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breast-implant-removal

Medical and cosmetic technology has certainly improved over the years, but breast implants are not permanent. There are different reasons why someone may choose to remove their implants, whether a routine removal and replacement, an unforeseen medical complication, or just an aesthetic change. No matter the case, breast implant removal surgery at Rotemberg Plastic Surgery can be performed safely, and most of the time without visible scarring.

What is Implant Removal?

Breast implant removal is a surgical procedure performed to remove implants that were inserted during breast augmentation. Implants are not permanent, and need to be removed every 10 years, give or take depending on the specific case. Complications or unforeseen events may lead to you needing to remove them sooner. Some patients may choose to stay without them, while some have them replaced.

Woman should have silicone implants checked every 3 years and replaced every 10 years per FDA guidelines.

The newer generation of silicone implants have a double shell and last longer compared to the implants from the 80’s, but they are not permanent and woman cannot and should not keep them forever. Saline implants are slightly different because when they ruptured, the breast will decrease in size within a week and the shell then needs to be removed. If a patient has saline implants and they rupture, depending on the implant company, they will replace the implant free of charge if the patient has their implant information on hand.

Some women may be hesitant to have their implants removed because they are concerned that their breasts may become flat or unattractive. There is also a fear that the stretched skin may require you to also undergo a breast lift, leading to additional scarring, while other believe they need to have their implants replaced to maintain an aesthetically pleasing bust.

Miami’s top female plastic surgeon Dr. Silvia Rotemberg specializes in this procedure, doing her absolute best to make sure your breast shape stays natural and aesthetically pleasing without needing ancillary procedures.

Reasons to Remove Implants

Capsular Contracture

When the implant is inserted, the body’s natural response to accepting this foreign object is to form a collagen fiber capsule around it. This is a normal occurrence, acting like a protective layer from the rest of the body. In some instances, the collagen fibers can shrink and tighten around the implant; this is referred to as capsular contracture.

The 4 Grades of Capsular Contracture
Grade 1: Breast is soft and looks normal
Grade 2: Breast is slightly firm but looks normal
Grade 3: Breast is firm and looks abnormal
Grade 4: Breast is hard, looks abnormal, and is painful when touched

Common instances that lead to capsular contracture are bacterial contamination, silicone gel leaking, implant shell rupture, and hematoma. The firmness can cause discomfort or change the appearance of the breast.

Breast Implant Rupture

implant-ruptureAs stated above, implants are not meant to last forever. They are a medical device, and as such they should routinely be checked on and replaced or removed altogether. The older the implant is, although rare, the more chance there is of implant rupture. And while there can be obvious symptoms such as physical change in size or shape of the breast, sometimes there can be no symptoms at all. This is why it is so important to come in for routine examinations and screenings to make sure everything is fine.

Aesthetic Displeasure

Although your breasts can look perfect when you first get your implants, bodies change overtime. Your natural breasts (one or both) can increase in size, nipple placement can shift, or your breasts can begin to sag with age. Some may desire an implant replacement to address these issues, others may want a different size, either smaller larger, for an aesthetic change, while some may not want augmented breasts anymore and desire their natural breasts.

Second Thoughts

Your breast augmentation can go perfect, you can heal perfect, and the outcome can be just what you wanted. But sometimes, what you wanted is no longer what you desire. There is nothing wrong with having second thoughts; the main priority is making sure you are happy with the way you look and feel. Implant removal can be performed if you no longer wish to have augmented breasts.

Surgical Options

Implant Removal

breast-removal-surgical-optionsThe most common approach to taking out an implant is simply by surgically removing it from the incision that was used to insert it. If there is no capsular contracture then the capsule is left in place. This will not be visible from outside view, as overtime it will collapse and self-absorb when left alone. This method of explantation has the best chance providing natural looking results without the need for additional incisions since the old incision is traced. It also avoids the risk of bleeding as capsules are highly vascularize and if attempted to remove they can bleed a lot.

Capsulectomy

Capsulectomy is a surgical procedure which removes the capsule your body created around the implant when capsular contracture occurs. If the capsule becomes hard and calcified, it cannot be left to self-absorb in the body; it has to be removed. When silicone implants rupture, it ruptures inside the scar tissue capsule. During the removal, Dr. Rotemberg will have to remove the whole capsule along with the implant. Removal of both will help the healing process.

Cosmetic / Reconstructive Removal and Replacement

Implant removal and replacement for cosmetic purposes can be done with the same size implant, larger, or smaller.

After removing an implant and capsule, the pocket is larger in size and therefore may need a larger size implant if the patient does not want to have a lift at the same time, avoiding the scars around the nipple/areola.

Implant removal and replacement with a smaller size implant can be performed with a breast lift. This is ideal for patients who had very large implants and want to downsize to a more natural look. Implant removal without replacement, depending on the breast size and implant, may not be an ideal option for patients with large breasts since the breasts will be deflated, droopy and small. If performed for reconstructive purposes, typically Dr. Rotemberg will place same size implant or slightly larger implant.

What to Expect During the Consultation

During your consultation with implant removal specialist Dr. Silvia Rotemberg, she will perform a thorough examination to determine whether it is time to remove your implants or if you can wait longer. If she believes it best to remove them, whether medically necessary or implant age, she will review your surgical options based on your condition. Dr. Rotemberg will also explain the ancillary procedures available if you would like any more aesthetic changes to your breasts.

Once you and she decide together on the best method for you, she will explain the process from start to finish so you are fully aware of all aspects of the procedure.

Dr. Rotemberg’s goal is to make you as comfortable as possible, so please ask any questions you may have; an open line of communication is necessary for optimal results and experience.

Preparation

Pick up any prescriptions Dr. Rotemberg prescribed ahead of time so you have them readily available after your surgery.You will not be able to drive yourself, so please arrange for a friend or family member to take you home from surgery. You should bring a pillow as padding between you and the seat belt. Arm motion will be limited for a while so make sure you have all necessary recovery items at counter level. Additional personalized preparations instructions may be given; please complete them all to ensure optimal results.

Procedure

breast-implant-removalBreast implant removal surgery is performed under general anesthesia on an outpatient basis. You will be able to return home after your procedure. The procedure generally takes around 1-2 hours, depending on the specific case.

Dr. Rotemberg will remove the implant from an incision made on the pre-existing incision when possible. Depending on what was discussed during your consultation, either just the implants are removed or both the implants and the scar capsules. Implants are replaced with new ones if you decided on implant revision. Once completed, drains are placed to catch excess fluids, and the incisions are then closed.

Ancillary Procedures

While implant removal is performed with a detailed eye for keeping the breast looking as natural as possible when the implant is taken out, some patients may desire additional breast work. Below are some ancillary procedures that can be performed in conjunction with implant removal surgery.

Breast Implant Revision

Some patients wish to replace their implants with new ones once the old implants are removed. This can be an even exchange for the same size, shape, texture, and type, or a different implant for an aesthetic change.

It doesn’t matter if you had implants for cosmetic or reconstructive purposes after breast cancer, they need to be replaced.

A lot of patients say their doctor told them they can have them forever, then they have a mammogram and see that it is ruptured, and it is 20 years old. Implants are not meant to stay in forever; they must be replaced at some point.

Breast Lift

A breast lift can be performed in conjunction with implant removal or implant revision. Although the breasts will typically “bounce back” to their original size and position, with age the breasts can naturally begin to sag which maybe wasn’t present when the implants were in. A breast lift procedure with Dr. Rotemberg will raise the breasts to a more youthful position while remaining natural looking.

Fat Transfer

8aa8e4f216c7a570251195fcb99bc74eIf you wish to remove your implants without replacements but still want a little added volume, fat transfer can be utilized. Fat transfer is a procedure which takes your own fat from another part of your body via liposuction and injects it into your breasts. This create natural looking and feeling breasts while modestly enhancing the size. This method is good for those who do not wish to introduce more foreign objects into the body; the fat used is from your own body. Fat transfer can be performed in conjunction with a breast lift if you desire a more perky-positioned bust.

Recovery

Dr. Rotemberg will place you in a support bra after your surgery; this is to be worn at all times until she instructs you otherwise. Slight discomfort and swelling is normal and expected; this will subside with time and can easily be controlled with pain medication. She will place drains for any excess fluids, and they are typically removed within a few days. It is important to keep all incisions clean and dry; Dr. Rotemberg will give you instructions on how to do so. Walking as soon as possible will help reduce swelling and prevent blood clots.

You will need to come in for postoperative visits so Dr. Rotemberg can assess your healing progress.

You are able to return to work in a week after ample rest and proper recovery. Normal activities can be resumed in about 3-5 days. It is best to avoid strenuous activities and heavy lifting for about a month. Any scarring typically begins to fade after 6 months.

The FDA guidelines are for patients to obtain an MRI 3 years after implant placement and every 2 years afterwards. Some women may choose to follow these guidelines while others can be based on symptoms before the 10 year mark. Many insurance companies will not cover MRI for cosmetic breast implants unless the patient has symptoms or complications. Dr. Rotemberg recommends image screening around 10 years of implantation.

Cost

The price of your implant removal procedure will depend on your specific case and if you choose to undergo ancillary procedures. Some insurance companies will pay for the removal of the implants but the replacement is out of pocket, except for breast cancer patients where it is 100% covered.

To receive an estimate quote, please schedule a consultation and Dr. Rotemberg will gladly discuss pricing with you.