Breast Explant – A Guide For Women

Breast Implant Removal – A Guide for Women

There have been many recent stories published in the media regarding silicone breast implants and how they can damage your health. Understandably, many women with breast implants are confused about what to do. Claims like these about breast implants can make anyone question whether or not their bodies are better off without them.

Breast implant removal (or explant surgery as it is sometimes called) is increasingly being performed not just in Australia but around the world. Even in some reports, it’s suggested that clinics are preying on the anxieties of women. There are claims that some clinics are pressuring women to remove their implants with explant surgery just for profit.

So if you have breast implants, what should you do? Everyone is different. Each case is unique and requires a different approach depending on personal circumstances. You should consult with your GP and the surgeon who inserted your implants. At least this should establish who the manufacturer was, and what type of implant you have. Once these details have been established, here’s what you should look out for:

Warning signs to look out for:

I have saline implants with a smooth wall

If your implants have a smooth outer wall and are filled with saline, then there is no need to have them removed. Any leakage will not be harmful and will immediately be evident as the implant will deflate. This is the time to have the implant replaced. An implant leak can happen all at once, or it may happen slowly over a few days. The saline from your implant will simply get reabsorbed by your body.

I have silicone implants with a smooth wall

If your implants are smooth-walled and filled with silicone, then you should have imaging done. An MRI scan is one of the best solutions for imaging, although an ultrasound would also be suitable for this scenario. Both forms of imaging can help determine whether or not your implant is intact. Imaging is recommended because silicone implants can rupture without any visible evidence. If your implants are intact, then there is no reason to have them removed via explant surgery. You should continue to have imaging done at least every 2 years.

My implants have a textured surface

If your silicone or saline implants have a textured surface, they may require an assessment. Recent evidence has linked these types of implants to the development of a rare, but potentially fatal, type of cancer known as Anaplastic Large Cell Lymphoma (ALCL).  The coarser the texture of the implants then the more likely it is for this condition to develop.  The average time before the development of this disease is 8 years.  The risk of development of this condition ranges from 1:1000 for implants with a very coarse texture to 1:80,000 for implants with a very fine texture. If you have two implants then your risk is 1:500 and 1:40,000 respectively.

Despite the fact that there has been a worldwide recall of certain implants with a coarse texture, there is currently no recommendation to remove these implants if you don’t show symptoms. This is because of concerns that explant surgery entails surgical risk, including deformity. Deformity is particularly likely to occur if the surgeon is aggressive in his or her attempts to remove the capsule that is surrounding the implant. In the absence of disease, there is no scientific evidence to support the removal of the entire capsule. Usually, a partial capsulectomy is performed, and this is sent for pathological analysis. This does not produce any deformity except for the loss of volume associated with removal of the implants.

I’m experiencing symptoms caused by my implants

If you have symptoms caused by your breast implants such as if they are painful, hard (due to capsular contracture), too big, too high, too low, rippled or unnatural in appearance, then it is reasonable to have the implants removed. There is growing acceptance of a condition known as Breast Implant Illness (BII) which describes a constellation of symptoms including fatigue, foggy thinking, night sweats, joint pains etc. that can develop in some women with breast implants. In these cases organising the removal of your breast implants via explant surgery may result in an improvement to your health.

Remember, breast implants are not lifetime devices, and so it is not unreasonable for them to be removed at some stage. If you choose to have your breast implants removed, then the natural question which follows is whether you will need any further surgery to restore your appearance.

Options to Reconstruct the Breasts after Implant Removal

Partial capsulectomy

You may decide to just have your implants removed with a partial capsulectomy (for biopsy purposes) and to do no more. This procedure is the minimal cost, minimal risk option.

Implant removal and total capsulectomy

You may decide to have your implants removed and to have a total capsulectomy. This procedure is only required when the capsule is diseased. It involves higher risk and higher costs.

Implant removal and replacement

You may decide to have your implants removed and replaced with other implants. In this case, we recommend smooth-walled, saline-filled implants placed behind the pectoral muscles as this provides the greatest safety with an aesthetic result equivalent to other options.

Breast lift or auto-augmentation 

You may decide to have a breast lift or auto-augmentation. If your breasts have sagged, then a breast lift will tighten your breast skin and raise your breasts to a normal position.

Fat transfer

You may decide to have an autologous fat transfer. This procedure involves harvesting fat from areas such as your hips, abdomen or thighs and, following preparation, carefully grafting it into your breasts. You’ll have an all-natural breast augmentation, and it serves as an excellent alternative to implants for many women. The only limitation is the amount of fat that can be harvested and how much fat can be grafted into the breasts in any one session. Being able to create breasts which are soft and natural with an enhanced cleavage using your own tissue is a significant advance in breast augmentation surgery.

For more information on explant surgery, head to our page on breast implant removal and replacement.