19 Dec 2018

Should I Remove My Breast Implants?

Concerns about Breast Implant Illness (BII) are driving some women to consider removal of their breast implants. Research to this point does not support the existence of BII. Nevertheless, many women who believe they have BII experience at least temporary relief of their symptoms once their implants are removed (the possibility of a placebo effect must be acknowledged). Ultimately, if removing your implants might help you to feel better (even if only by relieving anxiety), what is the down-side in taking them out?

1.Loss of breast volume. Unless you have gained weight, breast volume will appear less than before your augmentation due to implant pressure causing flattening of the tissues, but breasts tend to ‘fluff out’ over a few months so volume loss becomes less obvious. Loss of volume can be treated (in part) by fat grafting, or a repeat augmentation down the road.

2.Loose, saggy skin. This is a bigger problem if very large implants were used. Breasts do not usually return to their pre-augmentation shape. Breast lift surgery can be performed either at the time of explantation or later once the tissues are stable (minimum 6 months).

3. Fluid collection and wound healing problems. When the implants were put in originally, a fresh space was created and then healing/scarring occurred around the implants. At explantation, the breast capsule (fibrous wall formed around the implant) remains, and may retain a pocket of fluid that varies in size with chest activity. This can be prevented by performing a partial removal of the capsule (capsulectomy) along with other maneuvers to encourage the pocket to heal closed. Drains may also be used temporarily to encourage the capsule to collapse.

4.Post-Capsulectomy complications. The more capsule removed, the more likely you are to suffer irregularities in the skin as the wound collapses and sucks in the skin surface. Removing the capsule is akin to removing wallpaper from drywall, and is a lot harder on the breast and pectoral muscle than was putting in the implant. Bleeding complications are more frequent, and the lining of the chest (pleura) is at risk of perforation and lung collapse.

5.Costs. BII is not an illness recognized by insurers, so removal of implants and capsulectomy for BII is not covered by insurance. Fees for this surgery may range from $5000 for implant removal and partial capsulectomy, to $10,000 for enbloc implant removal and capsulectomy.

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