Explant and Capsulectomy

While many women desire breast implants to enhance the size and shape of their breasts, others who have already undergone breast augmentation decide in the future to have their implants removed. At some point, these women begin to feel unsatisfied with their implants, either because they feel they are too large or have implant problems such as rupture or capsular contracture. There are also some who feel their implants are in some way causing health issues. Breast implant removal is a surgical procedure that involves removing a woman’s current implants and the scar tissue (capsule) surrounding the implants. This is also called explant and capsulectomy surgery.

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Reasons for Explant and Capsulectomy

Lifestyle Changes

Over time, many women may experience weight fluctuations that can cause their augmented breasts to look unbalanced and too large. Implant removal may help give them a more proportional breast size for their height and weight.

Implant Complications

Some women may experience complications with their breast implants, such as capsular contracture, implant rupture, or implant displacement. These conditions can result in discomfort, disfigurement, or pain. Removal can resolve these issues.

Unsatisfactory Results

Breast augmentation can leave some women unhappy with their results because the outcome is not what they expected. Implant removal can help patients feel more like themselves by restoring their natural breast appearance.

BIA-ALCL Textured Breast Implant Concern

BIA-ALCL stands for Breast Implant Associated Anaplastic Large Cell Lymphoma. This is a very rare and highly treatable type of lymphoma that can develop around Textured implants. The treatment is called an en-bloc capsulectomy and Implant removal (where both the breast implant and the capsule/scar tissue around the breast implant are removed in one piece.) The important consideration is to remove the capsule around the implant completely.

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Dear Dr. Spies & Staff,
Thank you so much for making my surgery a pleasant, successful experience. You were all wonderful!

Dr. Spies – Your talent and expertise is remarkable and I can see why you have an outstanding reputation.

Sincerely,

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Dr. Spies & Staff,
I just wanted to say thank you for all of your kindness & wonderful work I felt so comfortable with you & the staff that you all made this a good experience!

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Achieved With Explant and Capsulectomy

Natural Breasts

During the natural aging process, women may notice their implants no longer look as attractive or proportionate as they once did. Patients who wish to regain their natural-looking breasts can opt for this procedure to achieve the results they desire.

A Balanced Figure

Weight fluctuations and pregnancy can cause a woman’s breast implants to appear misshapen or asymmetrical. Explant and capsulectomy can improve the shape of breasts and make them more proportionate, producing a balanced silhouette.

Improved Self-Esteem

Patients who no longer want their breast implants may feel self-conscious about their appearance. Others may believe their implants no longer reflect who they are as a person. Explant and capsulectomy surgery can not only restore the breasts to their original state, but it can also boost a woman’s self-esteem.

Your Procedure

Explant and Capsulectomy Only

During your procedure, the entire capsule and implant are removed through an incision on each breast. Once the treated area has been cleaned, the incisions are closed using surgical sutures.

Explant and Capsulectomy With Breast Lift

Breast lift surgery can be combined with your explant procedure to lift and reshape the breast tissue to a perkier, more beautiful appearance.

Concerns

Recovery

Following your procedure, a surgical bra will be placed around the breasts to protect them as they heal. Swelling and bruising may develop, but these side effects should resolve after a few days. You will be asked to refrain from any strenuous activities that may put stress on your breasts for a few weeks. You can go back to work between one and two weeks after your surgery.

Scars

Explant and capsulectomy is an extensive procedure. Most are performed utilizing the scars you have from your first surgery. However, the operation may require a longer scar than the one used when your implants were placed. The scars will fade over time and are well hidden by bathing suit tops and bras.

Pain

You may experience some discomfort following your implant removal procedure. Dr. Spies will prescribe you medication to help minimize the pain.

Cost

The cost of your surgery will vary based on several factors, including surgical technique and anesthesia fees. Dr. Spies will provide you with a cost estimate during your consultation and determine the best plan to reach your aesthetic objectives.

Faqs

What will my results be like following my explant and capsulectomy surgery?

This procedure is an extremely satisfying procedure that can leave you feeling relieved, comfortable, and happy with your new breasts. However, some women need a breast lift to remove the excess skin that was stretched by the implant size.

How long will my procedure take?

Explant and capsulectomy surgery is performed on an outpatient basis under general anesthesia. The length of your surgery will vary depending on the extent of correction needed and can last between two and three hours.

What are the potential risks or side effects associated with explant and capsulectomy?

As with most surgical procedures, there are some risks involved with explant and capsulectomy surgery. They are rare but can include:

Infection
Bleeding
Poor wound healing
Change in skin sensation
Asymmetry
Fluid accumulation

What should I know about Breast Implant Illness?

Breast implant illness (BII) is a term that describes a collection of symptoms by patients with breast implants when there is no abnormal laboratory or physical finding to explain their symptoms. Common symptoms of BII can include fatigue, joint pain, brain fog, and chronic pain, among others. The exact cause of BII is unknown, and it is not considered a formal medical diagnosis at this time.

Many patients are curious about BII and wonder if it can affect them and if explant surgery is necessary. Here are some of the most current facts we know about BII:

BII has also been called different names, including silicone incompatibility syndrome (SIS), systemic symptoms associated with breast implants (SSBI), silicone implant illness (SII), and silicone implant incompatibility syndrome (SIIS).
The risk for developing BII has not been well established. There is no definitive causation of developing BII from breast implants—only a potential association.
Removing the breast implants is the most common treatment for BII.
The term en bloc removal has been commonly discussed on social media sites about BII. Women are asking for en bloc removal because of concerns that toxins from the implants, silicone, or bacteria/fungus could be in the capsule, and failure to remove it would leave toxins behind and impede symptom improvement.
En bloc capsulectomy is a surgical technique that removes the entire breast implant and surrounding scar tissue as one unit without breaking the capsule. En bloc capsulectomy is a more complex surgical procedure with higher risks of complications.
En bloc should not be labeled with capsulectomy in the absence of a malignancy.
There have been four papers published about BII. Results have shown that many patients attain rapid improvement in their symptoms (up to one year) independent of the extent of the capsule removal (en bloc, total, or partial capsulectomy). Partial or incomplete capsulectomy attains the same result in most patients as a total capsulectomy. A study published in the Aesthetic Surgery Journal found that the type of capsulectomy—total, partial, or en bloc—showed similar symptom improvement without any statistical difference regarding the reduction of symptoms based on the type of capsulectomy.
Total capsulectomy for cosmetic implant operations may be indicated for capsular contracture treatment, removal of ruptured silicone gel implants, or removal/exchange of textured implants.

If you are experiencing symptoms, schedule an appointment with your physician or board-certified plastic surgeon.

Verified Realself

Dr. Spies' office is located in Paradise Valley, Arizona, adjacent to the Paradise Valley Cosmetic Surgery Center.

Robert J. Spies, M.D.
5410 N Scottsdale Rd C 100
Paradise Valley, AZ 85253
Tel: 480-359-1019