How Long After Explant Can I Re-implant?

Question

Dear Doctors, I was explanted with capsulectomy 7 days ago, at my request due to implants being too large (375g/dual plane) and thinking I could return to my previous state. My surgeon recommended a smaller implant, rather than explant. My choice was wrong, and I now wish to do as he advised and have smaller implants "redone"...how long do I need to wait for this procedure after explant? Many thanks!

Raffy Karamanoukian, MD, FACS · Answer

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jeffrey E. Schreiber, MD, FACS · Answer

I would recommend waiting at least 3 months for your tissues to heal. However, the best time for surgery will depend on how you're healing and you'll need to be evaluated by a plastic surgeon for this.

Thomas Fiala, MD, FACS, FRCSC · Answer

I'm sorry to hear that you feel you made the wrong decision.  Right now, at 1 week post-op,  the tissues are inflammed and swollen, and are not optimal for re-do surgery.  It's wise to wait until this settles down. 

	Most surgeons would recommend about a 3-6 month time period for this.

	 

	All the best,

Camille Cash, MD · Answer

It's best that you allow your breasts to heal since the implants have been removed.  You can have new implants placed in three to six months.  This opinion may vary by surgeon and will be impacted by how you progress through recovery.

Heather Vande Ven, DO · Answer

The timing for re-implantation after explantation (removal) of an implant depends on various factors, including the reason for removal, the type of implant, and the individual's health status. It's crucial to consult with a skilled plastic surgeon, specializing in the specific type of implant, to determine the appropriate timing for re-implantation in your particular case.Factors that may influence the timing for re-implantation include:1. Healing: The surgical site needs time to heal properly after explantation. The healing process varies depending on factors such as the extent of the surgery, the individual's overall health, and any complications that may arise.2. Infection or Complications: If the implant was removed due to infection or complications, it's essential to ensure that the infection is fully treated, and any complications are resolved before considering re-implantation.3. Tissue Condition: Re-implantation may require adequate tissue condition and integrity at the site of the implant. This may involve waiting for tissues to heal or regenerate sufficiently to support the new implant.4. Medical Assessment: Your healthcare provider will assess your overall health and any underlying conditions that may affect the success of re-implantation. They will also consider factors such as your immune system function and any medications you may be taking.5. Type of Implant: The type of implant being re-implanted may influence the timing. Some implants, such as breast implants, may have specific guidelines or recommendations regarding the timing for re-implantation after removal.6. Patient Preferences: Your preferences and goals regarding re-implantation will also be taken into account. It's essential to communicate openly with your healthcare provider about your expectations and concerns.In summary, there is no one-size-fits-all answer to how long after explantation you can re-implant. It depends on various factors, and it's crucial to consult with a skilled plastic surgeon for guidance based on your specific circumstances.

Tom J. Pousti, MD · Answer

Thank you for the question.

	It would probably be in your best interest to wait about 6 months before re-augmenting the breasts.

	In planning your revisionary breast augmentation procedure it will be very important to communicate your size goals with your surgeon.  in my practice I find the use of goal pictures to be very helpful.  in your case you could use your own before breast-feeding pictures as the goal. I have found that the use of words such as &ldquo;natural&rdquo; or &ldquo;C cup&rdquo; or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.  

	 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

	 I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.  

	Best wishes.

Steven Turkeltaub, MD · Answer

At this point in time, there will be a considerable amount of inflammation and swelling which can interfere with precision of a subsequent procedure. There may be other influences as well.

	My recommendation would be to wait around 4 - 6 months for much of this normal healing process to subside. Nevertheless, there is really no specific right answer as you have noted by the variety of responses.

Steven Wallach, MD · Answer

Sorry that you made the wrong deicision, but you shoudl probably wait four to six months for the breat to assimilate and heal after the impalnts were removed. Then you can place new smaller implants in the future.

Peter E. Johnson, MD · Answer

Your situation is not unusual in that after wearing breast implants for a long time, they can be hard to live without. The best opportunity to replace the implants is at the time the old ones were removed and the capsules removed. We would now recommend that you wait about six months to allow the breast to heal, and then replace the implants so that the pocket and breast shape is better controlled.

	Best of luck,

	peterejohnsonmd

Stephen Delia, MD · Answer

Discuss your options with your surgeon.  I would consider doing the procedure soon in the early stages of wound healing or waiting at least 6 mo. until the scar tissue softens and matures.

How Long After Explant Can I Re-implant?

Answers (15)

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