Breast Implant Removal Sydney

Breast Implant Removal

Breast implant removal, also called explant surgery, is the removal of breast implants with or without the capsule of scar tissue that the body forms around them. Patients choose explant for medical reasons, personal reasons, or a combination of the two.

Medical reasons include implant rupture, capsular contracture where the capsule tightens and firms or distorts the breast, implants that have shifted position, ongoing pain, interference with breast imaging, or a diagnosis that requires the implant to come out. Other reasons are equally valid: implants that no longer suit your body or your life, breast tissue that has changed over the years, or simply not wanting implants any more.

Removal changes how the breasts look. They are usually smaller than before, and skin that was filled by the implant may appear loose or flattened, particularly after larger implants or many years in place. Where appropriate, explant can be combined with a breast lift, or mastopexy, or fat transfer. Dr Maryam Seyedabadi, Specialist Plastic Surgeon, consults in Paddington, Sydney.

Who it may suit

• Confirmed or suspected implant rupture, often identified on ultrasound or MRI
• Capsular contracture causing firmness, distortion, tightness or discomfort
• Pain, rippling, visible implant edges or implants that have moved
• Older implants, where you are weighing removal against exchange
• A settled preference to have implants out and not replaced
• Symptoms you attribute to your implants and want assessed and discussed factually

What the explant procedure involves

Explant surgery is carried out under general anaesthetic, usually through your existing scar, most often in the fold under the breast.

1. Your implant records are reviewed where available, and imaging such as ultrasound or MRI may be arranged first if rupture is suspected.
2. The implant is removed, through the previous scar wherever that is practical.
3. The capsule is then dealt with according to the agreed plan. Total capsulectomy means removing the whole capsule. En bloc removal means taking the implant and the unopened capsule out together as one unit. Partial capsulectomy, or leaving a thin healthy capsule, is sometimes the more appropriate option, because the capsule can be firmly attached to the ribs, chest wall muscle or the lining of the lung, and removing it there carries added risk of bleeding or injury. Dr Maryam will explain what she recommends in your case and why.
4. Tissue is sent for histopathology where clinically indicated, including any situation where BIA-ALCL is a consideration.
5. A lift or fat transfer is performed at the same time if that was planned, drains are placed if required, and the wounds are closed.

Recovery

Recovery after removal alone is generally quicker than after a combined operation. Individual healing varies and these ranges are indicative only.

• Discomfort, swelling and bruising commonly settle over the first one to two weeks.
• A soft support bra is usually worn for several weeks, and any drains are removed within the first few days.
• Many people return to light duties within about a week after removal alone, and later if a lift was done at the same time.
• Chest and arm exercise is typically resumed from around four to six weeks, on advice at your reviews.
• Breast shape keeps settling for several months, so the early appearance is not the final one.

Risks and considerations

Risks include bleeding, haematoma, infection, seroma, delayed healing, scarring, asymmetry, contour irregularity, loose skin, loss of upper breast fullness, changes in nipple or skin sensation, anaesthetic complications and blood clots. Extensive capsule removal adds risk of bleeding and, rarely, injury to the chest wall or entry into the chest cavity needing further treatment. Some patients are unhappy with breast shape once the implants are out and later choose a lift.

Breast implants are not lifetime devices, and anyone with implants may need further surgery over time. Recognised implant related problems include capsular contracture, implant rupture, changes in nipple or skin sensation and, rarely, breast implant associated anaplastic large cell lymphoma, known as BIA-ALCL, a cancer of the immune system arising in the capsule. BIA-ALCL usually presents as late swelling or fluid around an implant and is treated by removing the implant and capsule completely.

Your consultation with Dr Maryam

A referral, usually from your GP, is required before a consultation for cosmetic surgery in Australia. A cooling-off period of at least seven days applies between informed consent and the operation, and at least three months for patients under 18.

At your consultation Dr Maryam examines you, reviews your implant history, explains the capsulectomy options and their trade-offs, and discusses the alternatives, including leaving the implants where they are, exchanging them, or removing them together with a lift, so you can weigh the risks before you decide. Fees are quoted in writing afterwards. Removal for a medical complication such as rupture may attract a Medicare item number, while purely cosmetic removal does not. Rooms are at 2c Heeley Street, Paddington, phone 1300 067 668.