Breast implant removal has become increasingly popular in recent years. Millions of women had implants placed in their youth and later discovered changes in their bodies and breasts over time. Weight loss or pregnancy and breast feeding may lead to drooping, or ptosis. Weight gain may result in breasts that are too big.
Many women who desire implant removal are older, often 50-60+ year old, who no longer want large breasts. Sometimes patients may opt for implant removal due to uncommon but possible implant related issues such as deflation or rupture, contracture (firm scar around implant), asymmetry, or concern for breast implant ‘illness’.
Breast implant illness is a poorly understood and controversial condition in which some women believe their various symptoms may be due to their implants and often report they feel better after implant removal.

Regardless of the reason for implant removal, the treatment is the same: removal of implants (explantation) and removal of the capsules (capsulectomy). Removing a deflated saline or intact implant is not difficult. Removing a ruptured silicone gel implant is tedious and time consuming since all gel implant material should be removed. Fortunately, this is very uncommon with the latest generation of cohesive gel implants but more often seen with the older implants placed decades ago.

Capsulectomy, or removal of the scar around the implant, is more challenging. ‘En bloc’ or total capsulectomy is the goal to remove the entire capsule if possible. However, if the capsule is tightly adherent to the underlying rib cage, then great care must be taken to remove as much as possible without injuring, or puncturing the lungs (pneumothorax), which is a very rare but possible risk. Any residual capsule may be cauterized (rather than excised) to lessen the risk of injury to the lungs or chest wall. Capsulectomy is technically difficult and should be done thoroughly with precision surgery.

Elegant Precision™ Implant Removal is the process Dr. Steven J White MD with USA Plastic Surgery developed to optimize each step of implant removal (explantation) and capsulectomy. Using precision surgery techniques allows Dr. White to carefully remove the implant and capsule, typically with minimal bruising allowing a faster, easier recovery.

Implant removal without replacement of the implant or removal of the excess skin creates a ‘deflated’ appearance due to relative skin excess after implant removal. Ideally, a breast lift is done months later, once additional blood supply returns to the breast and nipple tissue.
Obviously, surgical treatment in the operating room is critically important. Unfortunately, some fail to recognize the importance of comprehensive postop care for these patients. It is imperative to carefully manage the healing process with adequate compression and support as healing progresses and the skin shrinks over time. Most patients are surprised by how much the tissues eventually shrink and some patients are so pleased with the results that they don’t feel a need for a breast lift.