Sometimes, after patients have enjoyed their breast implants for several years, they wonder when the right time for breast implant removal or replacement is. Whether patients visited me around 10 to 15 years ago for silicone implants or saline breast implants or had their surgery performed by another doctor altogether, it’s understandable to have valid questions about their options moving forward.
Should you remove your breast implants? How should you go about deciding whether or not to have surgery, how is the explant surgery done, and—most of all—what will your breasts look like after surgery? In this blog, I will answer these questions and cover the key details about each type of explant surgery, including the hardest of all, the “ vintage” implants that were placed over 25 or 30 years ago!
Saline Breast Implant Removal
Patients with saline implants in place usually have the easiest solution available to them. I can puncture the implant and allow the saline to absorb into the body naturally. As the implant deflates like a flat tire, the new flatter breast contour is revealed within about a week. After this, the empty shell can be felt through the skin, but it is usually very flat, and the breast size and contour can be evaluated by the patient. If it is too flat, they can switch gears and learn more about the breast augmentation revision process. If the result is acceptable, they can have the empty shell removed. This in-office procedure is performed with twilight anesthesia, making it very safe and affordable, with the usual fees between $3,500-$4000.
For the revision and placement of new implants, surgery is performed at the surgery center with general anesthesia. Patients must factor in the cost of new implants, making the total price tag about $10,000. Fortunately, since the pocket is already there, the revision surgery is not nearly as painful as the first time, and most patients can return to work in just 4 to 5 days. Another critical factor in the revision process is getting access to old records. This is a no-brainer if I was your original surgeon! If not, we always attempt to obtain records from the previous surgeon. If this isn’t possible, I bring the “tower of tits” to the OR—which is a variety of different-sized implants. We assess your current size and select the appropriate implant from the tower based on your aesthetic goals. Not to worry—I have over 25 years of expertise guiding patients through this highly personal process.
Silicone Breast Implant Removal
For my patients who have silicone gel implants, deflation is not an option, so a great deal of time and discussion dictates how we proceed. In many cases, a patient experiences weight gain over the years, or their larger breasts no longer align with their aesthetic vision. In this case, the question boils down to how much smaller they want to become and whether they need an implant at all. If the original implant was smaller, it can usually be removed, and there is no real noticeable difference in the size—only the contour and fullness are decreased. This is the best-case scenario; these silicone implants can be removed in the office OR, like a saline implant. But sometimes, there is a big implant that would leave a noticeable and unacceptable change. In this case, the best choice is to use a much smaller implant paired with a breast lift to tighten the skin envelope.
Capsular Contracture in Silicone Implants
It is unlikely, but also possible, for silicone gel implants to form hardened capsules. In this case, I may perform an “en bloc” capsulectomy to remove the implant and the hardened capsule. Then, the patient can have a new implant placed or decide to move on without implants. Understandably, this is a difficult decision, especially if they have had implants for most of their adult life. The added complexity is that if the implants were larger, how the skin responds when the implant is removed can be difficult to predict. Sometimes, the skin will shrink, resulting in an acceptable, albeit more “mature” breast contour. For a total capsulectomy and implant removal operation performed at the surgery center, fees range from $8,000 to $15,000, depending on if a new implant is placed.
Removing Ruptured Silicone Implants
Patients with silicone implants may not know if their gel implant has ruptured. There can be subtle signs, like a change in how the implant feels, but often there are no symptoms. And when it comes to removing the ruptured implants, I prefer to do this in the OR with general anesthesia to be sure I have removed all the gel that I can. The good news is we can use High-Resolution Ultrasound in the office, providing a better, more accurate window into what is happening inside. The “bedside” technology can help point us in the right direction, but it can have false positives and negatives.
Trust Your Breasts to Us!
At the end of the day, when a patient is considering removing their implants, the best course of action is to seek out a board-certified plastic surgeon with the expertise to help guide the patient. At Aesthetica, the entire team has worked together for quite a long time and has the experience and skill to navigate breast implant removal. In addition, the whole team is passionate about ensuring a seamless journey from the minute you walk in the door through the last post-op checkup. We encourage you to contact us online for a consultation, or call us at (614) 350-4722. As always, Breast Wishes!
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