Breast Implant Removal or Revision

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Breast implant removal surgery, often referred to as Explant, is a very common procedure and is growing in popularity as women embrace more natural lifestyle options. Breast implants are not lifetime devices and you may choose to have your breast implants removed, replaced, or adjusted for various reasons. The most common reasons for breast implant removal in Albany, NY, include capsular contracture, a desire for a different breast size, implant rupture or due to changes you see after menopause or childbearing.

At your personalized consultation with Dr. Capek, she will discuss the best options for you for breast implant removal to keep you looking and feeling your best.

Your explant surgery may include a breast lift, replacement of the implants with a different type or size, or a fat transfer procedure using your own fat. This alternative to implants has become a popular choice in the last 10-15 years. There are now more options than ever to give you an excellent cosmetic result and Dr. Capek is experienced with all these procedures.

Reasons for Explant Surgery

With the breast implant removal procedure, the choice of procedure will depend on the reasons for the explant and your aesthetic goals. The main concerns that lead to breast implant removal include:

Desiring a Different Size

This is one of the main reasons patients come to Dr. Capek to have their breast implants removed. You may desire larger-sized implants or smaller breasts. It is common for women to have 10-20 year old implants and over the years their breasts and figure have changed with pregnancy, menopause and weight changes. We often hear that the patient feels that their implants no longer serve your lifestyle.

Capsular Contracture

This is another common reason for implant removal or revision surgery. Capsular contracture refers to the hardening and tightening of scar tissue around an implant. This may occur shortly after your first breast augmentation surgery or many years later. Capsular contracture may make your breasts look distorted or asymmetric, and it may even cause breast pain.

Breast Implant Rupture

Both saline and silicone implants can rupture due to daily wear and tear, usually years after implantation, and sometimes decades. With saline implants, this is usually very obvious because the breast simply deflates as saline leaks out and is absorbed. With silicone implants, frequently there may be no symptoms at all, or you may notice a shape change, lump, or new discomfort. A mammogram may not detect breast implant rupture. The FDA recommends using high-definition ultra-sound to screen for silicone breast implant rupture regularly and if a rupture is suspected, this is often confirmed with a breast MRI.

Implant Malposition

In some cases, the implant position behind your breast may end up too low, too high, too close together, or too far apart. This can occur shortly after your first procedure or gradually over many years. There are various reasons this may happen, including capsular contracture, gravity in combination with thin tissue, asymmetric pocket creation, and tissue changes with age, weight, pregnancy, and menopause.

Additional surgery is usually needed to improve or correct the problem. It may include internal suturing techniques (capsulorrhaphy), implant replacement, or the use of an internal biological mesh ‘sling’ for additional support.

Implant Rippling

This is a cosmetic concern that occurs most often with saline implants in thinner patients. However, even a silicone implant can show visible rippling if the tissues covering it are thin to begin with or stretched out with a very large implant. This can be a difficult problem to correct but procedures like switching to a cohesive ‘gummy’ silicone implant or fat injections into the thin tissues to camouflage the rippling may be effective.

Recalled Implants, ALCL and BII   

More recent concerns with breast implants include the rare but serious risk of ALCL (Anaplastic Large Cell Lymphoma) associated with textured implants and the recall of the sale of these implants. Breast Implant Illness (BII), a term used by women who self-identify as complaining of a wide range of symptoms, is also a growing concern expressed by some breast implant patients. It’s a very broad topic that is beyond the scope of this page.

In both cases, breast implant removal may be considered, including capsulectomy and any of the procedures listed below, depending on your unique evaluation.

You can get more detailed information about Breast Implant Illness (BII) and Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) from the FAQ Documents here, and also from The Aesthetic Society.

board-certified plastic surgeon

DR. LUCIE CAPEK

Dr. Lucie Capek offers advanced cosmetic plastic surgery from the unique perspective of a female plastic surgeon. Since 1996, she has been serving patients in the Capital District from Albany, Saratoga, Schenectady, and Troy, NY. She is known for using the latest technology to perform body contouring, breast surgery, and facial cosmetic surgery. She personalizes every treatment to give each patient the most natural-looking results, enhancing their beauty and increasing their self-confidence. Above all, her practice is dedicated to your health and wellness. Dr. Capek understands that your beauty and confidence is about more than just your appearance. To schedule your first consultation, contact Lucie Capek, MD.

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Before Your Procedure

Before your surgery, a consultation with Dr. Capek is necessary. She will assess your unique situation and explain your various procedure options. She wants you to be an informed participant in the planning of your procedure so that you are ultimately comfortable and satisfied with your results. Knowing what to expect and being prepared every step of the way ensures a positive outcome.

As always, you want to be in optimum health when considering elective surgery. Follow a healthy lifestyle.  Have a healthy diet, exercise regularly, and don’t smoke since this decreases your body’s ability to heal normally. Follow your primary care physician’s advice when treating chronic conditions like high blood pressure.

Your Procedure 

Your breast implant removal surgery and how it is done will depend on factors such as the type of implant being removed, problems that are present, and the other recommended procedures planned to optimize your breasts.

Simple implant removal can be done in our QuadA-accredited office-based operating suite, Capek Surgical Arts, or a hospital operating room under local anesthesia for both saline and silicone implants. Dr. Capek can do this when no capsule removal is needed and silicone implants are not ruptured. Saline breast implants are sometimes drained prior to simple removal to allow for the skin to contract over several weeks, and for the patient to decide whether they want them replaced with implants or fat. There is minimal downtime and discomfort with this limited procedure. Contrary to misinformation online, capsulectomy is not always indicated or requires with breast implant removal, and saline implant deflation is a proven and safe option in many patients before implant removal.

Dr. Capek performs most explant and revision breast implant surgery in her office-based operating suite, Capek Surgical Arts, or an outpatient hospital operating room. If you have a capsular contracture, Dr. Capek performs a procedure called a capsulectomy to remove the scar tissue. This also creates a fresh pocket for a new implant. Sometimes this includes switching from a pocket under that is under the breast gland to one under the pectoralis muscle. Dr. Capek may use the same incision used to insert the original implants, although a different or larger incision may be needed. Once you have had a capsular contracture, you’re at higher risk of getting it again if implants are reinserted.

Patients sometimes ask about an ‘en bloc’ capsulectomy. This refers to removing the capsule in one piece with the implant contained in the capsule. It’s more accurately called a total capsulectomy because ‘en bloc’ resection is a medical term that is used when referring to cancer surgery. Capsulectomy is most often done for ruptured silicone implants but may not be technically feasible if the capsule is very thin or adherent to the ribs in submuscular implants.

Capsulorrhaphy and capsulotomy refer to either tightening or releasing the capsule surgically. This is done for implant malposition. It is sometimes combined with the addition of a biological mesh ‘sling’ when the tissues are too thin to support an implant in a stable position.

Replacement with New Implants

In many cases, we replace your breast implants at the same time as your explant or breast implant revision. If you decide to update your implant size, Dr. Capek will most likely use the original incision for implant removal and replacement. If you want a larger-sized implant, Dr, Capek will surgically enlarge the “pocket,” or space under the breast and surrounding your implant in order to accommodate the larger volume.

Do you want to go smaller? She may surgically reduce the size of the pocket with permanent sutures, allowing for the proper positioning of smaller-sized implants. Dr. Capek will recommend the type of implant that best achieves your goals. She may also recommend additional procedures that may be needed, like a breast lift or fat transfer.

Replacement with Autologous Fat

If you’re choosing to go smaller, or want a more natural look and feel, your implants can be replaced with your own fat. This is a very popular and successful procedure in our practice and works well when your natural breast tissue has already been ‘pre-expanded’ with implants. For details on fat transfer to the breasts, visit our Natural Breast Augmentation page.

Implant Repositioning

This procedure usually involves modifying the capsular tissue surrounding your implants. Capsulorrhaphy and capsulotomy refer to either tightening or releasing the capsule surgically. This includes releasing tight areas and/or placing permanent internal sutures to tighten or close off areas of the capsule. In rare cases, Dr. Capek adds a biological mesh ‘sling’ to support an implant in a stable position. The most common incision for this procedure is in the fold under the breast. It may be combined with other options such as a breast lift.

Simultaneous Breast Lift and Resizing of the Areolae

If you’re going smaller, or loose skin is a problem, you may also need a breast lift (mastopexy) at the same time. This may be a simple resizing of the areola to make it smaller and the breast skin a little tighter, or a more extensive skin removal which results in a lollipop (vertical) scar or anchor scar.

Dr. Capek and her entire staff strive to help you achieve the most beautiful and natural-looking results. We want you to feel confident and have the most optimal breast augmentation procedures to make your goals a reality while maintaining realistic expectations.

After Your Procedure

You can look forward to a better-proportioned figure, as well as improved self-confidence!

Following your surgery, plan to rest quietly for 24 to 48 hours. You can shower after 48 hours. Additionally, we recommend you wear a surgical bra around the clock for the first 2-3 weeks. The type of bra will be specified depending on your procedure. You may have drains for a few days if you’ve had a capsulectomy. We use dissolvable sutures and glue so very little wound care is required.

Patients with sedentary jobs may typically return to work within a week. Strenuous or high-impact activities like running may be restricted for 6-8 weeks. It is important to follow Dr. Capek’s aftercare instructions to avoid any complications. Recovery times vary from patient to patient depending on your health and the extent of your procedure. Follow-up appointments will be scheduled to oversee your recovery process.

Over the long term, you should continue with your regular mammograms and breast exams with your PCP or GYN. If you have silicone implants, periodic high-definition Ultrasounds are recommended to screen for silent implant rupture.

What are the Risks? 

Even with the care of a professionally trained, Board-Certified Plastic Surgeon like Dr. Capek, every surgical procedure carries some risk. Trade-offs include scars and and changes in the sensation of the nipple or breast. Though uncommon, risks include bleeding, infection, side effects from anesthesia and recurrent implant complications. However, with Dr. Capek’s care before, during, and after your surgery, serious risks and complications are infrequent.

QuadA Accredited

CAPEK SURGICAL ARTS

Dr. Capek is pleased to offer her patients an intimate, comfortable and discreet surgical experience at Capek Surgical Arts (CSA), her state-of-the-art Quad A accredited operating suite right here in Latham, NY. You can undergo your procedure under the expert care of board-certified Plastic Surgeon Dr. Capek and her exceptional team of anesthesia and clinical staff without having to go to a hospital or surgery center.. Cae you can expect with Dr. Capek and her team.

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Schedule a Consultation

Dr. Capek and her staff are available for follow-up visits and long-term care to help you navigate any questions that arise after your surgery.

To learn more about breast implant removal, schedule your consultation with Dr. Capek today. Our office is centrally located in Latham, New York just minutes from Albany, Schenectady, Troy and Saratoga Springs. Dr. Capek also offers telehealth virtual consultations.

Be sure to visit our before and after photo gallery.

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For more information, schedule your consultation appointment with Dr. Capek today!

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