Can Breast Implant Removal be Carried Out Under Twilight Sedation?

Hello! Thank you for your question! It is a matter of surgeon
preference as well as what is seen during your procedure that will
determine whether or not a complete capsulectomy is performed. If
significant capsule formation is seen intraoperatively, a full capsule
removal may be warranted with a drain in order to completely remove all
of the tissue and allow better adherence of your breast back to its
normal anatomic position down on your chest wall. If minimal contracture
is seen, it may be possible to leave the capsule, or place cuts within
the capsule to allow better adherence. It truly is dependent on what is
seen with your capsule and the issues that may be causing you to have
such a procedure (e.g., contracture from rutptured implant vs pain vs
simple pocket adjustment, etc).  Typically this is performed under general anesthesia, but may be able to be done with sedation, depending on your surgeon's comfort with this as well as your ability to withstand the procedure.  Without knowing your issues and
without an examination, it is difficult to tell you what may be the
best thing for you. I tend to favor performing capsulectomies (in an en bloc fashion) in order
to create a fresh pocket, reshape the pocket, allow better shape and
adherence of the overlying breast. I would discuss your issues with your
plastic surgeon who will assist you in determining the right modality
for you. Hope that this helps! Best wishes!

Simple Explantation or implant removal without capsulectomy can be performed in many cases under local anesthesia alone or with Twilight anesthesia especially for calm patients without significant medical problems.  Not all explants need drains. Many Plastic Surgeons use either an Office OR, free standing outpatient surgical suite or a hospital OR.

Thank you for the question.

If all that is being done is removal of the implants ( no capsule work)  then they may be safely and comfortably removed under local anesthesia for  a relatively calm patient. I generally individualize the type of anesthesia to be used based on the specific patient's  personality and  situation.

Best wishes.