Breast Implant Removal, Capsulectomy, and Breast Lift

About the Procedure

Through the hundreds of breast implant removal, capsulectomy, and breast lift procedures that he’s performed, Los Angles explant specialist Dr. Elliot Hirsch has developed his specialized technique to maximize both safety and cosmetic results.

This procedure is a modification of the anchor scar technique called an “open pattern with a vertical bipedicle.” The final scar is similar to the standard anchor pattern scar, but can be made shorter along the bottom part of the breast because Dr. Hirsch’s technique allows more room for intraoperative adjustments than a standard anchor pattern procedure.

The main differences between the open pattern/vertical bipedicle technique and other anchor scar techniques are:

1. how the skin incision is made and
2. how the breast tissue is treated.

 
In the open pattern technique, the shape of the breast lift incision is different than the standard anchor scar incision. This difference is made to allow adjustment of the amount of tension at the T-junction (place where horizontal and vertical incisions come together). This gives more precision in the cosmetic result and decreases healing complications as well which is important because every breast implant removal patient in Los Angeles is different and the procedures are specialized for each patient’s situation.

The other major difference is in how the breast tissue is addressed. A vertical bipedicle means that the breast tissue remains attached at the upper and lower part of the breast, and therefore blood flow remains intact from both the top and bottom of the breast.

Blood flow is critical for healing! In standard Los Angeles breast lift techniques such as the inferior pedicle or medial pedicle, the remaining tissue is attached either at the top OR the bottom of the breast. Because every explant patient has had at least one prior operation and there is no way to know the extent of the previous procedure or internal scarring, one of the safest ways to ensure blood flow to the nipple areola complex is to leave the tissue attached at the top and bottom. This technique also maximizes tissue preservation, which helps maintain as much volume as possible.

To learn more about this technique, feel free to watch the following video or read Dr. Hirsch’s publication.

Read Paper

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

Breast implant removal, en bloc capsulectomy, and breast lift

Post op

Most breast implant removal, capsulectomy, and breast lift procedures take around 3-3.5 hours. They are outpatient procedures, meaning that patients go home the same day.

Dr. Hirsch usually uses drains because when an implant is removed, it creates a space in the body that the body tries to fill with fluid. The drain removes this fluid and helps prevent a fluid build up, called a seroma. The drains are usually removed in Dr. Hirsch’s office 7-10 days after surgery. While the drains are present, it is important to limit activity to light walking and no heavy lifting or strenuous activity. Compression of the breasts/chest is important while drains are present as well. After removal of the drains, activity should remain limited until around 4-6 weeks post operatively, at which point patients can slowly resume regular activities.