Trends found in women who decide to Explant; Are there common factors seen that might help other women make better choices?

I'm considering a SMALL BA (like 180/200cc) on a small 113lb 5'4" frame. I wear XS tops, size 0 pants, and 34a bra. I've breastfed three babies. Some days I am more confident about a BA and others I'm 100% not doing it. I recently researched explants to see women's stories; it seems that one of the biggest trends is women who started with A and went too big (like 300-450cc+ and ended up with D+). Is this at all accurate? Are there any other trends/decisions that lend to explants later on?

Doctor Answers 8

Reasons for explantation

The most common reasons I am asked to remove breast implants in my practice are:1. A woman's body has changed significantly since she originally underwent augmentation. Most commonly she was much thinner and had very small breasts at the time of augmentation, but she has since gained weight. She may have had babies or gone through menapause (or possibly even both!!) and her body (and maybe her priorities) have changed. She may simply not want large or full breasts anymore. She may wear different kinds of clothes at this point in her life...just a few examples.2. She may actually be having problems with her implants and does not want to deal with it any longer. Perhaps she has had recurrent capsular contracture and does not want to consider any further surgery in the future. There are certainly other reasons but these are the most common. Explantation is more common for reason number one because there are women out there who have had breast implants for 30 or even 40 years and we all know that a woman's body can change a bit in that time period!! Good luck with your continued research. It sounds like you are choosing a very conservative size and I would guess you will be very happy. 


Nashville Plastic Surgeon
4.9 out of 5 stars 49 reviews

Breast Augmentation Regrets

I appreciate your concern, but breast augmentation surgery continues to be one of the most popular procedures we do. You are correct that most regrets from this surgery come from patients who went very large, but in my 25 years doing this operation and thousands of breast augmentation surgeries later, I can count on one hand the number of times patients asked me to remove them. The key is to find a surgeon who listens to you and respects your wishes regarding size. Be sure to consult with a board certified plastic surgeon. Good luck!

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 24 reviews

Women who decide to explant.

There can be many reasons why some will later decide to give up their breast implants. The issue might be capsular contracture, change of the breast shape or appearance over time, and implant wear or leak at which time some decide not to replace. Breast size and shape can be driven by trends, and the current one is a desire for a smaller or more moderate implant size. If you ignore the "trends" and fashion and make your decision based on your own feelings of what is best for you, you probably will be like most and keep your implants for life.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 40 reviews

Is Plastic Surgery Right For You?

Hello,
Thank you for your question. There are a variety of reasons and circumstances in which people will choose to have cosmetic surgery. It is not a bad idea to look at reasons why they may have breast implants removed. Sometimes having made the choice to place very large implants can be something a person feels differently about years later, although more commonly in my practice, patients will choose a secondary surgery to enlarge implants. Lifestyle changes and bodies change after childbirth etc. which would be another reason to consider secondary surgery. I recommend that an individual be comfortable and sure of their choice before proceeding with cosmetic surgery.  Plastic Surgery is not suitable for people who are prone to mood swings or erratic behavior, who abuse drugs or alcohol, or who are receiving treatment for clinical depression or other mental illness.I recommend that you book more than one consultation with a board certified Plastic Surgeon who specializes in this area. They will be able to address your concerns, provide feedback for your stated goals and questions, and this should help you feel more confident about the decision you make.
All the best

Trends found in women who decide to Explant; Are there common factors seen that might help other women make better choices?

Thank you for sharing your question.  There are many reasons that patients elect to undergo explantation including poor initial size selection, capsular contracture, changes in breast appearance with time, changes in lifestyle, etc.  The key aspect of your narrative, however, is your uncertainty regarding the procedure.  Most patients find research helpful in determining their true goal results, but ultimately if you are no 100% set on the procedure it is wise to delay or not pursue surgery until you are.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Trends found in women who decide to Explant; Are there common factors seen that might help other women make better choices?

Thank you for your question.   The most common reason that women choose to have breast implants removed is capsular contracture which accounts for 17.6% of breast implant revisions.  In my personal experience the second most common reason is that after having breast implants for many years  patient's life situations have changed  and they simply no longer want to have breast implants.Studies of the new cohesive gel breast implants  show that patients who choose to remove their breast implants without replacement do so at a rate between 2.8% and 4%..

There are many reasons why ladies choose to undergo explant surgery

I can see that you are a "worst case scenario" thinker!  It's an interesting approach to consider the reasons why ladies who have previously undergone breast augmentation would then undergo explant.  That's called wisdom - learning from the experience of others; I like that.  At any rate, I recognize your concerns about not only avoiding any potentially avoidable reasons for future explant, but also about achieving the particular aesthetic look on your petite frame that you are looking for.  The one thing that I will tell you up front is that if you cannot get yourself to a place where you are 100% committed to a recommended plan with a surgeon you trust to at least make a reasonable attempt to meet those aesthetic goals, you should not undergo the surgery.  This does not mean that anything is guaranteed; in fact, on the contrary.  But, the one thing you do have to commit to is the willingness to make that attempt to meet your stated goals.  Having said that, I can tell you that I have done many explants through the years, although still far, far fewer than the number of augmentations I have done.  In general, complete explant without replacement of implants is not real common.  The main reasons that I have seen in my patients choose definitive explant are capsule contracture, dissatisfaction with size, something I'll  call "change of heart," and in a very small number of cases, acute infections or healing problems.  Regarding the first one, most women who experience capsule contracture severe enough to warrant surgery will still go on to request replacement of their implants.  This is even more the case now that implant manufacturers are providing warranty coverage for certain instances of capsule contracture.  Sometimes a patient has had more recurrences than she cares to endure, or she simply decides at some point that she doesn't want to take a chance on another instance of capsule contracture, and she decides to have her implants removed altogether.  Fortunately, with a number of improvements in technique, implant technology, and postop management, capsule contracture rates have really dropped, and I don't see this kind of thing very much at all anymore.  I think the second and third reasons I have mentioned above are very close and go hand in hand in some instances.  Many times a patient will have made a decision about implant size at a different time in her life, or she may have delegated that decision to someone else, be that her surgeon, her friend or significant other, or a family member, like a sibling or parent, especially if financial consideration was involved in any of those.   I have seen all of these scenarios.  After spending some time with implants that she wasn’t committed to in the first place, it is easy to see how she could decide later that she not only doesn’t want implants that large, she simply doesn’t want implants at all.  Most of the time when a lady wants smaller breasts, she simply has her implants exchanged for smaller ones, with or without any breast lifting as indicated.  It is not very common for them to have the implants completely removed, but it does happen.  As I said, this type of situation is very close to the situation that I have called “change of heart.”  There have also been a number of instances in which I have met ladies who thought they might like their breasts with implants in them, only to find out at some point in the future that they actually didn’t.  This may have to do with their interference with running or other physical activity, how their clothing fits, self-consciousness in social situations, age and the feeling that they are now “too old to worry about large breasts,” or a whole host of other personal motivations to have their implants removed.  Sometimes this is relatively early, say within several months to a year of the surgery, and sometimes it is many years later.  Sometimes this also coincides with, or follows, changes that have naturally occurred in the breasts with pregnancy, weight gain or loss, menopause, or cancer.  There is just a variety of reasons, all personal to those individual ladies, why they have elected to undergo definitive explant procedures.  The one common theme has been that even considering any aesthetic problems resulting from the explant, they are usually all happy to have their implants out.   The last reason I mentioned doesn’t happen very commonly at all, but in some cases an implant will suffer an infection or exposure that can’t be treated with the implant remaining, and it has to be removed.  In some percentage of these cases a patient may elect to simply have the other implant removed too and not have a new one replaced in either breast. The key for you at this point is to nail down your specific goals for your breasts and then identify a  board certified plastic surgeon with lots of experience in breast surgery who can properly advise you on your goals and how possible they are to achieve, what it might take to achieve them, and what the risks and chances of those risks occurring with that plan are.  This process should also include a detailed exam of your existing breasts and chest wall, complete with measurements and a sizing exercise, and a review of the surgeon’s pre- and postoperative images of patients who have undergone similar procedures.  The more you can assure yourself that your surgeon understands your goals and that the plan is likely to achieve them, the less likely will be your desire to ever have your implants removed.  One thing I would like to mention for your consideration is a discussion of anatomically shaped breast implants, as these have been very successful in my practice for the ladies who are of smaller stature and who want modest, small breast augmentation with a more “natural” look.  Not all surgeons like to use this type of implant, though, so if you are interested in pursuing that as an option, be sure to ask any prospective surgeons you might meet about that up front.  Lastly, in addition to being certified by the American Board of Plastic Surgery, your surgeon should also voluntarily participate in the Maintenance of Certification program administered by that board. This is the best way to know that your surgeon not only has the best training and experience for the procedure, but that he or she has maintained currency in the certification requirements as opposed to practicing on a "lifetime" certificate which has only been reviewed once at the beginning of his or her career. For more information on this you can visit ABplsurg.org or ABMS.org. Good luck.

Explant

There are a variety of reasons that women choose to undergo removal of implants.  Some common ones are changed their mind, capsular contracture, or implant malfunction.  That being said,there are many more women who undergo augmentation and enjoy their implants without issue for years.  This is a very personal decision and one that you should go into positively, knowing that you are doing something for yourself that makes you feel good.

Camille Cash, MD
Houston Plastic Surgeon
5.0 out of 5 stars 29 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.