Breast Implant Exchange/Removal

As you get older, your implants may not look the way you want anymore. With breast revision surgery or implant removal, you can remove, replace, and address issues associated with your old implants and correct any deformities. Breast revision or implant removal surgery offers a redo for prior breast surgeries. It reshapes and reforms the breasts, addresses asymmetry, and treats complications like capsular contracture. Breast revision or implant removal is also used to rejuvenate aging or sagging breasts after a previous breast surgery, or to change implant size or type.

According to the American Society of Plastic Surgeons, breast augmentation continues to be the most sought-after cosmetic surgery procedure year after year in the United States. Because the number of augmentations is so high, this means that breast implant removal and revision has also been steadily on the rise.

What is Breast Revision Surgery?

Breast revision surgery can address breast size and shape, relieve discomfort from capsular contracture, and alter the style or type of breast implant. With breast revision surgery, old implants are replaced with new implants to improve or change the look of the breasts and update the implant material. This surgery can include:

• Reshaping the breast implant pocket to help reposition the new implant on the chest
• Increasing or decreasing the implant size, style, or shape
• Implant exchange with a simultaneous breast lift or reduction

Breast implants and their underlying tissue can change with time, affecting the appearance of the chest. Dr. Farber and Dr. D’Agostino highly personalize this surgery to each individual.

What Is Implant Removal Surgery?

Breast explant surgery, or breast implant removal, is a procedure to remove previously placed breast implants, often due to changes in aesthetic preferences, complications like implant rupture or capsular contracture, or health concerns such as breast implant illness (BII) or anaplastic large cell lymphoma (BIA-ALCL). Performed under general anesthesia, Dr. Farber and Dr. D’Agostino remove the implants – and, if necessary, the surrounding scar tissue (capsulectomy) – using the original incision sites to minimize scarring. Recovery generally takes a few weeks, with most patients experiencing relief from symptoms and a return to a natural breast appearance.

What Is an En Bloc Capsulectomy?

Simply defined, en bloc means “as a whole.” In an en bloc breast implant removal, the breast implant and the surrounding tissue, called a capsule, are removed together in one complete unit. The capsule remains intact, reducing the risk of contaminating the breast tissue with foreign substances.

When is an En Blo Removal Recommended?

There are many reasons to consider en bloc removal. Dr. Farber and Dr. D’Agostino can help you decide if a traditional removal will meet your needs or if you would benefit from a specialized implant removal procedure like en bloc. En bloc removal may be recommended if:

• An implant has a suspected leak or rupture
• Scar tissue and the implant becomes firm causing pain or distortion of the breast.
• There are concerns about breast implant illness
• There are concerns about BIA-ALCL (breast implant associated anaplastic large cell lymphoma)

Some patients prefer and request an en bloc removal even when it isn’t medically necessary.

What Will My Breasts Look Like After Breast Implant Removal?

Removing breast implants can affect the appearance of the breasts. Implants create space within the breast, and when they are removed, the breasts often appear flat and deflated. Dr. Farber and Dr. D’Agostino often recommend complementary procedures to restore the appearance of the breasts after implant removal.

Fat grafting is one option for providing volume to the breasts after implant removal. Fat is removed using liposuction and implanted into the breast. This option is ideal for women who want to volumize their breasts without breast implants.

Implant replacement is another option. After the old breast implant and capsule are removed, a new implant can often be placed into the breast. If a different size or type of breast implant is desired, this can usually be accommodated.

Finally, a breast lift is an option after breast implant removal. Dr. Farber and Dr. D’Agostino can reshape the breast tissues and remove excess skin to create a rejuvenated breast mound. A breast lift can be performed on its own or paired with implants or fat grafting, depending on the patient’s desires.

Reasons for Breast Revision or Implant Removal Surgery

Revision surgery after breast augmentation is more common than revision surgery for breast lift or breast reduction, although we do offer all these procedures. The primary reason for an increased number of corrective surgeries after breast augmentation is the implants. Breast implants are long-lasting, but they don’t last forever. We tell our first-time breast augmentation patients to plan on a revision surgery or two when getting their implants initially.

When is breast revision or implant removal needed? We tell our patients to come see us if they are unhappy with their breast appearance, if they are experiencing discomfort in their breasts, or if their implants are over 10 years old. A board-certified plastic surgeon can provide a lot more information than an internet search and is invaluable for learning about options and solutions. Common reasons for considering breast revision or implant removal surgery include:

• Size Change – Size changes are the top reason for breast implant exchange and revision surgery. As you age, your aesthetic desires may change. Many women find themselves wanting larger or smaller breast implants as the years go by. After breast reduction, a size change may be needed if your breasts continue to grow or if you realize that you should’ve gone smaller with your initial surgery.
• Capsular Contracture – Capsular contracture is a complication that occurs when the scar tissue surrounding the implant hardens and contracts, causing pain, discomfort, and breast shape changes. Revision surgery will remove the problematic tissue, replace or remove the implant, and alleviate the symptoms of capsular contracture.
• Implant Positioning Problems – Inexperienced breast surgeons often struggle with implant positioning. The implants may be placed too high on the chest wall, too low, too close together, or unevenly. Revision surgery improves implant placement for a more natural, symmetrical breast appearance.
• Asymmetry – Some women choose breast augmentation or reduction to correct congenital asymmetry; others may develop asymmetry as a result of a previously performed surgery. Breast revision surgery addresses asymmetry using tissue excision, implants, and other techniques to achieve breasts that are similar in size and appearance. Remember, perfectly symmetrical breasts don’t exist in nature or after breast surgery. The goal of breast surgery is similar breasts, not identical.
• Sagging – Breast implants don’t correct breast sagging. Many women receive breast augmentation to alleviate sagging breasts, and find themselves disappointed by their larger, sagging breasts. A revision procedure can lift sagging tissues and reform the breast shape.
• Post-Pregnancy or Weight Loss Breast Changes – Pregnancy causes significant breast changes for many women, prior breast surgery or not. Many women require a breast revision, lift, reduction, or augmentation after pregnancy to restore breast appearance. Breast surgery is almost always included in our mommy makeover procedures.
• Unsatisfactory Results from Prior Breast Surgery – The most important decision you’ll make in breast surgery is your choice of surgeon. Many of our breast revisions are performed to repair damage caused by an inexperienced surgeon without proper training in breast surgery.

If your prior breast surgery left you with unsatisfactory results, come see us for a do-over. Dr. Farber and Dr. D’Agostino are highly experienced breast revision surgeons and can skillfully address both simple and complex issues arising from previous surgeries.

Breast Revision or Implant Removal Surgery Candidates

To be considered a good candidate for breast revision or implant removal surgery, you should be in overall good health, a non-smoker, and have a BMI of 30 or less. Dr. Farber and Dr. D’Agostino also recommend patients be at a stable weight for at least 6 months. During a private consultation with Dr. Dr. Farber and Dr. D’Agostino at 5th Avenue Plastic Surgery, you’ll discuss your goals for your breast revision or implant removal procedure and determine your ideal look, concerns, and surgery goals. Model candidates for breast surgery revision or implant removal include individuals:

• Dissatisfied with the appearance or volume of their breasts
• Having trouble with the condition of their breast implants

The Breast Revision or Implant Removal Surgery

Breast revision surgery begins by administering general anesthesia. The incision will be created, and your old implants will be removed, and the pocket (capsule) is evaluated and corrected if needed. The old implants are then replaced with your new ones. Implant options include saline or silicone, with various cohesiveness, volumes, projections and profiles customizable to your desired look. After your implants have been placed in the breast pocket and Dr. Farber and Dr. D’Agostino are satisfied with the new implants and shape, they will close your incisions with absorbable sutures, leaving you with your new and improved chest.

For implant removal, Dr. Farber and Dr. D’Agostino will create your incisions in the most inconspicuous location possible. They can often reuse the same incision sites as your original breast augmentation procedure. They will remove the implants and likely perform a breast lift or fat transfer procedure at the same time.

Breast Revision or Implant Removal Surgery Recovery

After your procedure, you’ll experience swelling and bruising that typically subsides within a few weeks. You’ll likely experience discomfort in your chest area. You will be instructed to limit your activity level for a few weeks while you recover. Dr. Farber and Dr. D’Agostino will provide detailed aftercare instructions – you can expect to see full results within up to six months.

Schedule a Consultation

Breast revision or implant removal surgery can rejuvenate your breasts to fit the contours that you are striving for. We look forward to addressing your concerns and improving your curves at 5th Avenue Plastic Surgery. To meet with Dr. Farber and Dr. D’Agostino, our board-certified plastic surgeons, contact our office today by calling or booking an appointment through our online platform.