Dr. James D. Namnoum | Board Certified Plastic and Reconstructive Surgeon
Breast Procedures
Breast Implant Removal
Many women who have had breast augmentation surgery are happy with their choice, but various changes to your body or your lifestyle may lead you to consider having your breast implants removed. Breast implant removal, also called explant surgery, is a cosmetic procedure to remove breast implants.
Explant Surgery Specialist in Atlanta
Atlanta breast surgery specialist and board-certified plastic surgeon Dr. James Namnoum is highly experienced in breast implant removal procedures, including implant removal with fat grafting, implant removal with a breast lift, and breast implant revision. At his Atlanta office, Dr. Namnoum works with patients who are interested in breast implant removal to develop a treatment plan that will best meet their individual needs and goals.
Common Reasons for Breast Implant Removal
While many women are happy with their breast implants for their entire lives, there is a range of reasons that a woman may decide to have an additional plastic surgery procedure to have her breast implants removed, including:
Changes in Weight or Body Type
Often weight gain or loss can lead to breast asymmetry, loose skin, or a breast size which is no longer desirable. Women thrilled with their breast augmentation when they were younger may find that their breast implants no longer suit their body type and may opt for new implants or no implants at all.
Breast Implant Complications
Occasionally, breast augmentation patients may experience an implant rupture. A ruptured saline implant and subsequent deflation is not dangerous, nor is a ruptured silicone implant, but it can cause aesthetic issues.
Another common complication is an excess or hardening of scar tissue called capsular contracture. Like a ruptured implant, it isn’t associated with any health danger, but it can sometimes cause aesthetic issues. Capsular contracture can be treated with revision surgery, but some patients opt for implant removal.
Changing Trends or Personal Preference
Some women decide that their breast implants no longer fit with their personal style, or they want to swap saline implants for silicone implants. Other women may decide that they desire a more natural breast shape or a larger or smaller breast size.
Health Concerns
Breast implants are well-studied, clinically tested, and FDA-approved for safety.1 Some women may consider having their breast implants removed because they have heard about a breast cancer link. However, the only cancer linked to breast implants is Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a very rare and highly treatable disease that has only been associated with certain brands of textured implants, which have since been recalled. The vast majority of implants in the U.S. are smooth-walled implants, not textured. Even if you have a recalled implant, the FDA does not recommend removal unless you are experiencing symptoms such as persistent pain and swelling around the implant.2
How Does Explant Surgery Work?
Your explant treatment plan will vary depending on several factors, such as your aesthetic goals, your age, the size of your implants, and the length of time you have had them. Patients will typically receive general anesthesia for this procedure. Dr. Namnoum will begin by making an incision, which is usually an inframammary incision that is placed within the natural fold underneath the breast.
When a person has breast augmentation surgery, the body’s natural response to the breast implants is to surround them with a thin layer of scar tissue, which is called the capsule. Dr. Namnoum will incise the capsule to remove the breast implants. In some cases, he may perform a total capsulectomy, which involves removing the entire capsule of scar tissue. However, in many cases, it is safer to leave some of the scar tissue in place and remove only a portion of the capsule.
Once the implant is removed, the patient can opt for no additional surgery or breast reshaping and lift with or without fat grafting. Dr. Namnoum will use advanced glandular rearrangement techniques to reshape the breast tissue and optimize the appearance of the breast. By adjusting the internal structures of the breast, Dr. Namnoum can achieve fuller, more attractive post-implant results.
Breast Implant Removal Options
For patients with specific aesthetic goals, Dr. Namnoum offers several approaches to breast implant removal:
Explant with Fat Transfer
If you would like to have your implants removed but you are concerned about the loss of breast volume, fat transfer may be a solution. In this procedure, Dr. Namnoum will use liposuction to harvest fat from an area of your body, such as your abdomen, and then he will transfer it to your breasts in order to provide fullness at the top of the breast.
Explant with Breast Lift
A breast lift can be a good option for patients who are concerned with sagging or drooping breasts after breast implant removal. Breast lift surgery, also called mastopexy, can be performed in conjunction with breast implant removal in order to avoid a deflated look. Glandular tissue is rearranged to improve the shape and projection of the breast, and the skin is tailored. A breast lift offers a perkier, more youthful appearance and can be beneficial for patients who have had implants for a long time or are having very large implants removed. A breast lift can be performed with fat grafting to further refine the result after explanation.
Breast Revision Surgery
If you are unhappy with the way your current breast implants look but you are still interested in breast implants, then breast revision surgery may be an option. In a revision procedure, Dr. Namnoum can replace your current implants with new breast implants that are smaller or larger, and he can improve the placement for beautiful, natural-looking results. A breast lift with or without fat grafting may be beneficial for some patients.
Preparing for Breast Implant Removal
The first step in the breast implant removal process is a consultation appointment with Dr. Namnoum at his Atlanta office. He will discuss your goals, talk about your medical history, answer any questions, and examine your breasts in order to develop a treatment plan that meets your needs. If you decide that explant surgery is right for you, you will need to stop using any nicotine-containing products prior to surgery.
Breast Implant Removal Recovery
Recovery from explant surgery can vary depending on your treatment plan. Patients who had their breast implants removed with minimal capsule removal and no other procedures may have a quick recovery with very little discomfort. Patients who have breast lift surgery with their implant removal will have a longer recovery period with several weeks of activity restriction. Dr. Namnoum and his team will give you detailed aftercare instructions, and they will be available to answer any questions about recovery after breast implant removal.
Frequently Asked Questions About Breast Implant Removal
Will my breasts look deflated after implant removal?
Human skin and tissue can be very resilient, and many women are pleasantly surprised by how good their breasts look once they heal from explant surgery. That said, if you had very large implants that stretched your skin or if you have lost skin elasticity with age, you may experience some sagging after implant removal. If you are concerned about the loss of volume or sagging, you may consider a breast lift after implant removal.
What kind of results can I expect?
Your results will depend on your treatment plan, but rest assured that Dr. Namnoum will tailor your plan to meet your needs and goals. If needed, he will recommend additional procedures, such as fat grafting or a breast lift, in order to help you achieve the look that you want.
Do I need an en bloc removal?
If you have researched breast implant removal, you may have come across the term “en bloc removal”. While there are advocates for en bloc removal, it is important to understand that there are inherent safety risks with this technique. En bloc refers to removing the entire capsule intact with a zone of surrounding soft tissues. This requires a larger incision and means that tissues above and below the implant capsule are included with the specimen. This approach can be dangerous if the capsule is very thin or the implant was placed underneath the pectoralis major muscle with the deep surface resting on the ribs. In these instances, en bloc threatens the health of the nipple and breast skin and risks injury to the lung and pleura. Dr. Namnoum prioritizes patient safety, and he does not use this radical technique unless absolutely necessary. He will recommend a breast implant removal plan that he believes is best for you.
Am I a candidate for breast implant removal?
The best candidates for breast implant removal are in good general health, non-smoking, and at a stable weight.3
1 U.S. Food and Drug Administration. What to Know About Breast Implants. Available: https://www.fda.gov/consumers/consumer-updates/what-know-about-breast-implants Accessed March 19, 2020.
2 U.S. Food and Drug Administration. Questions and Answers about Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). Available: https://www.fda.gov/medical-devices/breast-implants/questions-and-answers-about-breast-implant-associated-anaplastic-large-cell-lymphoma-bia-alcl Accessed March 19, 2020.
3 American Society of Plastic Surgeons. Breast Implant Removal. Available: https://www.plasticsurgery.org/cosmetic-procedures/breast-implant-removal/candidates Accessed March 19, 2020.
