What Is Breast Augmentation Removal Surgery?
Breast implants age just as our bodies age and with time there are changes that occur. Often these changes cause minimal disruption to patients but pain, discomfort and visible change to implants can occur meaning that some patients will opt for either breast augmentation removal surgery or get them replaced.
The most accurate data available on implants from the FDA suggests that 30% of all primary breast implants will need breast explant surgery within 10 years and that 50% of implants in revisionary breast augmentation need to be removed within 10 years. It is uncommon for implants to be removed/changed within weeks/months of surgery although infection, extrusion and rotation/migration of implants can occur.
Why Should I Get Breast Augmentation Removal Surgery?
Most of the reasons for breast implant removal surgery/change of implants are related to the ageing changes of the implants and the breast/skin. Age-related changes of the breast/skin can lead to the skin/breast drooping over the implants and the need for a mastopexy as a secondary procedure. Rippling or palpability can also occur with time due to thinning of the skin. As implants age, the lining of the capsule surrounding the implants can change and go hard and that can lead to the development of capsular contracture which will result in the patient getting breast augmentation removal surgery or revisionary surgery. The capsule is scar tissue that surrounds any implant in the body and is a protective lining. Where this scar tissue changes and tightens it can cause changes that lead to pain, discomfort and visible changes. Leak or rupture of the contents of the implant can also occur.
Many women have breast augmentation initially at a vulnerable time in their lives and live with implants believing that without them they would be perceived as unattractive. Years later many women are adamant that they will have no breast tissue after breast explant surgery only and are frightened to consider it as an option. In many cases there is sufficient breast tissue, the results are very acceptable and there is often a sense of relief after breast implant removal only.
Are There Any Downsides To Having Breast Implants Removed?
When patients consult for revisionary breast augmentation it is important to discuss the pros and cons of breast implant removal only and removal and replacement +/- mastopexy. Breast explant surgery only is often not the desired operation chosen by many patients as many women cannot imagine what it would be like to live without implants – especially where they have had implants for many years. They often perceive a loss of femininity, a need to change clothing/image and worry about how other people will react. Consultations regarding breast augmentation removal surgery are complex and the pros and cons of removal only and replacing +/- lifting need to be discussed in detail.
What Should I Consider Before Removal Surgery?
The most important decision when considering breast augmentation removal surgery is the benefit to the breast and the surrounding tissue. Removal of the breast implant and the surrounding capsule allows the breasts to recover from the stretching effects of implants and the possible effects that the implant and capsule have had on the body. Patients often feel that they will have no breast tissue after breast explant surgery and fear the result and do not consider the benefits.
When considering breast explant surgery, one must consider the breast, skin and capsule. It is often best to remove the capsule in its entirety and where this is removed with the implant this is called en bloc removal. It is often best to let the breast tissue and skin settle although one can try and elevate the tissue higher up the chest wall at the same time where appropriate. Breast augmentation removal surgery is often not that painful and patients recover relatively quickly. With breast implant removal, the surgeon will perform the operation and where an inframammary incision has been used one must try and elevate this scar so that upon removal the scar sits near the crease/fold of the breast. There are always risks of irregularities but often there are more extensive irregularities before surgery and irregularities afterwards are often well tolerated.
What Happens Post Surgery?
Following breast explant surgery, the majority of patients feel relieved and surprised by how good the result is and they do not react in a negative manner psychologically that one could predict. By removing the breast implants, the breast is able to settle and it gives patients the opportunity to see what it would be like without the implants. Although the majority of patients are offered the opportunity to have a further breast augmentation +/- mastopexy at a second stage it is not unusual for patients to be happy after breast augmentation removal surgery only.
For those that do decide to have further surgery at a second stage following breast augmentation removal surgery as a first stage, it is much easier to plan and discuss the options and allows patients to make an empowered choice regarding types of implants +/- mastopexy. There is no doubt that the informed consent process for revisionary breast augmentation is optimal when breast implants are initially removed in the first stage. Patients treated in this staged manner may well behave more like primary breast augment patients during the second stage rather than one stage revisionary breast augmentation and there may be increased longevity of the implants and more optimal outcomes using the two-stage approach.
What Are The Risks Involved With Implants?
Throughout the years there have been many incidents of patients needing to have breast explant surgery as a result of MHRA or DOH advice in relation to specific breast implants. Concerns regarding connective tissue disorders led to a moratorium of silicone gel implants in the USA (no link has been proven). Links to rare conditions and cancers such as anaplastic large cell lymphoma remain under investigation (approx 1 case per year in the UK) and it is unlikely that there will ever be a breast implant that is considered 100% reliable and 100% safe. Patients must carefully consider breast implant removal only and should consider breast augmentation removal as a breast rejuvenation technique.
Patients generally see breast implant removal as a last resort. It is important that all patients considering breast augmentation revision should consider removal only as an aesthetic operation. Consideration of removal only is always in the patient’s best interest within the revisionary setting. Patients need to carefully weigh up the pros and cons and make an empowered choice. They must consult with a clinician who has experience in all the various different forms of revisionary breast augmentation surgery in order that their expectations for revisionary breast augmentation surgery are realistic and that optimal results can be achieved.
Understandably, having any surgery can cause some anxiety in people, even if it is as simple as breast augmentation removal surgery. Our friendly surgeons are experts and will be with you every step of the way with your breast implant removal. How long the breast implant removal surgery will take does depend on the type of procedure you have. If one is having breast explant surgery only, then the procedure will take between one and two hours to complete. If one is also having other procedures, then this will be discussed in your consultation. The breast implant removal surgery will be under a general anaesthetic so you will be asleep throughout it.
Many patients who are having breast augmentation removal surgery will have to decide whether they are wanting breast implant removal only, or are having revision surgery which will be discussed in a consultation. If you have decided to have breast explant surgery, then you can see examples of before and after breast implant removal procedures above.
Over time, breast implants can visibly change and also cause pain and discomfort, so around 30% of people will have had their breast implants removed or replaced within 10 years. Some can last much longer than this, with the average lifespan of breast implants being between 10 and 20 years. When having either a primary breast augmentation or a revision, it is important to remember that you will need to have either breast explant surgery or a breast augmentation revision at some point. Needing to have revisionary surgery or a breast explant in the months or first few years following the surgery is rare.
It is important to know that if you have breast explant surgery rather than a revision, your breasts are unlikely to return to what they looked like pre-primary augmentation. Having implants does stretch the skin to make room for the implant, so when they are removed, it is likely that your breasts will feel less full and you will notice more of a sag compared to when you had implants. Of course, this will depend significantly on the original size and shape of your breasts and also the size and shape of your implants. During a consultation with your breast explant surgeon, they will be able to provide a more accurate prediction of what to expect post surgery.