A patient may be unhappy with her breast implants because of their size, shape, position, feel or an implant-related complication. Other patients remain satisfied with the surgical result but decide that implants no longer fit their lifestyle or personal preferences.
The right solution depends on what is causing the concern and what the patient wants her breasts to look like afterward. Options may include implant revision, replacement, removal or removal combined with a breast lift.
Start by Identifying the Problem
Breast implant concerns can involve:
- Implants that feel too large or too small
- Asymmetry
- Excessive firmness or capsular contracture
- Implant displacement or bottoming out
- Rippling or implant visibility
- Rupture or saline deflation
- Breast sagging over the implants
- Pain or discomfort
- A cosmetic result that no longer matches the patient’s goals
- A personal decision not to have implants
Revision breast surgery is more complex than a primary augmentation because the surgeon must evaluate the implants, capsule, breast tissue, skin, existing scars and previous implant pocket.
Can the Implants Be Replaced or Repositioned?
Yes. If the patient still wants implants, breast implant revision may involve:
- Replacing a ruptured or aging implant
- Changing the implant size, width or projection
- Correcting implant position
- Repairing or modifying the implant pocket
- Treating capsular contracture
- Combining implant revision with a breast lift
Replacing the implant alone may not correct a problem caused by stretched skin, an abnormal pocket or scar tissue. The entire breast must be evaluated before selecting the operation.
Can Breast Implants Be Removed Without Replacement?
Yes. Patients are not obligated to replace their implants. Breast implant removal or explant surgery can be performed without placing another implant.
The appearance after removal depends on the original breast tissue, implant size, skin elasticity, pregnancy, weight changes and how long the implants have been present.
Some patients obtain an acceptable result from removal alone. Others may have loose skin or sagging and choose to combine removal with a breast lift. A lift is an option—not an automatic requirement.
How Does Dr. Bogue Manage the Implant Capsule?
The body forms scar tissue, called a capsule, around every breast implant. During explant surgery, Dr. Bogue performs a total capsulectomy, removing the capsule as well as the implant.
A total capsulectomy is not the same as an en bloc resection. En bloc removal means taking the implant, capsule and an additional margin of surrounding tissue together as one specimen. Dr. Bogue does not routinely perform en bloc removal because it is not warranted for ordinary explant surgery and can require removing unnecessary healthy tissue.
The removed capsule is always sent to pathology for examination.
What If Pain Is the Main Concern?
Breast pain may result from capsular contracture, implant position, scar tissue, nerve irritation, musculoskeletal problems or another cause. Removing the implant cannot guarantee relief when the source of the pain is uncertain.
Dr. Bogue evaluates the possible causes and discusses whether implant removal, revision or another form of medical evaluation is most appropriate.
Do I Have to Return to My Original Surgeon?
No. Patients may consult another board-certified plastic surgeon, particularly when they want a second opinion or require complex revision surgery.
Dr. Bogue’s experience includes primary breast augmentation, complex implant revision, total capsulectomy, explant surgery and breast reconstruction. His approach begins by listening carefully to what the patient dislikes, understanding the result she wants and explaining which options can realistically achieve it.
Read Signs It May Be Time to Consider Breast Implant Removal for additional information about rupture, capsular contracture and changing personal preferences.
To discuss implant revision or removal in Boca Raton, call 561-886-1000 or request a consultation online.