Removal of breast implants will inevitably cause volume loss to the breast. Sometimes the skin is able to retract on its own with time. But sometimes it may be necessary to excise the skin and lift breast tissue, in order to achieve your desired breast contour. This can be done during the same surgery or after you have healed from the breast explantation.
Breast augmentation with implants or fat transfer is also an option after your breast explantation surgery, if you are looking to maintain your breast volume. It can be helpful to bring your breast implant tracking card to your consultation.
The decision to have plastic surgery is extremely personal, and you’ll have to decide if the benefits of the surgery outweigh the risks and potential complications of surgery.
You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks. It is important that you address all your questions directly with your surgeon.
A breast explantation is performed under a general anesthetic. During the procedure, one or a combination of incisions are made in a circular pattern around the areola, in a line extending from the areola to the breast crease, and horizontally along the breast crease (commonly referred to as a lollipop/anchor scar) depending on whether you combined your surgery with a breast lift or capsulectomy. Dissolvable stitches will be used along the surgical incision. Surgical dressings will be applied and a compression bra will be used on top.
A good candidate for surgery is a patient who is relatively healthy and has realistic expectations for post-operative outcomes. The breast shape that you start with determines the shape that you end up with after the implants have been removed. A breast lift may be necessary to return the nipple to a better position and for a better breast contour.
It is also strongly advised that you be a non-smoker at the time of surgery. If you are a smoker we recommend you quit smoking at least 3 months prior to surgery as nicotine can interfere with blood supply and potentially cause complications with healing after surgery.
Breast implant illness and en bloc capsulectomy are two buzzwords that have recently been tied together by the internet. An en bloc capsulectomy is a complete removal of the capsule as one piece. However, this requires more scarring for the patient and potential damage to the chest wall depending on how attached the capsule is to the chest wall. Sometimes this may not be the best option for the patient.
Breast implant illness (BII) is a term that some women and doctors use to refer to a wide range of symptoms that can develop after undergoing reconstruction or cosmetic augmentation with breast implants. BII can occur with any type of breast implant.
BII is poorly understood, and experienced differently by patients. If you are concerned, it is best to speak with a healthcare professional for more information.
BIA-ALCL
On July 24, 2019, Allergan announced a voluntary worldwide withdrawal of unused stock of BIOCELL® textured breast implants and tissue expanders from doctors’ offices and hospitals, and a suspension of any future sales which is part of the voluntary recall of BIOCELL® textured breast implants and tissue expanders. This was done in response to concern around a condition known as BIA-ALCL.
BIA-ALCL is not breast cancer - but rather, it is a type of non-Hodgkin's lymphoma (cancer of the immune system). In most cases, BIA-ALCL is found in the scar tissue and fluid near the breast implant, but in some cases, it can spread throughout the body.
At this time, the overall incidence of developing BIA-ALCL is considered to be low (occurring in less than 0.03% of patients with BIOCELL® textured breast implants); however, a BIA-ALCL diagnosis is serious and can lead to death, especially if not diagnosed early or promptly treated. In most patients, BIA-ALCL is treated successfully with surgery to remove the implant and the scar tissue surrounding the implant; however, some patients may require treatment with chemotherapy and/or radiation therapy
BIA-ALCL symptoms include breast enlargement or hardening, persistent pain, lump in the breast or armpit, or a large fluid collection surrounding an implant. These symptoms have been reported between 6 months and 26 years after implant placement, and are typically diagnosed an average of 7 to 9 years after implant placement. BIA-ALCL is highly curable if detected early. Prompt diagnosis is key. BIA-ALCL occurs most frequently in patients who have breast implants with textured surfaces. This is a cancer of the immune system, not a type of breast cancer. The current lifetime risk of BIA-ALCL is estimated to be 1:2,207-1:86,029 for women with textured implants based upon current confirmed cases and textured implant sales data over the past two decades.
