Saline Over the muscle Breast Implant Removal; Are they more difficult or easier less painful to remove?

I had Brest implants smooth saline put in via tuba method there's 400cc. above the muscle. I've had them for 11 years and not sure if I should have removel and lift together or remove implant first and then I'll feel better be able to loose some weight then have a lift? Which gives a better result?what area is the best place to remove implant & capsule from nipple or underneath? Also how much does it cost on adv. to do just a lift like this in Los Angeles area? My HMO will cover removel only...

Doctor Answers 10

Breast implant removal

Youpose many interesting questions.  Saline implant over the muscle is quite easy to remove with an incision under local.  There is no question in my mind that you will need to have a lift after having relatively large implants over the muscle.  It is impossible to tell without a physical examination how much of your breast now his implant and how much is your natural tissue. This is important because if you don't have much natural tissue this will not be affected significantly by any weight loss . Having an examination by a board-certified plastic surgeon is your best option to determine this.  In my practice most patients prefer to have a one stage procedure rather than walking around with deflated  unattractive breasts. 


Sacramento Plastic Surgeon
4.9 out of 5 stars 108 reviews

Explantation without lift

Breast implant removal should be performed with complete en bloc capsulectomy without lift.  The capsule should not be left in place or the space will not heal.  In patients that believe that their implants are causing them illness, leaving the capsule behind will not result in any improvement in their symptoms. Because the removal of the capsule and lift performed together can compromise the blood supply to the skin, breast and nipple to a potentially devastating degree, they should never be performed together.  After the explantation with capsulectomy is healed, you can develop a plan for further surgery if it is warranted and is safe from a technical standpoint.  

Saline Over the muscle Breast Implant Removal; Are they more difficult or easier less painful to remove?

Thank you for your questions.  In general, it is less painful to remove the saline implants than placement of the implants in the original augmentation.  It is best to remove the implants through an incision at the breast crease, in my opinion.  The capsule usually does not need to be removed but a drain is used to help with healing and decrease the formation of fluid buildup, called a seroma.  If you are considering losing weight after removal of your implants, I would recommend letting your tissue settle before having a breast lift.  Be sure to see several board certified plastic surgeons for consultations in your area.  Best wishes. 

Jeanette Padgett, MD, FACS
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 9 reviews

#Explant #BreastImplantRemoval - Saline Over the muscle Implant Removal

In general, saline implants over the muscle are relatively easy to removed, when compared with implants under the muscle.  And smooth are easier to remove than textured.  Sometimes this can be done under local anesthesia alone; it can almost always be done under some sedation or with general anesthesia.  Exactly what needs to be done, and how, depend on specifics that have to be assessed in person.  If, after consultation with your surgeon, there is a reasonably good chance that you would be happy with implant removal alone (ie without a lift) then I would normally advise staging the procedure.  That means having the implants removed and then waiting 6-12 months to consider whether or not you'll need a lift.  If on the other hand you have significant sagging even now, and are likely to need a lift, then I'd try to do it all once.  For these and other reasons, you'll have to go over the specifics of your care with your own board-certified plastic surgeon.  I hope that this helps and good luck.  Dr. Alan Engler, Member of #RealSelf500

Removal of sub glandular saline implants does not require removal of the Can Be Done with Local Anesthesia.

Removal of saline implants can easily be done with local anesthesia or IV sedation with local anesthesia. The infra mammary approach would be preferred. I would delay the mastopexy until the breasts have recovered from the ex-plantation. It might not be indicated. There is no reason to remove the capsule.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

Breast implant removal surgery concerns…

Generally speaking, breast removal surgery is a very well-tolerated procedure with minimal discomfort associated with it. I think you will be best off achieving your long-term stable weight prior to undergoing any type of breast surgery.


 In regards to breast implant removal and breast lifting surgery concerns. Short answer: much will depend on your physical examination ( factors such as degree of breast ptosis, current position of breast implants, number of previous operations, assessment of breast skin quality/elasticity…) and your plastic surgeons' clinical judgment.   



Longer answer: in person consultation will be necessary to provide you with precise advice. The main issue of concern is adequacy of blood flow given the extensive breast surgery planned. In my opinion, if the degree of breast lifting ( distance of movement of the nipple/areola complexes) is significant, then you may be better off having the procedure performed in 2 stages. If the degree of breast lifting is relatively small ( shorter distance of movement of the nipple/areola complexes) then it is likely that the procedure can be performed in one stage. If in doubt, in my opinion, the two stage approach is safer.



In "borderline" cases where there is doubt whether breast lifting is necessary or not, I advise patients to undergo explantation only and to give their breasts the benefit of the doubt (allow for about six months to pass after breast implant removal) before deciding whether breast lifting would be beneficial.



I hope this, and the attached link (dedicated to breast implant removal surgery concerns) helps. Best wishes.


Saline Over the muscle Breast Implant Removal; Are they more difficult or easier less painful to remove?

Simple removal of your saline breast implants is not difficult or painful. This can sometimes be done under local anesthesia. However, if you have your capsules removed along with your implants, this would require a general anesthetic and can be a challenging. If you need a breast lift, this can be done at the same time. Cost will vary depending on your location. Thank you for sharing your questions. Best wishes. Dr. Gregory Park, San Diego Plastic Surgeon

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 158 reviews

Saline Over the muscle Breast Implant Removal; Are they more difficult or easier less painful to remove?

So I think is it always a good idea to lose as much weight first as possible. Then I would see a surgeon for a consult to decide if you can have removal and replacement with a lift or if it would be better to remove them and wait to have then replaced. In my state insurance would never cover the removal as they were placed for cosmetic reasons so its all cosmetic. You should expect that as you go see surgeons. Most of us do not deal with insurance companies for these types of cases because they are cosmetic because they were placed for cosmetic reasons. The other thing you should be careful of is that if you called you insurance company 99% of the time the person on the other end of the phone has no clue and gives you the wrong information. I like to remove capsules from under the breast fold but others will do the around the nipple incision. In my hands breast crease is so so much easier. I hope this helps. I do not know LA fees so I have no clue what do tell you but it could easily be 6-12K or more depending on what you need done. 

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 45 reviews

Saline Over the muscle Breast Implant Removal

In your situation the best result would come from deflating the implants in the office with a needle, waiting 6 weeks to allow your tissue to contract naturally as much as it can, then removing the implant through a small fold incision and doing a lift if it is necessary.  A lift is not always needed.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Breast implant removal can often be done without additional scars

Saline implants are a great gift for women thinking about implant removal. I can deflate them easily and painlessly in the office. Once deflated, your breasts will tighten up over weeks so you can see what you will look like without a lift, BEFORE going to the operating room. This takes the "what if"  fear out of the whole process. In my practice, most women are quite satisfied with their natural breasts and don't need any lift. 

Elizabeth Slass Lee, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 50 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.