Explant and breastfeeding options. En bloc, capsulectomy, local or general anesthesia?

Question

Interested in getting implants removed, they are 5 years old, under muscle, silicone. I am 28 years old, Currently breastfeeding 10 month old, trying for another baby in November 2020. Trying to figure out timing or what is possible. If I do get them removed, en bloc, capsulectomy, local or general anesthesia? Also do I need to worry about recovery with picking up little ones? Any insight is much appreciated.

Daniel Barrett, MD · Answer

Dear xolauren591ox,
as long as you don't have capsular contracture, you can get removal of implants are leave the capsules. Generally speaking, it is possible to remove implants under local anesthesia. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kenneth Hughes, MD · Answer

When placed through an inframmary incision, the implant never really touches the breast tissue; it slides underneath it, so this approach has the least impact on the gland itself. Removing the implants and the capsules through the inframmary incision should not cause issues with breastfeeding. 
Leaving a capsule behind is preferred if it is thin and pliable. If there are calcific components, or silicone granulomatous material, or if the capsule is deforming the breast tissue, then removal of the capsule may be warranted.
The removal of breast implants as a stand alone procedure can be performed under local anesthesia.

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Assuming you are not having any issues with your implants, and they have not hardened, or thickened, you can have the implants removed alone. This is most safely done in the OR. Hope this helps.

Camille Cash, MD · Answer

You can elect to have your implants removed as long as you are not breastfeeding or pregnant.  If the capsules are thickened, causing issues, or if the implants are ruptured, then it is recommended that they be removed at the time the implants are taken out.  If they are thin and not causing issues then it is your option to have them removed or leave them behind.  I encourage you to meet with a board certified plastic surgeon near you to learn more.

Connie Hiers, MD, FACS · Answer

If you are having no issues with your capsule being hard and thick, the implants can just be removed. Saline implants can easily be removed under local anesthesia, and many gels as well. You will not need to be breastfeeding or pregnant when this is done. You will need some time to heal before returning to full activities.

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