Breast Explant Surgery

At United Plastic Surgery, Dr. John Larson and Dr. Phuong Pham perform breast implant removal (explant surgery) for Newport Beach and Temecula women who have decided to move on from their implants. Our board-certified plastic surgeons are breast enhancement specialists who provide extensive experience with this procedure, as well as attentive, highly personalized care.

What is breast explant surgery?

Breast explant surgery is the surgical removal of breast implants and possibly the scar tissue around the implants. This procedure differs from revision breast surgery in that the surgeon does not replace the implants.

Why do women get explant surgery?

Breast implants are not meant to last a lifetime; they will need to be removed at some point. Many women choose to replace their implants in a procedure called elective implant exchange or revision breast surgery at some point after breast augmentation. Others prefer to continue life without implants for a variety of personal reasons, including:

• Changes in lifestyle and preferences
• Implant leak or rupture
• Complications such as capsular contracture (where the natural scar tissue around the implant, called the capsule, thickens and squeezes the implant)
• Concerns about BIA-ALCL (breast implant-associated anaplastic large cell lymphoma), a rare cancer of the capsule (not breast cancer) associated with certain textured implants
• Worries about BII (breast implant illness) due to symptoms they believe are caused by their breast implants, such as fatigue, headaches, chronic pain, brain fog, and hair loss

What is involved in breast explant surgery?

Our surgeons perform explant surgery using local anesthetic with sedation or general anesthetic, depending on the complexity of the surgery. Whenever possible, the surgeon places the incisions in the same place as the original breast augmentation procedure to avoid creating another scar.

Our surgeons perform explant surgery using any of the following techniques:

• Traditional implant removal: The implant is removed from the capsule, and the capsule is left inside the breast. This option works well for women with thin capsules that the body can easily break down over time.
• Total capsulectomy with implant removal: The implant and capsule are removed, but not necessarily in one piece. After making an incision in the capsule, the surgeon removes the implant and then separates the capsule from the surrounding breast tissue and removes it—sometimes in multiple pieces.
• Partial capsulectomy with implant removal: The implant is removed, and some (but not all) pieces of the capsule are removed.
• En bloc capsulectomy with implant removal: The entire capsule is removed with the breast implant inside. This is the preferred technique for ruptured implants and the most complex to perform.

While the en bloc technique is desirable, there are times when the capsule is too hard or securely attached to the chest wall, and the surgeon may use another technique (for one or both breasts). After removing the implant and capsule, the surgeon irrigates the pocket thoroughly with an antibiotic solution. If the patient desires, the surgeon can reshape the breasts with a breast lift. The surgeon may place surgical drains to prevent fluid buildup within the breast and promote optimal healing.  

En Bloc Implant Removal Photos

Here are some photos of actual implants and capsules removed by our surgeons.

En Bloc Implant Removal—Ruptured Implant

Dr. Pham removed the implant and capsule as one piece to contain implant materials from contaminating the breast tissue.

En Bloc Implant Removal for Capsular Contracture

These photos show an en bloc implant removal for severe capsular contracture.

En Bloc Implant Removal With Capsulectomy

These photos show an en bloc implant removal with capsulectomy, with one side having severe contracture.

En Bloc Implant Removal for Capsular Contracture & Breast Implant-Associated Illness

These photos show an en bloc implant removal for capsular contracture and BII.

What happens when breast implants are removed and not replaced?

If breast implants are not replaced, the breasts will initially look deflated and settle into their final shape within about 2 to 3 weeks. Because implants and gravity stretch the breast skin and tissues over time, the breasts typically do not look like they did before breast augmentation. A breast lift can help create more aesthetically pleasing results.

How long is recovery from breast explant surgery?

Experiences vary widely between patients because of the specifics and complexity of their explant surgery and whether they underwent breast lift. Some patients may have more scar tissue than others. For most explant procedures, recovery involves just a few days to a week of downtime. En bloc implant removal is typically more complex and often requires a longer recovery period. Patients may need to wear a surgical compression bra during their recovery.