Can my breast implants be removed under local anesthesia?

Nurse Becky:Breast implant removal (both silicone and saline) is straight forward, non tender, and in our office, is ideally suited as an in office procedure using local anesthesia, as one as the capsule is grade1. The procedure doesn't require the patient to forgo meals, work, or time with family and friends. Your confidant can stay in the room with you during the procedure if you prefer and the patient may drive herself to and fro. No drains. But if there is an encapsulation (contracture), the procedure is more extensive and requires general or IV sedation because the entire capsule is also removed. 

It might be difficult to remove silicone under local.  If they were saline, the implants could be intentionally ruptured fro removal.  Either way, straight local does not seem to be the most sensible option.  Very little can be done with this technique.

If you don't have any signs of capsular contracture then the surgery should be well tolerated under local anesthesia. It only involves a small incision to access and remove the implant. Since it's saline, the implant can be punctured and drained to allow easier removal as well. You might have a little soreness at the incision site but nothing ice and ibuprofen can't take care of. I hope that helps. 

Hi there,
Recovery after breast implant removal will depend on a variety of factors including magnitude of the actual surgical procedure as well as the background patient's health status and tolerance to anaesthesia and surgical operations. Recovery can obviously be more prolonged especially when a capsulectomy is indicated or in situations where a replacement of implant is desired or a concurrent breast lift is required.
Although a "straight" explantation without any of the above additional surgical manoeuvres is relatively uncomplicated, it is always wise to be prepared for the "unexpected" where a general anaesthesia will be necessary to enable a safe and secure operative environment for an optimal surgical outcome. While it could be influenced by both surgeon's & patient's preferences, a "quick" general anaesthesia is usually very safe and a small "price" to pay for ensuring a proper revisional procedure is performed under ideal conditions.
Depending on individual patients' circumstances, a "straight" uncomplicated breast explantation can easily be performed as a day procedure with relatively minimal down time from the actual surgery. However, depending on the context of associated indications and motivations for the surgery, there may be psychological sequelae in adapting to your new self without the breast implants in the acute recovery period. 
Hope that helps.
Best wishes 
Ellis Choy

The answer depends on the individual's situation and the complexity of the surgery. Yes, breast implants MAY be removed under local anesthesia, especially if there are no issues like capsular contracture (thickened scar tissue) or other issues that would require a more complex procedure. The general idea is that if the implants are intact, and if the surrounding tissue is not problematic, the removal can often be done with local anesthesia.


However, if the capsule around the implant needs to be removed (capsulectomy), or if there are complications such as thickened or calcified capsules, general anesthesia is often preferred. This is because removing the capsule can be more involved and uncomfortable to do under local anesthesia alone. Safety is ALWAYS the priority.


It's important to have a detailed discussion with an experienced plastic surgeon who can customize your surgical plan and determine the best technique for you based on your individual anatomy and goals.


Dr. Krishna Vyas, MD, PhD, MHS
Harvard, Johns Hopkins, & Mayo Clinic Educated
Double Fellowship Trained
Aesthetic Plastic Surgeon
New York, New York

Our patients’ safety is of utmost importance to our practice.  The safest way to perform operations such as explant is under a general anaesthetic in an accredited hospital.  This also helps reduce complications such as infection and pain.
Many patients do report the procedure and recovery period is much easier than the initial breast augmentation surgery. 

I have on occasion removed implants under local anesthesia. However, it may be advisable to have the capsule that forms around the implants removed as well. If the capsules are going to be removed, then you will most likely need general anesthesia. The implant pocket will never heal completely unless the capsules are removed. Leaving the capsule in place could put you at risk of fluid collections in the future. Even if the capsules are not completely removed, you will probably be more comfortable with some sedation or general anesthesia. 

Recovery from simple explant performed under local is typically uncomplicated. Patients will return to most activity within 3-5 days. It will take 4-6 weeks for complete healing, but this will not restrict most activities.As always, discuss your concerns with a board certified plastic surgeon (ABPS).

As you can see there are varying opinions on whether the capsule needs to be removed along with te implant.  In my practice, if there is a normal (grade 1 capsule) then i would be comfortable removing just the implant, and yes in some circumstances I remove them under local anesthesia.

Yours is a very good question!
 Breast implants MAY be removed under local anesthesia. In general, it can be done with an absolute minimum of discomfort and a very easy recovery. The one thing to consider is what will be done with the resulting  loose skin after removal of the implant. Some patients choose to leave the breast as is, while some choose to have a breast lift at the same time as implant removal. 
Interestingly, there are many types of breast lifts that can also be done under local anesthesia, at the same time as implant removal. In some cases, this may compel a patient to decide for sedation or general anesthesia, though. If the decision is made to completely remove the implants capsule, it may be a better idea to perform the operation under anesthesia as the more involved and potentially uncomfortable to do under local anesthesia.With regard to the recovery, the answer is often dependent on what type of procedure you have done. If the implant is simply removed and the capsule left behind, there will be minimal discomfort during your recovery. You may be sore for a couple of days, but will only need Advil or Tylenol, if anything. If another procedure, such as breast lift or fat transfer, is done at the same time, you may have somewhat more discomfort. That said, even with more involved provisional procedures, recovery is generally easy.
When undergoing breast implant removal, it is critical that you seek the advice of a physician who is certified by the American Board of Plastic Surgery and has extensive experience with breast augmentation, revision and removal.
 I wish you the best,
 Dr. Gabbay.