Oncologist vs. plastic surgeon for explanting?

I'm not really sure why you would have your implants removed by an oncologist.  This is really a procedure that should be performed by a Plastic Surgeon unless there is a concern of associated cancer.  To answer your question more effectively, it would help to know why you are going with a cancer-specialist.  

Breast explanation is an easy procedure if the implant is not ruptured, if there is no capsular contracture and if you do not want anything else done with your breasts. However most people do, and thus, it is better to go to a plastic surgeon who can not only do the explantation, deal with potential problems of implants, but also can plan the next procedure appropriately with you.

I just gave a lecture on explantation to the California Society of Plastic Surgeons meeting.  This is a topic that has seldom been talked about or written about.  If there is ample breast tissue and the skin is thick and tight and the implant isn't too big, the operation is very straightforward.But if the tissue is thinned, if there is any droopiness or unevenness, if the tissue is damaged or the skin thinned, then making the patient look right is more difficult.Some patients need to have a lift at the same time and deciding whether, when, and how to do the lift following an explant is extremely challenging.There are lots of subtleties in how to manage these, and tricks such as deflating saline implants, deciding whether a lift is necessary, etc.The decision as to what to do with the capsule surrounding the implant - leave it alone, remove part of it, or remove all of it - are complicated decision.  So too are the issues about whether to put in a drain, which incision to use to remove the implants, how to reposition breast tissue if it had been shifted with the earlier operation, whether and how to fix an indented scar, etc.  These sorts of things can only be made by a plastic surgeon - and one indeed experienced with these particular problems.So if you are sure you have an absolutely straightforward problem you could have the oncologist do it.  But here's my question: Why? Why not have an expert do it?  If you live in a remote area and there isn't a good plastic surgeon around then that may be a reasonable thing to do.

Why on Earth would you even consider having an Oncologist do this surgery?  This is an operation that the Plastic Surgeon is specifically trained to perform.  An Oncologist is a medical doctor and not even a surgeon!!!

Thank you for your question.  Removal of the implant is straight forward.  The judgement and experience to know how to handle the capsule as well as to guide you in making the right choice based on your exoected outcome is where the training and expertise of a Plastic Surgeon is valuable.

Unless you have breast cancer and are undergoing a mastectomy, I would suggest having a plastic surgeon remove your implants. Plastic surgeons have been inserting and removing implants of all types for many years. Some oncology surgeons have removed very few implants, and may not be well trained on what to do with the capsules.

It is my hunch that you are probably dealing with a surgical oncologist and not a medical oncologist. I would be rather surprised if a medical oncologist would do an explant, let alone find an operating room that would permit it.Removing an implant is rather simple.  Dealing with the resulting breast contour is another story completely. Without knowing the particulars of your case, I would certainly favor having a plastic surgeon deal with the explant.All the best. 

Explantation is a often a very difficult operation and I do not think that a surgical oncologist is trained for this procedure.  You would be much better off finding a plastic surgeon who has done at least 50 explants, and knows how the remove silicone lymph nodes if needed.