Should I get breast implant removal? (Previously tuberous breast to capsular contracted breasts with implant) (photo)

Question

I was given 445ccs, textured, infra mammary incision and sub pectoral placement. After my surgery, small signs of capsular contraction. Three years later - first unplanned baby breastfeeding - capsular contracted breasts are terrible (still tuberous). I have concerns for the links of textured implants and cancer as my family has a strong history of breast cancer. It is really affecting my mental health. How do I get my breasts to looking normal and low cancer risk? Medicare?

Kenneth Hughes, MD · Answer

Several recent publications have estimated the risk of developing anaplastic large cell lymphoma (ALCL) in individuals with textured breast implants. The FDA reports that ALCL may develop in 1 in between 3,817 to 30,000 women with textured breast implants.  As of this date, the risk appears to be very small. The FDA has not recommended removal or replacement of textured breast implants or tissue expanders in asymptomatic patients.
An MRI can be performed when an ultrasound or mammography fails to provide adequate information. The most common test for ALCL is to take a biopsy of an enlarged lymph node and check it for lymphoma cells. In most cases, ALCL is found in the scar tissue and fluid near the implant but can be widespread.Consider all the pros and cons of removing the textured breast implants and replacing them with smooth ones.  Your board certified plastic surgeon and results of imaging can help you make the best decision for your mental health and genetics.

Sugitha Seneviratne, MBBS, FRACS (Plas), FACCS · Answer

Hi, thank you for your story and picture. Tuberous breast deformity is usually managed with augmentation and mastopexy or breast lift surgery and whilst your special circumstances may have resulted in the approach taken in your surgery, you will benefit from clinical assessment and examination by an experienced surgeon regarding breast implant revision and mastopexy surgery. While there is no evidence that the risk of breast cancer is increased by textured nor smooth breast implants, the risk of Breast Implant Associated Anaplastic Large Cell Lymphoma is estimated at approximately 1:2000. Given your underlying tuberous breast deformity, you may be eligible for a medicare rebate to assist with part of your costs of revision breast surgery. I hope this is helpful.

Natalie Ngan, FRACS (Plast) · Answer

Considering removal of breast implants can be a difficult decision.  Predicting the appearance of breasts after the implants are removed can also be difficult.  There are many factors that I take into consideration when seeing women for explant surgery.  The main factors include:
The size of the implants - the larger the implants (in relation to your body size) the bigger the change to your breast appearance after removal.
Skin quality - insertion of implants stretches the skin. The better quality your skin is, the more it will retract well after implant removal and your breasts may look fairly similar to prior to implant insertion.
Your expectations - in my experience, women who wish to have their implants removed have very different goals from when they were inserted. The more realistic your expectations, the more satisfied you will be after explantation.
Based on your photos (which is never as accurate as assessment in person), you may benefit from a breast lift (including an areolar reduction) at the time of explant, if you choose to go ahead. Currently there are no recommendations to remove textured implants, however as the absolute lifespan of an implant is unknown, many Plastic Surgeons would recommend removal +/- replacement at 10 years.  With a capsular contracture, Medicare will contribute to your surgery, however having valid private health insurance will cover a larger proportion of the cost of this surgery.

Camille Cash, MD · Answer

Based on your photo and description I think you would benefit from a revision to your breast surgery.  You can consider either removal or exchange of the implants along with a lift.  I encourage you to visit with a board certified plastic surgeon near you to discuss your concerns and learn more about your options.

Gary M. Horndeski, MD · Answer

The technique I recommend is explantation and lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.  At the same time or later, fat transfers can be performed if additional volume is desired.Best Wishes,Gary Horndeski, M.D.

Should I get breast implant removal? (Previously tuberous breast to capsular contracted breasts with implant) (photo)

Answers (9)

Answer: Should I get breast implant removal

Answer: Should I get breast implant removal

Answer: Explant and The Bellesoma Lift

Answer: Explant and The Bellesoma Lift

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Everything you need to know about Breast Implant Removal

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Should I get breast implant removal? (Previously tuberous breast to capsular contracted breasts with implant) (photo)

Answers (9)

Answer: Should I get breast implant removal

Answer: Should I get breast implant removal

Answer: Explant and The Bellesoma Lift

Answer: Explant and The Bellesoma Lift

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.