferences and budget.

Question 2

Breast implant removal pros and cons

Accepted Answer

Pros

If you’re worried about the health risks of breast implants, removing them can bring peace of mind. This includes concerns about breast implant illness (BII)—the common term for a constellation of reported symptoms that has yet to be medically recognized—and breast implant–associated anaplastic large-cell lymphoma (BIA-ALCL), a rare type of non-Hodgkin's lymphoma linked to textured implants.
Removing implants makes it easier to detect breast cancer with a standard mammogram.
You’ll no longer need to worry about implant surveillance and “silent” (undetected) ruptures. The FDA recommends routine screenings (MRI or ultrasound) for silicone gel implants to check for ruptures and any other problems. Removing implants eliminates the need for these potentially expensive, time-consuming procedures.
Having your implants removed also means you won’t need to worry about potentially having to replace them later. “I had a 58-year-old patient recently who said she’d rather spend money on a cruise when she’s 70 than have her implants replaced,” says Dr. Patricia McGuire, a board-certified plastic surgeon in St. Louis.

Cons

Breast implant removal surgery can change your breast size and shape in unpredictable ways. The smaller the implants and the less time they’ve been in place, the greater the chance that your breasts will return to their natural pre-op state. But you may still experience decreased fullness, sagging or excess skin, uneven breast shape (asymmetry), and a loss of elasticity. You may also have irregularities or indentations.
You may also notice changes in sensation, which should improve over time as the nerves heal.
Removal techniques like en bloc capsulectomy carry serious risks, including punctured or collapsed lungs, breast deformities, and/or significant scars.
Most insurance companies won’t cover breast implant removal procedures (because breast implant surgery is an elective cosmetic procedure), and the surgery can be expensive.

RealSelf Tip: If you’re considering removing your implants and your original surgeon says “you look great—there’s no reason to take them out,” get a second opinion. This can be a challenge for women who believe they have breast implant illness, so you may need to contact a few surgeons until you find one you really connect with.

Question 3

How much does it cost to remove breast implants?

Accepted Answer

Your breast implant removal cost will depend on your plastic surgeon’s level of experience, their practice location, the type of explant surgery you have, and a few other key factors.

Combining breast implant removal surgery with a lift (mastopexy) or fat grafting may add thousands of dollars to your bill.

Most surgeons offer payment plans or accept third-party financing options to help make explant surgery more affordable.

See our complete guide to breast implant removal costs

Question 4

Breast implant removal pictures: what to look for

Accepted Answer

As you're choosing your surgeon, look for before and after explant pictures with symmetrical, natural-looking results and well-hidden scars. Photos with vertical scars running from the areola to the crease are a sign that the patient also had a breast lift, a common addition to explant surgery.

The breast implant removal photos in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

Question 5

How does breast implant removal surgery work?

Accepted Answer

This is a highly customized procedure that can take anywhere from under an hour to over three hours, depending on your surgeon’s technique, whether you’re incorporating a breast lift or fat graft into your surgery, and if your surgeon is removing the scar-tissue capsules along with your implants (a procedure called a capsulectomy).

Whether a capsule should be removed is usually dictated by its grade (from 1 to 4), as defined by how it feels and looks. A thick, calcified capsule must be removed at the time of explant; otherwise, it may still be felt or seen beneath the skin.

Here’s a quick overview of the main techniques. Your prospective surgeon should explain their recommendation in detail during your initial consultation.

Explant only: When there aren't any implant complications (like a thickened capsule or ruptured implant) or worries about BIA-ALCL, this is a simple surgical procedure that can be performed under local anesthesia with oral sedation, according to Dr. Haws. Most commonly, removal is done through an incision made in the inframammary fold, which is often the original incision site. It can also be done via an incision around the areola.
Explant with partial or total capsulectomy: In cases of capsular contracture or suspected BIA-ALCL, capsules are removed along with the implants under general anesthesia or IV sedation. The implant is usually delivered before the capsule is dissected out.
Implant deflation and removal: Many women with saline implants choose to have their implants deflated before removal to minimize scarring. During the procedure, which can be performed under local anesthesia, fluid is drawn through the skin using a needle and syringe, and the breast tissue gradually settles. This allows the woman and her surgeon to evaluate how the breasts will look after explant and determine whether a lift may be needed to correct sagging skin.

After breast implant removal, you’ll go to a recovery room for observation until your doctor clears you to go home. You’ll likely be given a surgical bra to wear as you recover, to encourage closure of the “pocket” and minimize fluid that can lead to complications, like an infection.

You may or may not be asked to wear a compression garment after explant surgery; there's not a definitive answer as to whether it's necessary, says Dr. Thomas Trevisani, a board-certified plastic surgeon in Winter Park, Florida. "It does not appear that compression following explant is a guarantee to prevent fluid accumulation. It can't hurt, so if it is available, it would be a good idea to do it."

In some cases, doctors choose to insert thin surgical drains ,which are kept in place for three to five days after surgery to help prevent fluid accumulation.

This is an outpatient surgery. Make sure you have someone you trust there to take you home afterward and stay with you for at least the first night.

Related: 3 Women Describe What Breast Implant Removal Is Like

Question 6

Can you have a breast lift at the same time as implant removal?

Accepted Answer

A breast lift (mastopexy) is often done at the same time as explantation, but many surgeons recommend waiting several months to assess the size, shape, and tissue quality of the breasts after implant removal.

“In all implant removals, the tissues are stretched and thinned. But within a couple of months, they ‘fluff’ back up, giving a less deflated or ‘wrinkled’ result,” says Dr. Haws. Allow time for the tissues to retract before deciding whether a breast lift will improve you satisfaction.

In lieu of a breast implant removal and lift, some patients opt for fat transfer breast augmentation to restore some of the lost volume and avoid feeling flat after breast implant removal. Excess fat is removed from another area of the body—often the abdomen, flanks, or thighs—via liposuction and transferred to the breasts. Not all of the transferred fat survives, but what remains after four months is permanent.

Beyond correcting breast deflation after explant, fat transfer can also camouflage minor irregularities, like wrinkled skin, small divots, and asymmetries, that can occur post-explant.

While many women prefer to have these procedures at the same time as explant, “they can also be done at a later date if the patient opts to see what implant removal alone does,” notes Dr. Jason Pozner, a board-certified plastic surgeon in Boca Raton, Florida.

Question 7

What is en bloc capsulectomy?

Accepted Answer

En bloc capsulectomy (or resection) means that the entire capsule surrounding the implant is removed intact, with the implant inside. Complete capsules are also removed during a total capsulectomy, but they may be extracted in pieces.

The en bloc procedure is indicated only in the case of a medically necessary breast implant removal, such as a silicone implant rupture or a diagnosis of BIA-ALCL, where it’s imperative to to remove the capsule without spillage.

In cases of breast implant illness, there’s no scientific evidence to support en bloc capsulectomy, says Dr. Haws. In fact, a recent Aesthetic Surgery Journal (ASJ) study found that the type of capsulectomy—en bloc, total, or partial—does not affect symptom improvement.

The en bloc procedure is risky and has considerable limitations and drawbacks. Potential complications include punctured or collapsed lungs and large scars. Learn more.

Related: Breast Implant Illness Patients Are Demanding a Say in How Their Implants Are Removed—But Is Their Technique of Choice Too Risky?

Question 8

What to expect after breast implant removal

Accepted Answer

Unless you’ve had en bloc procedure, implant removal recovery tends to be easier than the initial surgery to place the implants. You’ll be sore, but pain is typically minimal, and narcotic pain medications aren’t usually required for longer than a day or two.

You should be able to resume normal daily activities, like showering, eating, and walking, within 24-48 hours of surgery.

You may even be able to return to work after a day or two, as long as your job doesn’t require heavy lifting.

Your total recovery time and restrictions on activity will depend on the type of surgical procedure you have and how you progress through the healing process.

Your surgeon will help you assess that at follow-up appointments.

Question 9

How soon will you see your final results?

Accepted Answer

You’ll see smaller breasts immediately after you remove breast implants, but it will take time for any swelling and postoperative changes to subside before you see your end result.

According to Dr. McGuire, women need to be prepared for a significant difference in their breasts after implant removal. “Many of these women haven’t seen their actual breasts for 10, 15, or more years, and they’re 10 to 15 years older than they were when the implants were placed,” she says. “I tell them to be prepared for initial shock and some second-guessing when they see their now ‘age-appropriate’ breasts.” After a few weeks, she says, most of her patients are happier to have smaller breasts.

Results are permanent, but the aging process will continue, so breasts may lose firmness and fullness and start to sag. Dense breast tissue is replaced by fatty tissue as you get older, so if women gain weight, breasts often get bigger.

Related: Chrissy Teigen Posts Photos of Her Breast Implant Removal Scars

Question 10

Will you feel better after breast implant removal?

Accepted Answer

Many patients do feel better after removing their implants. There are also women who regret their decision to explant and wind up re-implanting. Much depends on the motivation for explanting and how well the tissues rebound.

As previously noted, removing breast implants means eliminating various risks—the risk of rupture, capsular contracture, ALCL, aches and pains, future surgeries—and this alone can bring relief. Many of those who explant due to BII symptoms claim to feel better, at least temporarily, once their breast implants are taken out.

The aforementioned ASJ study sheds light on symptom resolution following breast implant removal. The study evaluated three groups of women: patients who underwent implant removal for symptoms they attributed to their implants, those undergoing removal/exchange without symptoms attributed to implants, and women undergoing cosmetic breast lift who have never had any implanted medical device.

Symptom surveys were performed before surgery as well as 3-6 weeks, 6 months, and one year postoperatively.

As expected, “the surveys before surgery showed the BII cohort to have many more symptoms, including brain fog, anxiety, and joint pain, than the two control cohorts,” says Dr. McGuire, a principal investigator on the study. “Six months postoperatively, 94% of the BII patients had at least partial symptom improvement.”

Question 11

Are there alternatives?

Accepted Answer

Breast implant revision surgery includes both removal and replacement with new implants—larger, smaller, or newer versions.

Breast implant technology has improved significantly in recent years, with safety improvements that include more rupture-resistant shells and more cohesive silicone gel that feels more natural.

Women who initially chose implants for breast reconstruction can have revision reconstruction using "flaps" taken from elsewhere on the body. “Some surgeons are using donor tissue for aesthetic reasons in case of explant, but these procedures are far more complicated and costly than traditional procedures,” Dr. Pozner cautions. They also come with a much longer recovery time and the risk of contour irregularities at donor sites.

Question 12

Sources & studies

Accepted Answer

Center for Devices and Radiological Health. “Questions and Answers about Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).” U.S. Food and Drug Administration, FDA, 2019.

Center for Devices and Radiological Health. “Risks and Complications of Breast Implants.” U.S. Food and Drug Administration, FDA, 2019.

Center for Devices and Radiological Health. “Update on the Safety of Silicone Gel-Filled Breast Implants.” U.S. Food and Drug Administration, FDA, 2011.

Headon, Hannah, et al. “Capsular Contracture after Breast Augmentation: An Update for Clinical Practice.” Archives of Plastic Surgery, vol. 42, no. 5, Sept. 2015.

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