Should I push to aspirate before explant? I can't seem to find a doctor who feels it is necessary (Photo)

Many women who under explant alone are dissatisfied because of the hanging skin and loss of volume.  I recommend explantation using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained, if not injured during your previous surgery.  At the same time or later, fat transfers can be performed if additional volume is desired.  Best Wishes,Gary Horndeski, M.D.

Thank you for sharing your excellent question.  As you have silicone textured implants and are asking for removal, the surrounding scar tissue, and fluid, can be tested at the same time as the explant surgery.  If there is concern for BIA-ALCL it can then be tested for.  Hope this helps.

Hello,If you have saline implants, then aspiration of the saline prior to surgery is fairly routine. However, if there is fluid around your implant and these are textured silicone implants, you should have them removed and the fluid should be sent for testing at the time of surgery. If you did not want to have the implants removed, then aspirating the fluid would be appropriate. Please ensure that your surgeon is sending the fluid and the capsule to pathology for testing. The current FDA testing recommendations for fluid around a textured implant are the following: "collect fresh seroma fluid and representative portions of the capsule and send for pathology tests to rule out BIA-ALCL. Diagnostic evaluation should include cytological evaluation of seroma fluid with Wright Giemsa stained smears and cell block immunohistochemistry testing for cluster of differentiation (CD) and Anaplastic Lymphoma Kinase (ALK) markers."Please ensure you are seeing a board certified plastic surgeon as he/she should be familiar with testing recommendations. All the best,Dr. BlaggAustin, TX

As you already are planning to have the implants and capsules removed your surgeon can send the fluid away for testing at the time of surgery.  There is no specific need to have the fluid aspirated or tested beforehand.

Based on the information you have posted, I do not think there is any reason to aspirate before explantation. In other words, given that you are planning on having the breast implants removed soon, I think aspiration of the fluid will not help (or change your management in any positive way). Based on your description, removal of breast implants, capsulectomy,  and sampling of any fluid around the breast implants will be indicated. Best wishes.