Breast implant removal
All about breast implant removal
Breast implant removals are performed for a number of reasons, including but not limited to lifestyle changes, illness, replacement or rupturing. Women who have had breast implant surgery will ultimately need another breast implant revision procedure. These procedures include:
- Removing the implants and replacing them with new implants
- Repositioning the existing implants, or
- Removing the breast implants without replacement. If you have had complications with your breast implants (including infection or capsular contracture) your Plastic Surgeon may recommend that the breast implants are removed
Other reasons breast implants need to be removed include:
- A build-up of calcium
- Infection and/or bleeding, or
- Necrosis or the development of dead tissues around the breast implant
Price
We have worked hard to be able to offer an affordable price so patients do not feel pressured to visit under qualified practices or destination surgery.
Our breast augmentation surgery includes surgeons fee, hospital fee, general anaesthetic costs, compression garments and lifetime follow up care.
Some Medicare rebates and health fund covers may apply to this procedure
When is breast implant removal recommend?
Every year there are thousands of women who undergo breast augmentation surgery. Although relatively rare, there are many reasons that breast implant removal surgery becomes necessary. Breast implants don’t last a lifetime and will need to be replaced at some point even if there are no other problems. Most implant manufacturers identify that breast implants commonly have an implant life of between 10 and 15 years. Breast implant problems do exist and have a variety of causes, although risk factors have diminished greatly over the past 20 years. Still, over 23,000 women had their implants removed in 2013.
Breast implant removal may be needed to relieve a condition called capsular contracture. This is a condition where the capsule, which naturally forms around all implant, begins to contract thereby squeezing the implant. The severity of contracture varies from person to person. This may be completely unnoticeable, may become very painful, and lead to distortion of the implant and breast. There are four recognized degrees of this condition (Baker Grade 1 through Grade 4). The implant will need to be removed it the breast has become distorted, hard or painful.
Another common reason for breast revision surgery to remove implants, is overall dissatisfaction with the appearance of the breasts. Breast size, and breast tissue quality can and do change over time, often in response to hormonal changes that are occurring in the body. It is very common to hear from patients who loved their breast size when they underwent breast augmentation initially, and who have noticed enlargement of their own breast tissue over time.
Sometimes there is a rippling effect of the implant edges and the implant can be felt and/or seen. In this case, the surgeon will attempt to use the same incision created during the original process to remove the old implant and to reinsert the new one, or to perform other procedures to ensure the breast looks attractive and natural following the procedure.
A ruptured implant must be removed. Silicone ruptures can be ‘silent’ as the gel is engineered to remain in place (Cohesive, or highly cohesive silicone gel). In fact, there may be no symptoms at all. These may be detected during routine mammograms or ultrasounds but the most sensitive imaging study to evaluate breast implants is an MRI. It is recommended that women with silicone breast implants have an MRI routinely to detect these types of ruptures. Saline implant ruptures are usually noticeable to the patient, as the device commonly deflates causing the breast to become noticeably smaller. Implants can rupture due to age-related mechanical injury, car accidents, mammograms or from being nicked by surgical instruments when undergoing a breast biopsy.
This is an extremely rare entity that has been classified as a T-cell lymphoma that occurs adjacent to breast implants. The exact cause is unclear. In recent studies, although the absolute number of cases is very low, BIA-ALCL has been found more commonly in patients who have had textured implants placed. Texturing of implants does vary depending on the manufacturer, and many of the cases associated with textured implants occurred predominantly with those devices made by one particular company (Dr. Brenner does not use implants from that company). However, some cases have occurred in women with smooth implants as well, both with silicone and saline devices. This entity most commonly presents as a late seroma (fluid collection) around the implant. Appropriate treatment includes removal of the implants, fluid and breast capsules.
The Breast implants may have shifted (breast implant malposition) and are now located in an area which is uncomfortable, such as the armpit. Or they may have shifted into a position that is unattractive (i.e. bottoming out, also known as inferior malposition). During your consultations with Dr. Brenner, he will offer alternatives to implants if reinserting them is not an option. In some cases, it is not possible for medical reasons. The important thing to remember is that Dr. Brenner has extensive experience and success in restoring a normal, natural appearance to breasts following changes resulting from pregnancy, natural aging, as well as myriad post-surgical issues as demonstrated above.
Breast Implant Illness (or "BII")
In recent years, there has been heightened attention to a non-specific disease labeled as “breast implant illness” (or “BII”) by many patients. This is not an actual medical diagnosis and does vary between women most likely due to genetic factors. This likely explains the very low incidence. This may encompass many diverse and unrelated systemic illnesses, in particular, illnesses that are commonly classified as auto-immune. Although there is no clear evidence that breast implants cause any of these disease processes, many patients have difficulty moving past the association.
Further, there is some thought that these symptoms may be associated with colonization of the implant with some type of bacteria, which may set up a sub-clinical infection of the implant space. Patients have reported the following symptoms:
- Numbness and tingling of the breast and extremities
- Headaches
- Malaise
- Feeling like they are in a ‘fog,’ memory difficulties
- Fertility issues/ menstrual changes
- Insomnia
- Muscle aches, joint pains, and breast pain have been described by patients.
Most patients who present with these types of issues (usually after a long and comprehensive evaluation by their primary care doctor that rules out other more likely and serious illnesses) often request to have their implants removed. They also commonly request to have their breast capsules removed at the same time. Many patients report improvement in their symptoms following surgery for removal, though this is not universal.
What we’re doing at One?
Dr Wessels has become a specialist in breast explant surgery due to the sheer number of cases he sees each year. He has become an advocate for the illness and worked hard in raising awareness to women who are suffering by appearing on multiple different TV shows, radio interviews and magazines to discuss breast implant illness.
The One explant team
Although there is no medical diagnosis of BII we have a team who are currently researching the illness and a liasons in clinic to guide patients through the explant process.
Simone Mckenzie – Breast implant illness patient and now client liaison
Anita Jacobs – Breast implant specialist and lead researcher in BII
Dr Louis Wessels – Breast implant removal specialist
Dr. Wessels featured on 9NSW The Today Show ‘Breast Implant Illness’
The Surgery & Recovery
Before your procedure, Dr Wessels and our surgery team will make sure that you are comfortable and well before going ahead. Dr Wessels will draw on your breast to plan the where the incisions will be.
Breast implant removal or explant surgery is performed under general anaesthesia. The procedure normally takes 2 hours and starts with an incision being placed under the breast fold, where your augmentation incision was. The new incision will be 1 – 2 cm longer than the previous scar. Dr Wessels then performs a total en bloc capsulectomy by withdrawing the implant and the capsule at the same time allowing the breast tissue and muscles to settle back to their original position for a more natural appearance. Total capsulectomy removes all the scar tissue, including the ones around the implant along the ribs and lungs. Once the capsule and implant is successfully removed the incisions are carefully closed in layers with a concealed absorbable stitch. The incisions are then covered with a waterproof dressing. Patients are then taken to recovery for 2-4 hours with our recovery care specialists. All patients will have drains in place for 2-7 days following surgery. Some patients will be required to stay overnight in hospital and others may be allowed to go home following surgery provided they have an organised carer.
Kingsway Day Surgery (Miranda, NSW)
East Sydney Private Hospital (Woolloomooloo, NSW)
Macquarie University Hospital (Macquarie University, NSW)
Kareena Private Hospital (Caringbah, NSW)
Double Bay Day Surgery (Double Bay, NSW)
After surgery our recovery specialists will given post-op instructions. It is important to follow carefully. You will be provided with a script for medication, which you will need to purchase after surgery and instructions on when to take the medication over the days ahead. You will be discharged from hospital when your companion picks you up from the hospital. All patients must have a companion to stay with them for 72hours following surgery.
The first week after surgery you should stick to gentle day-to-day activities. This includes minimal house duties, no lifting, staying home as much as possible and sleeping in an elevated position. Commence postoperative exercise (instructions given post surgery).
- Surgical drains will be removed either in hospital or by clinic Nurse at One Cosmetic
In the second week of recovery try not to raise your blood pressure too much and still sleep in an upright position. Patients will also be required to attend a postoperative appointment at our office in week 2. this will be scheduled prior to surgery.
In week 2 patients may:
- Commence a light walk
- Return to work in week 2 if you have an office job with little physical activity
- Avoid sexual intercourse
- Start driving provided they are not taking any pain medication. We also recommend waiting 3 days for the medication to be out of your system
Weeks 3 – 5 patients with more physical jobs can return to work.
In weeks 3-5 patients may:
- Start getting into a light exercise routine, using lower body
- Start doing more physical household duties
In weeks 6-8 patients may:
- Commence normal exercise routine and duties. Please note, do not push yourself into being back into your pre surgery routines.
- Swimming, bathing running, yoga, stretching, spin class and Pilates
- Stop wearing compression bra
At this stage patients are mostly fully recovered and sutures are absorbed. Patients should always wear a supportive bra when exercising or performing physical activity. For all patients with teardrop breast implants we recommend that you do not ever go back to using or exercising chest muscles heavily as teardrop implants can rotate.
In weeks 9-12 patients may:
- Contact sport
- Boxing and upper body exercise
Risks
Modern surgery is generally safe but does have the potential for risks and complications to occur.
Some possible complications and risks associated with breast lift surgery may include:
- Surgical risks such as bleeding or infection
- Fluid accumulation around the operation site(s)
- Visible and prominent scars including keloid and hypertrophic scars. These are raised, red and thickened scars that may form over the healed incisions. They may be itchy, annoying and unsightly but are not a threat to health
- Allergic reaction to suture materials, tape adhesive or other medical materials and lotions
- Skin discoloration, permanent pigmentation changes, swelling and bruising
- Fatty tissue deep in the skin could die (fat necrosis) leaving hard lumps
- Changes in breast and nipple sensation
- Temporary or permanent areas of numbness
- Asymmetry (unevenness) of the breasts
- Excessive firmness of the breast
- Potential partial or total loss of nipple and areola
- Need for further surgery to treat complications
- Risks of anaesthesia including allergic reaction or potentially fatal cardiovascular complications such as heart attack
- A blood clot in the deep veins of the legs (deep vein thrombosis), which can move to the lungs (pulmonary embolus) or to the brain and may be life threatening
At One, we are regularly researching how to minimise the possible risks during the procedure and our methods are now being adopted worldwide.
Frequently Asked Questions
We regularly get asked about our procedures, so we have put together a couple of questions we get asked on a regular basis. If there is something else you would like to know, please get in touch!
No, we cannot make any guarantee that removing breast implants can relive patient s of illnesses. We ask patients to cross out all other possibilities before removing their breast implants.
This is really common for women to be concerned about the appearance of their breasts post explant. Dr Wessels regularly performs explant surgery in combination with a fat transfer and a breast lift.
Yes, in some cases this surgery is considered a medical procedure so your private health insurance may cover your hospital costs.
In some cases, Medicare rebates are available on this procedure.