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Breast Implant Removal

The placement of breast implants during breast augmentation can be one of the most effective ways to accentuate your natural curves. Many patients enjoy their breast enhancement results for decades, but we understand there are a number of reasons why an individual may want to have their breast implants removed at some point in time. You may want to exchange your breast implants for a different size or type during breast revision, or you may decide to remove your implants altogether. As board-certified plastic surgeons, Dr. Ram Kalus’ and Dr. Craig Rowin’s primary concern is, and always has been, the overall health and well-being of their patients. This is as true for a patient whose reasons for surgery are purely cosmetic as it is for a breast cancer survivor, or for a patient undergoing breast reconstruction for any other possible reason.

For those who have had their breast implants for many years and either feel they no longer want their implants or they have experienced something more concerning, such as unexplained symptoms that may be related to their breast implants (Breast Implant-Associated Illness), both Dr. Kalus and Dr. Rowin are sensitive to these concerns. They specialize in breast implant removal surgery and are committed to restoring both healthy and aesthetic breasts following the removal of implants.

Please contact Plastic Surgery of the Carolinas for a confidential and thorough evaluation if you have considered breast implant removal for any reason.

What is ALCL?

Short for “Anaplastic Large Cell Lymphoma,” ALCL is a very rare cancer of the immune system that has recently been associated with certain types of aggressively textured breast implants—namely, the BioCell textured implants from Allergan®, which were voluntarily recalled by the company in July 2019. The cancer has typically been found in the scar tissue surrounding the implant, known as the “breast capsule,” but it can also spread to other parts of the body.  While these implants have never been placed at Plastic Surgery of the Carolinas, nor is any type of textured implant utilized at our practice, we feel compelled to ensure our patients stay up-to-date with these essential breast implant developments. ALCL is extremely rare and current literature suggests that the risk of developing the condition is 1 in 20,000 for patients who have textured implants. Still, the need to remain proactive about potentially concerning symptoms exists with any cosmetic surgery, and our plastic surgeons fully recognize the desire of some patients to remove their implants altogether for their own peace of mind.

ALCL Symptoms

While Breast Implant-Associated Large Cell Lymphoma is a serious condition, the FDA is not yet recommending removal of textured implants for patients who show no signs of concern. Instead, they implore patients to stay observant to aesthetic changes in their breasts as well as symptoms like:

  • Pain after the breasts have healed from surgery
  • Breast asymmetry
  • Lumps
  • Swelling

In most cases of ALCL, symptoms do not present until many years after implant placement. If you are experiencing any of the above indications, a physical evaluation with your primary care provider can shed light on the cause of your symptoms. As with any potential medical condition, an early diagnosis and timely treatment are essential in successfully addressing ALCL.  

What are My Options For Breast Implant Removal?

Your breast implants can be removed with or without the associated capsule of scar tissue, which refers to a fibrous “shield” that forms around an implant. This scar tissue is the body’s natural reaction to a foreign object being placed in the body and generally only warrants removal if the capsule is hard, tight, or painful. Breast “explantation,” which is the most common removal technique and refers to the extraction of the implant as well as the implant capsule, typically takes one to three hours and utilizes general anesthesia. 

Breast Implant Removal With Replacement

Patients commonly opt to remove their older devices and replace them with newer implants of a different size, type, shape, or brand. Drs. Kalus and Rowin can exchange your saline implants with natural-looking silicone gel-filled implants, or vise versa. Upgrading your implants will involve much of the same process as breast augmentation with regard to your consultation and choosing the right implants for your needs. In most cases, the same incisions made in your initial surgery can be reused for your secondary procedure. 

Breast Implant Removal Without Replacement

You can also choose to remove your breast implants altogether while forgoing a replacement. The exact explantation technique will depend on your unique situation, but a procedure known as an “en bloc capsulectomy” is a common approach for those who wish to remove both their implant and the surrounding scar capsule. During surgery, the entire capsule (including the implant) is removed at one time or “as a whole” to help ensure the implant remains intact within the scar tissue. This approach can lower the risk of foreign substances leaking into other parts of the body, even in the case of implant rupture. 

Breast Implant Removal and Lift/Reduction

A breast implant removal plus lift/reduction procedure is designed to extract your implants while addressing the tissue changes caused by years of implant use, ultimately restoring or enhancing your original breast shape. Over the years, implants can stretch the skin and cause additional laxity, especially considering factors like pregnancy, breastfeeding, and weight fluctuation. Unfortunately, the skin does not always “snap back” to its original elasticity and shape after your implants are removed. Breast lift or breast reduction surgery can be performed to enhance or restore your contours, allowing you to remove your implants without sacrificing the appearance of youthful, aesthetic breasts. 

Breast Implant Removal With Fat Grafting

Another innovative technique to improve the breast shape after your implants are removed is through fat grafting, which harvests excess fatty tissue from another part of the body and repurposes it to enhance the volume, shape, and contour of the breasts. Sometimes known as a “natural breast augmentation,” this approach uses your own tissue as a natural filler to achieve a more aesthetic breast appearance. Since fat grafting employs your natural tissue, the result can be very long-lasting and there is generally no risk of an allergic reaction. 

What is the Breast Implant Removal Recovery Process Like?

Recovery after breast implant removal will vary from patient to patient depending on which technique was utilized and whether scar tissue was extracted. In general, discomfort during the healing process may be relatively higher if scar tissue was removed in conjunction with your implants. In any case, non-opioid oral pain medication can manage any bruising, swelling, or tenderness that arise after surgery. These reactions are to be expected, but they usually subside as your recovery progresses.

Most women are able to return to their normal routines—that is, office work, school, errands, etc.—one week after their procedure. More strenuous types of work may have to be avoided for a slightly longer period of time. Dr. Kalus and Dr. Rowin recommend refraining from any sort of heavy lifting (including grocery bags), aerobic exercise, or strenuous activity for at least four weeks, or until they instruct otherwise. A significant amount of downtime after breast implant removal is usually very rare.

At Plastic Surgery of the Carolinas, your health, safety, and overall happiness are the top priorities for our plastic surgeons and medical team. If you would like to discuss your concerns in person, or if you would like to schedule a consultation for the removal of your breast implants, please contact our practice today.

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