What is the best way to remove silicone implants under the muscle?

HI, I want to get explanted due to a painful capsular contracture on my right breast. In 2010 had removal of 675 saline implants, replaced with 325 silicone and a full lift. Still too large and had a contracture start within a month. Are drains necessary to prevent a seroma? Is a capsulectomy necessary? I've only seen one PS who says can do under local and just remove. Didn't mention any drains.

Doctor Answers 7

Implant removal

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You can simply remove the implants under local and it is a simple and short procedure.You could do a capsulectomy or removal of the capsule but it may not be necessary

Fort Myers Plastic Surgeon
4.9 out of 5 stars 70 reviews

Requires More than Local Anesthesia

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This is a procedure where the capsule should be removed and drains placed to manage the fluid.  This should not be perform under local anesthesia.

Dr. ES

What is the best way to remove silicone implants under the muscle?

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  If there is implant rupture or capsular contracture, the capsule should be removed.  Drains are reasonable but not mandatory.

Kenneth Hughes, MD

Los Angeles, CA

What is the best way to remove silicone implants under the muscle?

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Although precise and meaningful device would require in person consultation, some general thoughts may be helpful to you. 

Generally speaking, if the breast implant capsules have thickened and/or are otherwise symptomatic, there is an indication to have them removed. I use drains.  

 What your breasts will 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.

Patience is definitely indicated after removal of breast implants; it will take many months for the skin to “bounce back” and for you to see the final appearance of the breasts.

I hope this, and the attached link, helps.

Painful contracture and breast implant removal

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Removing the implants can be done under local although I like to do it under general anesthesia so I can roughen the capsule which I think makes healing together of the old pocket more likely and less prone to a chronic post-operative seroma.  I do not use drains for that, although some surgeons do, which is reasonable. However, with a painful contracture, you might have thickened or calcified capsule which would best be removed.  That would need general anesthesia, and usually requires a drain.

Removing Silcione Implants and possible capsulectomy

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Implants can be removed under local anesthesia, but performing capsulectomy under local would be more difficult and more painful.  There is raw tissue after capsulectomy and seroma can form which is why a drain is left in place for a period of time to close of the space.  If you have a very firm capsule then you would likely require a capsulectomy.  If it is just an early contracture then you would not necessarily need to have the capsule removed.  

Good Luck

Gaurav Bharti

Gaurav Bharti, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 124 reviews

Extent of dissection is dependent on underlying issues

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Thanks for your question. If you have  hard firm capsule, then it should be removed along with the implants and a drain placed. This is not a procedure that can be done under local because it would be too painful. If the capsular scar tissue does not need to removed then it may not require a full general anesthetic or a drain. Best of Luck!

M. Scott Haydon, MD
Austin Plastic Surgeon
4.8 out of 5 stars 93 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.