Getting breast implants is a choice, but deciding to have them removed may be completely optional or due to medical necessity. Either way, it’s important to make sure clients know what to expect from the procedure and how to prepare for it, says Robert Kraft, M.D., plastic surgeon at Advanced Dermatology, P.C. (NY).
About 20,000 breast implant removal surgeries are performed each year in the U.S., according to the American Society of Plastic Surgeons. But 70 percent of those procedures stem from three main problems: the breast implant has leaked or ruptured; collagen fibers have grown around the implant, painfully squeezing it (called "capsular contraction"); or the woman's breast has changed in shape or size.
"Most women who choose to have breast implants don't consider that they may one day need to be removed," says Kraft. "But the procedure, while unusual, underscores the fact that breast implants are not designed to last forever. This means women should be informed about what's involved."
Reasons for breast implant removal
Changing their minds is natural, and women with breast implants may decide that they're too big or small and want to exchange them for implants of a different size. Others may not like the artificial look or decide they're too high or low and want to return to having only their natural breast tissue, he says.
But typically, medical reasons necessitate the removal of breast implants. Filled with silicone, gel, or saline, the implants may eventually leak, and all breasts eventually change in shape and size. Other reasons for breast implant removal include, and should be discussed with patients to ensure they keep an eye out:
- Visible wrinkling or rippling of the implant
- Hardening of the implant
- Allergic reactions to the implant
- Uneven appearance of breasts
- Persistent breast pain following implant insertion
"Many factors explain why women would want or need to revise their breast implants, replace them or opt out of having implants at all," says Kraft. "All motives are valid and should be handled seriously by a woman's doctor."
Undergoing the procedure
What's involved with removing breast implants? The surgery is same-day, meaning clients can go home shortly after the one- to two-hour procedure or in certain cases need to stay in the hospital overnight. Using intravenous sedation or general anesthesia, a surgeon typically removes the implants using an incision along the crease beneath the breast. Extra care will be taken if the breast implant has ruptured, and hard scar tissue that may have formed around the implant area will also be removed. "After the implants are removed, the skin will look loose," says Kraft. "Another procedure is typically needed to lift the breasts and adjust the skin and tissue if the patient isn't exchanging her implants for a fresh set. This can be done at the same time as the implant removal or at a later date."
Before the breast implant removal is scheduled, surgeons should speak with clients about their expectations—including whether they desire new implants, and their type and size—and will need to be certain to follow certain pre-operative procedures, he says. Blood and imaging tests may be scheduled, and the patient may be asked to stop taking some medicines and supplements up to a week beforehand. Once home, breast implant removal patients are typically advised to use compression bandages or wear a special bra to lessen swelling along with avoiding heavy lifting and extensive reaching for several weeks.
"If breast implants are intact and aren't causing any trouble, then there's no need to remove them," says Kraft. "But for some women, this surgery is exactly the right choice and the results leave them feeling better inside and out."