Breast Implant Removal (Explantation)

Reasons for wanting to have breast implant removal (explantation) may have to do with physical and/or psychosocial concerns.

For example, there are patients who despite best efforts experience repeated complications with the breast implants. These complications may involve leakage of implants, infection, capsular contracture (encapsulation) and/or implant malposition problems. Patients who have had these complications may decide to rid themselves of breast implants and their associated risks/complications.

Other patients who seek to have breast implants removed for “medical reasons” may feel that the breast implants are causing certain physical ailments. These patients may have undergone extensive medical, laboratory and/or radiological workup of physical symptoms only to be left without a specific diagnosis or cause of their symptomatology. This lack of diagnosis may cause the patient to feel that the breast implants are the “cause” of the physical ailment leading these patients to want to have their breast implants removed. Obviously, these patients should be cautioned that there is no scientific evidence that the removal of breast implants will eliminate any of the symptoms they are experiencing.

On the other hand, some patients decide that they do not want to “keep”  breast implants in place for non-physical reasons. These patients often report that they no longer feel that the breast implants are “necessary” or that they are at a different place in life and no longer want a “foreign body”. These patients may simply wish to have a more “natural” existence, which does not leave any room for breast implants.

There are rare occasions when patients wish to have their breast implants removed only days or weeks after having had them placed. In these cases, it is best to allow several months to pass before making drastic decisions that may be based on strong emotional reactions that tend to occur after body changing plastic surgical procedures. Of course, it is always best to prevent these types of situations by determining patients' motivations for having a breast augmentation done in the first place. Generally, self-motivated patients (seeking the operation for the right reasons) who have been considering the operation for at least a year tend to be less likely to want to have breast implants removed subsequently.

One common question asked in regards to breast implant removal is what should be done with the breast implant capsule. Generally, unless the breast implant capsule is thickened, calcified, or otherwise troublesome there is no indication to remove the thin capsule. Removal of the capsule would unnecessarily increase the risks of the breast implant removal procedure. Nevertheless, some patients may wish to have the capsule removed despite the lack of medical necessity.

Tom Pousti MD

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