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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  • Posted on Dec 19 2018 By admin

    You are correct that we should post photos from explantation, so that patients can appreciate how problematic their result will be cosmetically.
    I COULD create a storm of business by endorsing BII, but I don’t see convincing evidence of this illness in my practice or the literature, and I won’t lie to create a demand for unnecessary surgery. That said, I do believe that patients who believe they have BII can obtain relief with implant removal. Also, a surgeon does not need to ‘believe’ in a disease, or be inspired by a patient, to do an excellent job surgically. I have operated on many criminals convicted of serious crimes, and can still take pride in my work even if I am not motivated by the patient I am treating.

  • Posted on Dec 19 2018 By Elisa Germain

    Why are there no before and pictures of explant procedures ? There are so many doctors in the states that do believe in BII and I know for a fact my implants have made me ill along with almost 70 thousand other women who have now come together. It’s too bad I cannot find a surgeon here in Canada that have the skills and the compassion to believe implants are harmful. Plus it has been confirmed there is a connection to BiA AlCl cancer. When will the medical community in Canada catch up! You are a doctor , you SEE first had what you are removing … hard to believe you don’t see the connection that this foreign toxic implant is causing illness. I will be heading to the states for my surgery where I will be paying double the price but at least I will be with a doctor who no longer implants women and I can trust he will remove all the capsule because he is a believer. I wish Canada had such a surgeon. There are at least 6 such surgeons in the states. Feng , Chun, Dev, Edward Melmed just to name a few. Women in Canada are sick and feeling very let down my the medical communities. The BII community is growing fast and we all make recommendations and share our consult experiences and surgery experiences with one another. A women mentioned you the other day but after reading what you’ve said about Bii and the fact you have pics of scrotums but no pics of explant ?? You are not an option for me. I may not have had information to make an informed decision regarding getting these toxic bags put in but all of us are making sure we will make an informed decision to get them out. I wish just one PS would stand up for what is right here in Canada , women would be knocking your door down!

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