Breast implant removal – often called explant surgery – permanently takes silicone or saline implants out, along with some or all of the scar tissue around them, depending on the reason. Expect your breasts to look and feel different, and plan on several weeks of healing.
Why Do Women Have Their Implants Removed?
One of the most common reasons is capsular contracture. After an implant goes in, the body naturally forms a thin shell of scar tissue around it – the capsule – which sometimes tightens and hardens, causing pain and distorting breast shape. According to Living Beyond Breast Cancer's medically reviewed explant guide, other common reasons are a ruptured or leaking implant, a shifted implant, ongoing pain, or infection. And many women simply change their minds – no medical reason is required.
Then there are health concerns: breast implant illness (BII) describes symptoms some women connect to their implants – fatigue, joint pain, brain fog, rash, and others. Dr. Martin Newman, Department Chair of Plastic and Reconstructive Surgery at Cleveland Clinic Florida, notes that "there isn't an official medical diagnosis for BII, and there is much we don't know about the condition," and Cleveland Clinic describes it as a diagnosis of exclusion: other causes need to be ruled out first. Living Beyond Breast Cancer cites small studies finding that 70 to 96 percent of women with these symptoms report feeling better after removal.
BIA-ALCL is a rare lymphoma – an immune system cancer, not breast cancer – seen in a small number of women with textured breast implants, most often the Allergan BIOCELL type recalled in 2019. The classic sign is breast swelling, which can appear years later. But if you have textured implants and no symptoms, Dr. Newman is clear: "the FDA does not recommend having implants removed unless patients are experiencing symptoms."
What Happens During Explant Surgery?
The procedure is typically done under general anesthesia. According to the American Society of Plastic Surgeons (ASPS), the surgeon makes an incision along the lower fold of the breast or around/below the areola – often reusing the original implant incision – and removes them.
Living Beyond Breast Cancer describes three approaches for the capsule – that scar-tissue shell:
En bloc capsulectomy. The implant and the entire capsule come out together in one piece, the implant still sealed inside. Surgeons strongly recommend it for BIA-ALCL, suspected infection, or BII concerns.
Total capsulectomy. The implant comes out first, then the whole capsule is removed in pieces – often the approach for pain or contracture, or when the capsule is too thin or stuck to come out in one piece.
Partial capsulectomy. The implant comes out first, then most of the capsule. Sometimes the surgeon leaves a bit behind on purpose: peeling capsule off the ribs can tear into the chest – rarely collapsing a lung. That risk runs higher with under-the-muscle implants.
The removed capsule or fluid may also be sent to a lab, where testing can check for cancer cells, infection, silicone material, and CD30 – a protein linked to BIA-ALCL.
What Will My Breasts Look Like After the Implants Come Out?
Honestly: different – and often smaller and softer than you remember. The ASPS puts it plainly: after removal, the breast profile may look flatter or droopier than before surgery, with possible irregularities or indentations from the scar tissue.
Why? The implant stretched the skin and tissue for years. Once it's gone, the pocket collapses and the skin doesn't always bounce back. One thing to hear clearly: removal does not return your breasts to how they looked before you got implants. Time, gravity, and the stretching from the implant itself have all changed the tissue.
The final shape also takes time. According to the ASPS, healing can take up to a year before the final results are visible – the outcome depends largely on the size of the implants removed and the tissue left. Judging the result in the first few weeks won't tell the full story.
Should I Get New Implants or a Breast Lift at the Same Time?
You have three main paths, per Dr. Newman of Cleveland Clinic: definitive removal, removal with replacement, or removal followed by a breast lift (mastopexy) – some patients combine replacement with a lift.
Remove and do nothing more. The simplest option if you're comfortable with a smaller, flatter result.
Remove and pair it with a breast lift. Dr. Newman notes this is the most popular choice among his patients – the lift removes excess skin and reshapes the tissue, directly addressing the deflation and droop that removal alone leaves behind.
Exchange for new implants. Living Beyond Breast Cancer notes that explant differs from exchange surgery, which swaps old implants for new ones in the same operation. If you liked having implants but had problems with the old ones – a rupture, contracture, or a size you never loved – replacement is worth discussing.
What Is Recovery Like?
How long recovery takes depends on what else is done: according to Living Beyond Breast Cancer, recovery can take up to several weeks when removal is paired with another procedure like a lift. Expect soreness and swelling that fade over weeks. Follow your surgeon's instructions on activity limits and follow-up visits – those take priority over any general timeline.
What Are the Risks?
Like any surgery, explant carries risks. According to Living Beyond Breast Cancer, these are seroma (a pocket of fluid under the skin), hematoma (a pool of blood under the skin), and – in rare cases – a collapsed lung when the capsule was stuck tightly to the chest wall. Past chest radiation can also make wound healing more difficult.
The most common complaint isn't medical at all – it's the look. The ASPS warns breasts may come out flatter or droopier, with indentations or irregularities. Honest expectations matter before surgery, not after.
Am I a Good Candidate for Implant Removal?
If you have implants and want them out – for any of the reasons above – you're likely a candidate. Surgeons generally want patients in good overall health, at a stable weight, with realistic expectations about how their breasts will look afterward. The ASPS notes this surgery is appropriate when you have capsular contracture, pain, imaging that shows a leak – or simply when you no longer want your implants.
Ready to Talk It Through? Schedule Your Consultation
Thinking about having your breast implants removed? Start with a real conversation with a surgeon who will tell you straight what to expect.
Renew Me Plastic Surgery in Miami offers consultations for breast implant removal, where Dr. Paul Boulos will review your situation, explain your options – removal alone, removal with a lift, or replacement – and answer every question you bring.
Call (786) 957-1777 to schedule, or visit us at 730 NW 107th Ave, Suite #117, Miami, FL 33172.
Sources
Living Beyond Breast Cancer – Explant surgery: https://www.lbbc.org/about-breast-cancer/treatments/breast-reconstruction/implant-reconstruction/explant-surgery
American Society of Plastic Surgeons – Breast Implant Removal: Steps of the procedure: https://www.plasticsurgery.org/cosmetic-procedures/breast-implant-removal/procedure
American Society of Plastic Surgeons – Five things to know if you consider explant surgery: https://www.plasticsurgery.org/news/blog/chrissy-teigen-removed-her-breast-implants-five-things-to-know-if-you-consider-the-procedure
Cleveland Clinic ConsultQD – Is Fear Driving Increase in Breast Implant Removal?: https://consultqd.clevelandclinic.org/is-fear-driving-increase-in-breast-implant-removal
Explore Related Resources at Renew Me Plastic Surgery
breast augmentation | breast lift | financing options
Learn more about tummy tuck in Miami or contact our team to discuss your goals.
