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Breast Implant Removal Surgery by Dr Craig Rubinstein
Dr Craig Rubinstein explains his 6 Breast Implant Removal surgery trends, which include:
- Removing breast implants instead of replacing them
- Removing either the whole capsule (en-bloc) or only a part of it along with the implant removal
- Getting a breast lift (mastopexy) or reduction after removing the implants or having a fat grafting procedure done after removal
- Wanting to have breast implants removed due to pregnancy
- More mums and mature patients removing implants are content to have natural breasts as the implants have done their job
- Specialised techniques for breast implant removal surgery
As the name suggests, the main goal when having breast implant removal surgery is for the plastic surgeon to remove the patient’s breast implants. Furthermore, breast implants do not last forever, they have a ‘shelf life’ of approximately 10-15 years. At this stage, the implants need to either be replaced with a new implant or removed completely. However, the choice of whether to simply remove or to remove and replace the implants is entirely up to the patient. Aside from that, the surgeon can remove the breast capsule and/or any silicone material that came from complications such as implant leaks or ruptures.
Breast Implant Removal Practices Used by Dr Craig
Below are some breast implant practices used in surgery:
Trend #1 – Removing breast implants instead of replacing them
Reasons, why Implants may need to be replaced, include:
- Having botched or textured implants. Cheap surgeons found in pop-up clinics are the top cause of botched implants.
- They have little regard for the process during or after the surgery.
- Complications have occurred, and there is a need to either replace or remove them.
Problems that can occur if the procedure is not done properly:
- Capsular contracture
- Implant malposition
- High malposition
- Low malposition
- Lateral malposition
- Symmastia
- Implant rupture
- Implant rippling
Textured Implants
Textured implants were originally used to minimise movement between the implant and pocket created by the surgeon. However, these tear-drop-shaped implants have since caused more problems than solutions as any movement or rotation once inserted can cause a deformity in the look of a patient’s chest. Furthermore, studies indicate that patients with textured implants have a higher risk of a rare form of cancer known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). This is not a form of breast cancer, but rather a cancer of the immune system. Recent data from Australia shows that the risk of getting BIA-ALCL is as high as one in a thousand women.
Trend # 2 – Removing either the whole capsule or only a part of it.
A capsule is the scar tissue that forms naturally around foreign objects placed inside the body. The process of removing the capsule is called a capsulectomy.
There are three options that Breast Implant Removal patients can consider:
- Firstly, removing only the breast implants.
- Secondly, removing the implants and only removing part of the capsule.
- And thirdly, removing both the implants and capsule completely.
As stated above, completely removing the capsule is called a total capsulectomy. This is where the entire capsule is removed after pulling out the breast implants. The entire capsule can either be brought out in one or multiple pieces, depending on how the surgery is going.
While having the breast implants removed and only a partial capsulectomy means that aside from having the implants removed, small portions of the capsule will be taken out as well. The areas where the capsule was removed can be used to treat capsular contracture or be used as a sample for pathological evaluation.
En Bloc
The third case refers to having a breast implant removed along with the whole capsule. This can also be called an En Bloc Capsulectomy. This is when the capsule is removed in one piece, with the breast implants found inside the capsule. En Bloc is a French term that means continuity and is a procedure that is frequently requested by patients. The term En Bloc was originally used by cancer surgeons and referred to the removal of all cancer cells and the tissue found in the surrounding area involved. Moreover, the complete removal of both the capsule and implant decreases the chance of leakage from the implant.
Trend #3 – Getting a breast lift (mastopexy) or reduction after implant removal
Patients are usually given the choice of having a Breast Lift (mastopexy) after having their breast implants removed. Our surgeons often suggest waiting to have the breast lift (mastopexy) instead of directly after the implant removal. This is due to the fact that it is technically more difficult to do procedures that are “opposite” where the surgeon will have to lift the original size of the breast. The average wait period between removal and lift is 1 year. During this time the patient has not only recovered but is physically and emotionally ready to undergo the surgery.
Although you may want the breast lift (mastopexy) immediately after implant removal waiting can help prevent and also avoid risky complications that could occur if you opt to have the breast lift (mastopexy) right away. However, it is still entirely up to the patient. You can still undergo the lift surgery after the removal, given that your doctor deems you fit to do so.
Breast Lift (Mastopexy) Incision Choices
Existing incision and a circumareolar incision
A circumareolar incision is where the incision spot that was originally created during your implant surgery will become the removal incision as well. This is for those who only need a mild lift since a single incision will be created around the areola. With this incision, the breast tissue will be lifted and the sutures that are used to hold the breast are positioned in a higher place.
An inverted-t incision
This type of incision is designed for women that have either poor skin quality, an inframammary incision scar or women that have excessively loose breasts. This incision technique combines vertical and transverse incisions. This allows not only maximum skin removal but also breast shaping. As the name suggests, the final scar is similar in shape to an invert “T”. It has also been likened to an anchor, consisting of a scar around the areola, then straight down the centre of the breast down to the breast fold and horizontally across the base of the breast.
This type of incision is common for women who have heavier breasts and severe descension. Allowing for some of the breast tissue to be removed while the rest will be shaped and lifted into a higher position. This may give the breasts an altered appearance. The surgeon may also reposition the nipples if they have descended.
Trend #3 – Having a fat grafting procedure done after Implant Removal
Fat grafting, also known as a fat transfer, is where the patient’s fat is used to augment or enlarge the breast. The fat used for the transfer will come from different parts of the patient’s body, such as the abdomen, hips and/or back. Not only does this may help to add volume to the breasts but it may also address the areas where the transfer comes from. Because this procedure uses the patient’s own natural tissue there must be enough excess fat in the areas mentioned earlier for it to be a viable option.
While fat grafting results are smaller compared to implants it has fewer risks and is less likely to affect milk ducts and nerves in the breast. Another important note is that fat grafting is not a replacement for implants. Consult with the surgeon first and gather enough information about the procedure before pursuing it.
Trend #4 – Implant removal due to pregnancy
If a patient becomes pregnant after having implants, worrying about how the breast implants could interfere with their ability to feed their baby or the condition of their breasts after breastfeeding is to be expected. It is unlikely that the implants will cause any problems when it comes to breastfeeding. Furthermore, if the implants are placed in the subpectoral or dual plane position then it is even less likely to interfere with breastfeeding. While breasts tend to get bigger during and after pregnancy (thanks to milk supply, weight gain and hormones they can eventually settle into a different size and shape than they were pre-pregnancy. Some women find that they no longer want or need implants after pregnancy.
It is important to note that breast tissue may not only increase as soon as you get pregnant but they will likely decrease again once you start nursing and then again when you finish. This may eventually lead to breast descending and lost volume. This is why some patients opt for a breast lift (mastopexy) after the breasts have settled.
Trend # 5 – Mums and Mature patients removing implants
As you age, so, too, do your implants. Your implants should be changed approximately every 10 years. However, there may come a time when you decide that your implants are no longer a priority for you, maybe you became a mother, or your financial position has changed and you can no longer justify the cost or perhaps you simply don’t want to undergo unnecessary surgery. As we age, everything starts to slow down, including our healing and recovery time. So it’s understandable that some women come back to their surgeon and decide it’s time to have their implants removed and not replaced. This is considered one of the top breast implant removal surgery trends mainly because either the patient’s life has changed or they simply don’t want to risk their health anymore. The choice is always up to the patient.
It doesn’t hurt to consult your plastic surgeon if you are contemplating having your implants removed, they can verify that it is indeed a suitable option for you.
Trend #6 – Specialised techniques for breast implant removal surgery
The old and traditional way of making a larger incision into your skin to pull out your implants is long gone. This method is now out of date and no longer necessary. Thanks to today’s technology and medical advancements, we now have very specialised techniques for removing implants using a suction bottle or vacuum sleeve. The vacuum sleeve enables the removal of the whole silicone implant as well as the capsule in one block. Although this technique is not for everyone, it is usually the first procedure suggested to the patient. The highest priority of the procedure is to ensure that the implant is removed completely. If a capsule has formed around the chest area then the capsule will be removed as well.
Everyone’s body is different.
It’s important to remember that everybody’s body is different, everyone’s breasts are different and as a result, what works for one person may not work for somebody else. This applies to all surgery, not just breast augmentation, breast lift (mastopexy), or implant removal. It is therefore important that you are confident that your plastic surgeon has tailored your procedure or procedures to you and your body type. The same goes for when you want to remove your implants, it is better to ask questions and to fully understand the procedure before deciding on whether or not to go through surgery again.
Summary
The different trends mentioned above are the techniques, procedures, or reasons why and how women want to remove their implants. There is nothing wrong with wanting to remove them. Over time, people tend to want different things, and sometimes, it is what is most suitable for them and their bodies.
Other Top Trends in Surgery
- Top Tummy Tuck (Abdominoplasty) Trends – Common Practices in Abdominoplasty Surgery with Dr Craig Rubinstein
- Top Breast Augmentation Trends – Common Practices for Breast Augmentation
- Top Breast Lift (Mastopexy) Trends – Common Practices for Breast Uplifting Surgery
- Top Breast Reduction Trends – Common Practices for Breast Reduction
Further Reading – Medical References
ASPS USA – Breast Implant Removal
About Dr Craig Rubinstein
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Dr Craig Rubinstein FRACS (Fellow of the Royal Australasian College of Surgeons) is an experienced Melbourne Specialist Plastic Surgeon for breast and abdominoplasty surgery.
Dr Rubinstein offers women personalised abdominoplasty surgery and all forms of cosmetic breast surgery.
BOOK A CONSULTATION (03) 8849 1400
Next Steps in Your Surgical Journey
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About Your First Consultation
- Dr Rubinstein’s Consultation fee is $300.
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What to Bring to Your Consultation
- You are more than welcome to bring a friend or relative to help discuss the information and your choices.
- Ensure you also take a lot of notes and thoroughly examine the documents provided.
- Please be aware you may need to undress for a physical exam so wear simple clothes.