Explantation? Does It Require More then Just Removal of Implant to Get Hopeful Pleasing, Understood Deflated Appearance

50 years old. 145# 36D. from 36C...270cc saline round...I keep hear about capsulectomy??? No issues with implants just feel top heavy...and they are heavy!!! creasing in shoulders from bra strap...and would like them off rib cage!!!

Doctor Answers 9

Explantation of Implant

When breast implants are removed, the result depends on your existing breast tissue and skin elasticity and the size of the implant being removed.  If you have a very large implant in relation to the your breast tissue, then you should expect loose skin and a ptotic (loose) breast.  If you have a small implant in relation to your natural breast size, then if the implant is removed, the volume will be less (breast smaller) but you may not have as much skin and looseness issues as with larger implants.  It is reasonable to have them removed and then observe for several months how your skin contracts and settles.  At that point, you may decide if you wan to have a lift to help reshape the existing breast tissue.  I hope this is helpful.


Good Luck.

New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

Removing Breast Implants

I have found over the years that an occasional patient wants her implants out. And almost all patients are concerned that their breast will drop dramatically. That has not been my experience. It is more that the skin surface moves closer to the ribs. For a few weeks the breasts may have a somewhat deformed look but gradually assume quite a natural appearance. I would definitely not undergo a lift for at least 3 months. Also, it is rarely necessary to take out the capsular scar. That is there as a response to the implant and when the implant goes away the scar thins out and does not have any further effect. If the capsule is heavily calcified as we see sometimes in very old implants it should probably be removed.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Breast Implant Removal Results?

Thank you for the question.

Removal of breast implants is not necessarily require capsulectomy.  Based on your description however ( pictures would be helpful)  I wonder if breast lifting or reduction may also be helpful.

Generally speaking what breasts look like after explantation  depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back),  the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation). 

Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will  potentially influence the factors discussed above. If you take these factors into consideration and apply them  to your specific circumstances you may get a good idea of what to expect after the implants are removed.
Consulting with a well experienced board-certified plastic surgeon in person will be helpful.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Explantation of saline implants

Hummelstown5016:  I hope that I correctly understand your question.  Your saline breast implants have resulted in excessive volume, weight and an undesirable aesthetic outcome.  Assuming that you have not accumulated excessive scar tissue around the implant (capsular contracture), it should be a simple matter for your implanting physician to remove your implants through the same incision.  Depending on how long your implants have been in place, your breast skin may shrink somewhat.  good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews


I would recommend a total capsulectomy in order to avoid potential complications.  There is a peer reviewed article that outlines the need for this as later without a complete capsulectomy they report increased infection, seroma, and problems with cancer detection.  I would also recommend an internal lift at the time of the explant in most cases in order to decrease the pocket, hide indentations, and increase breast projection.  We do about 4 to 6 explantations a week, so we have a great deal of experience with this surgery, as well as the need to complete the capsulectomies in many patient who did not have the entire capsule out by their explanting surgeons.

Susan Kolb, MD
Atlanta Plastic Surgeon
4.2 out of 5 stars 28 reviews

Explantation of breast implants

The way to understand this process is that a breast implant is just a pillow of volume. If the implant is properly sized and positioned it does not stretch or distort the breast, and if later removed, the breast should return to the size, shape, tone, and position it would have had if the implant were never there. Think of taking out a foot that fits a shoe and what happens to the shoe. If the breast was altered or distorted by the implant or some other procedure then this may alter the breast permanently. In other words, breasts can change during the years after the implant was put in but they would have done that anyway. Removing the implant doesn't change that. 

A breast implant does not lift the breast and taking it out does not make it sag. Putting an implant in may make a breast look less saggy (ptotic) and taking it out (explantation) may make it look saggy or deflated, but neither actually happens because of the implant (assuming it was properly fitted and nothing else was done). It is just as difficult to see exactly what a breast will look like after an augmentation as it is to see exactly what the breast will look like after the implants are removed. Although intentionally deflating a saline-filled implant voids the warranty and realistically commits the patient to an explantation, it can show them what the breast will look like without the implant. 

The capsule around the implant is the normal way that the body heals around a synthetic object that it can't heal into. It is somewhat like the scar from a healed incision. There is no reason to remove it if it is normal and even if removed with an involved and potentially bloody procedure, a new layer of scar tissue will form. I disagree with the response that indicated a significant risk of seroma or fluid collection with normal capsules but even if it occurred it would be fairly easy to manage without an implant in place. 

Removing saline-filled implants through an inframammary crease incision can be done with local anesthesia alone and is usually best to be done first and then evaluate for options for a mastopexy (lift) or even replace the implants at a later time. 

Scott L. Replogle, MD
Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

Explanatation and breast shape

Breasts derive a pleasing shape from proper balance between skin and volume.  If you are having trouble because you feel your breasts are too big and/or too droopy you should have the implants removed.  If the capsules are found to be heavy, calcified, or otherwise abnormal, then the capsules can be removed at the same time.  If this leaves you with too much skin then a breast lift (mastopexy) may be needed.  Depending on actual residual breast volume you may want to have new implants placed.

Your surgeon should be able to advise you as to whether or not a lift will be needed to provide you with an aesthetically pleasing result.

Daniel Greenwald, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 46 reviews

Explantation and impact on breast shape.

Explantation will obviously lead to smaller breasts, but a common concern is the amount of sagging or deflation of the breast that will occur. With saline implants, you can see the results from explantation by undergoing a deflation procedure in the office where the saline is removed from the implants. This can tell you if you need a lift or not. As for a capsulectomy, this is generally performed at least in part due to the high risk of seroma or fluid accumulation in the capsule if left intact.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 25 reviews

Implant removal, explantation, may be easier than expected

Very often an explantation of implants, or implant removal is a very simple process. It should be quite easy to remove your saline implants through the existing incision without the need for breast lift. Capsulectomy is often not needed for a saline implant as well.

Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.