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Breast Implant Removal

About the procedure

For many reasons such as breast implant rupture, capsular contracture, or simply not wanting implants anymore, Los Angeles breast augmentation patients may choose to undergo removal of their breast implants. There are many different ways that this procedure can be performed: the implants can be removed alone, the implants can be removed with the implant capsule, or the implants can be removed alone or with the capsule and combined with a lift (mastopexy).  Other procedures such as liposuction and fat grafting can be performed at the same time as well to improve breast appearance. 

The video below shows Los Angeles breast implant removal specialist Dr. Elliot Hirsch performing an implant removal, total (en bloc) capsulectomy, and a breast lift.

Breast Implant Removal, Total Capsulectomy (en bloc), and Breast lift

Typically, the breast implants and capsules can be removed through the same incision that was used for the breast augmentation, which minimizes new scarring.  If a lift is performed as well, the implants and capsules can be removed through the lift incisions, which also limits scarring. 

Most patients who have their breast implants removed say that they feel a soreness, like after working out in the gym.  This usually lasts a few days and is much better after a week or so.  After two weeks, most patients are able to resume their regular activities without much difficulty.  Dr. Hirsch recommends wearing a soft, supportive sports bra or other similar bra without underwire during this healing period.

Frequently asked questions about breast implant removal

What it the breast implant capsule?

Any time that a foreign body such as a breast implant, knee implant, pacemaker, or any other similar device is implanted, the human body responds by forming a capsule around it.  The capsule is composed of scar tissue as well as other cells from the body.  This is separate from the breast implant shell, which is a silicone capsule that surrounds and contains the silicone gel or saline filling of a breast implant.

Does the implant capsule need to be removed when the implants are removed? What happens to the capsule if it is not removed?

Because the capsule is part of the body, not all capsules need to be removed along with the implants.  Often, if the capsule is not removed, it may be reabsorbed by the body over time.  However, if the implant is silicone and it is ruptured, the capsule should be removed along with the implant so that the loose silicone is removed.  Dr. Hirsch performs a total capsulectomy, or en bloc capsulectomy, so that the implant and capsule are removed in one piece and the silicone is contained within the implant capsule.

My implants are big and I am worried that my breasts will be saggy if the implants are removed. What can be done to help my breast appearance?

Large breast implants cause the skin to stretch over time.  Although the skin will shrink a little bit after the implants are removed, the breasts will often look empty and deflated after the implants are removed.  As a breast implant removal specialist Dr. Hirsch will often recommend a breast lift at the same time that the implants are removed.  The lift allows Dr. Hirsch to carefully sculpt the breast tissue, remove excess skin, and reposition the nipple to give the breasts their best possible appearance.  The breast lift can also be combined with fat grafting and/or liposuction as well.

There are several different types of breast lifts.  For patients with smaller implants or a minimal amount of breast ptosis (saggy breasts), a circumareolar lift (around the areola) can be performed.  For patients with bigger implants and more breast ptosis, a lollypop lift is an option, which gives a scar around the areola as well as a scar that extends down the breast.  For patients with big implants and/or significant breast ptosis, an anchor-pattern lift may be necessary.  Dr. Hirsch has developed a special type of anchor pattern lift that helps maximize blood flow and healing, and retains the maximum amount of breast tissue to help him optimize breast appearance.  Be sure to ask about this at your consultation with Dr. Hirsch!

What is breast implant associated ALCL? Am I at risk?

Breast implant associated Anaplastic Large Cell Lymphoma, or Bia-ALCL, is an extremely rare disease that may arise in patients with breast implants, specifically textured breast implants.  Every year, millions of women receive breast implants and currently, less than 400 cases of Bia-ALCL have been reported, so this should not be a concern to the overwhelming majority of patients who have breast implants.

Bia-ALCL typically presents as a swelling in the breast, usually only on one side, and often occurs many years after the breast implants were implanted.  When patients undergo imaging studies, there is fluid in the breast, and this may be sampled and the fluid sent for analysis.  Specific biomarkers such as CD30 may be positive in patients with Bia-ALCL.  Treatment for Bia-ALCL is a total (en bloc) capsulectomy and additional chemotherapy may be needed.  This is usually performed by a multidisciplinary team including a plastic surgeon, surgical oncologist, and medical oncologist.

Will I need drains after my breast implant removal surgery?

It depends on what specific procedure is performed.  Some patients will need drains after the procedure while others will not.  If drains are used, they are usually left in place for a week, and are easily removed in the office at your post-operative visit.

Meet Dr. Elliot Hirsch

Dr. Elliot M. Hirsch is a Board Certified Plastic and Reconstructive Surgeon who specializes in both cosmetic and reconstructive breast surgery. He is one of the busiest and most sought after plastic surgeons in the Los Angeles area, and has published over 40 papers in the breast surgery field. Dr. Hirsch has been educated at some of the most prestigious institutions in the country, including Johns Hopkins University, the University of Southern California, and Northwestern University.

To read more about Dr. Hirsch, please visit his extended biography page.
Read Dr. Hirsch's Biography