Can an explant be done while awake?

Simple implant removal can be done quite comfortably under local. Simple being saline implants or newer silicone implants. Older silicone implants that are likely ruptured may need general Anesthesia. Also if the capsule needs to be removed for any reason you’ll need general anesthesia.
See a board certified plastic surgeon to make sure it’s done safely.

Thank you for your question. Yes, you can have your implants taken out without anesthesia as long as you do not have capsular contracture or a significantly large breast pocket with associated implant migration. Both these conditions can affect the overlying tissue and the desired outcome to produce a more natural result. All the best!

We commonly perform breast implant removal under local anesthesia. If you are comfortable being awake for the procedure it can be easily performed without general anesthesia. You would want to make sure to find a provider well versed in performing procedures while patients are awake. I hope this helps. -Dr. H

Greetings!
Explanation can be done under local if capsules are intact with no evidence of capsular contracture. Speak with your surgeon to achieve your breast goals.
Mays Plastic Surgery

Dear brantford23,
it is hard to tell for sure without an examination. Generally speaking, it is possible to remove breast implants under local anesthesia. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

The ideal conditions to be met, for an explantation under local anesthesia are: relatively thin tissues, acceptance of an inframammary incision, no capsular contracture and smooth implants as opposed to textured implants. If your tissues are thin, it is simply easier to gain access to the capsule where your implant is. An inframmary incision is also very close to the bottom of the implant and makes access easier as opposed to other incision options. The current recommendations are not remove the capsule around the implant unless there is severe capsular contracture, or there is a very high likelihood that the implant is ruptured. Smooth implants are simpler to remove than textured implants as the textured implants may stick to the capsule and it can be more uncomfortable to remove these as opposed to a smooth implant. That said, general anesthesia is exceptionally safe in the year 2024 as long as you’re healthy individual. If you were planning on having any other adjunct procedures done, such as a breast lift, general anesthesia would be a great choice. Best wishes.

Yes, an explant can be done awake if the silicone implant is still intact. If there is a rupture (can be diagnosed with in-office ultrasound), the silicone outside of the shell is quite messy and would likely best done in the operating room. I would recommend seeing a board-certified (American Board of Plastic Surgery); ideally, a surgeon with also a history of proper aesthetic breast surgery training.

I do not recommend local anesthesia or being awake during surgery. I use local with sedation so that the patient is breathing on their own but in a deep sleep. It is a very good and safe method. As for general anesthesia, this may be needed but it depends on a persons individual medial health history.

You do not need general anesthesia. It can be done with IV sedation or with just local anesthesia. If you have textured implants or ruptured silicone gel implants that require a capsulectomy you would need IV sedation. If you have an intact saline or silicone implant without a capsule you can remove with just local in the office.

Hello @brantford23, thank you for your question. Yes, you can have implants removed under local anesthesia in specific cases. However, this depend on surgical technique and the extend of the procedure. For me it's important in an explant a complete capsulectomy and immediate reconstruction of the breast perform with general anesthesia, cause it is always safer to use general anesthesia for a surgical procedure. General anesthesia has been used safely in hundreds of thousands of surgeries each day, with very few adverse events being reported. In fact, many studies have suggested that using general anesthesia for major procedures such as this one can actually reduce the risk of complications compared to using local anesthesia. Best wishes!

Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP).