BREAST IMPLANT REMOVAL
Breast implants are foreign materials that are not lifetime devices, and will need to be removed (or replaced) at some point in time. Increasingly, women are choosing to have their implants removed without replacement.
Breast implant removal, or explant surgery, is recommended when there are complications including:
- Capsular contracture, when scar tissue that normally forms around the implant tightens and squeezes the implant resulting in progressive hardening, distortion and deformity of the breast
- Implant malposition, where the implant may move from its original pocket resulting in various deformities including the double-bubble deformity (where the implant drops below the inframammary fold)
- Breast implant associated anaplastic large cell lymphoma (BIA-ALCL), a rare type of lymphoma that grows in the tissue capsule which the body has formed around the implant
- Breast implant illness (BII)
- Neck, shoulder and back pain, which are common symptoms in women with implants that are too heavy for their bodies
- Changing preferences, including changes in personal preferences, beauty ideals or lifestyle changes
Breast implant removal surgery, or explant surgery, is performed under general anaesthesia. A single dose of intravenous antibiotics is given at the start of surgery.
The incision is placed along the lower fold of your breast, known as inframammary fold incision. If you have had your breast implants inserted using this incision, the old incision is re-used but will need to be extended. The average length of the incision is 10 cm.
Every effort is made to remove the implant with its surrounding capsule (total capsulectomy), as long as it will not cause unacceptable damage to the surrounding structures (skin, breast tissue, muscle, ribs and lungs). Any part of the capsule that is left behind will be diathermied. This never occurs with abnormal and thick capsules, but may occur with thin filmy capsules. The removed capsules are always sent for pathology testing (and microbiology testing).
The pectoralis muscles are repaired if required.
At the end of the procedure, the cavity is washed out with antiseptic and water, and soaked in local anaesthetic to reduce post-operative pain.
A drain is inserted to remove any fluid that may accumulate in the cavity. No other foreign materials are used.
The incision is closed with dissolvable sutures and skin glue, and covered with a waterproof dressing.
The procedure normally takes between 3 to 4 hours depending on the thickness of the capsule (thicker capsules are faster) and location of the implant (in front of the muscle is faster).
What will my breast look like after breast implant removal?
Your breasts will not look the same as before your original breast implant surgery. The weight of the breast implants stretches your tissue and causes changes in the rib area. After surgery, breast sagging and deflation occurs, which may improve over the course of 3 to 6 months.
The appearance of your breasts after explant surgery depends on
- The size of your implants: larger implants will have more stretching effect on the natural breast
- The size of your breasts before implants: women with naturally smaller breasts will have less skin and breast tissue to 'sag'
- Body changes while having implants (e.g. weight changes, pregnancy, menopause): hormonal and weight changes will often make your breasts saggier and without the extra volume of the implant, your breasts may look more deflated
- Your age: small breasts in young women may contract back to close to their original appearance, whereas, older women have less elastin and collagen in their skin and are less likely to revert back
What is the expected recovery after breast implant removal surgery?
Hospital Stay. Most people go home the morning after surgery. It is recommended that you be accompanied home by a carer who will stay with you (or very close by) for the first 24 to 48 hours.
Drain Care. You will go home with drains, which may stay in for 2 weeks. You will be taught how to look after the drains prior to discharge. Community nurses will visit you at home, and remove the drains when the drainage is less than 30 ml/day for 2 consecutive days (or on postoperative day 14).
Wound Care.
Your wounds are closed with dissolvable sutures and skin glue and covered with waterproof dressings. Remove your dressings in 2 weeks, and the wounds can get wet in the shower and be pat dry. Scar care instructions will be provided.
Bras.
It is recommended that you wear a supportive wire-free bra for the first 3 months (the wire can irritate your scar). Front closure bras are generally easier to put on in the post-operative period.
Driving. You should not drive until the drains have been removed.
Physical Activity.
You are encouraged to do as much walking as is comfortable. Avoid lifting (over 5 kg), pushing or pulling for 4 weeks - this includes lifting children and housework such as vacuuming or hanging out the washing. Avoid exercises that create a lot of 'breast bounce' for 4-6 weeks - such as jogging or cardio sessions. You can start exercising at 25% of your normal level after 6 weeks, and gradually increase to your usual level over 4 weeks. You may also wish to see a physiotherapist
for professional help in regaining your upper body strength.
Work. Most people with desk jobs can return to work after 2-3 weeks, but people with more physical jobs (especially repetitive arm movements) need a minimum of 4-6 weeks off work.
All our patients are provided with a comprehensive care plan during the recovery process from explant surgery.
What are the risks of breast implant removal surgery?
All surgery has risks despite the highest standard of practice. Some of the possible risks associated with breast implant removal surgery include:
- Bleeding
- Infection
- Damage to surrounding structures
- Seroma: accumulation of fluid at the operation site which can result in swelling
- Unacceptable scarring, including hypertrophic or keloid scars
- Changes in nipple or breast sensation (temporary or permanent)
- Dissatisfaction with the appearance of the breasts
- Persistence of symptoms attributed to breast implant illness
- Need for further surgery to treat complications
What is the cost of breast implant removal surgery?
The fees below include the surgeon’s fee, surgical assistant’s fee, anaesthetist’s fee and overnight stay in hospital, as well as follow up care for 12 months. You will also receive a box of essential recovery items, including Nokori Procedure Kit and post-surgery compression bra (Amoena Leyla).
For patients with private health insurance, the cost starts from $8500. There may be additional costs related hospital excess and pathology services. You will be able to claim a portion of the fee (approximately $1000) back from your private health insurance (as long as you are covered for item numbers 45551 X2).
For patients without private health insurance, the cost starts from $13,000. There may be additional costs related to pathology services. You will be eligible to claim a portion of the fee (approximately $800) back from Medicare.
You may be eligible for financial reimbursement from the implant company and/or be eligible to have
early access to your super
on compassionate grounds to fund your surgery.
A non-refundable deposit of $1000 is required at the time of booking for surgery, and full payment is required 2 weeks prior to surgery.
Related Information
Dr Mary Ling performs breast implant removal surgery at Gosford Private Hospital located on the beautiful Central Coast in NSW. Dr Ling also contributes data to the Australian Breast Device Registry and encourages her patients to participate in an Australian study examining the adverse effects of breast implants.
Dr Ling welcomes patients from across NSW including Sydney, Newcastle, Hunter and Illawarra Shoalhaven regions. Video consultations are available to interstate and international patients.
