Published February 14, 2020 By Adam Lowenstein

The American Society of Plastic Surgeons reports that over 310,000 breast augmentation procedures were performed in 2018. That same year, just over 29,000 breast implant removal procedures were performed. Multiple studies by implant manufacturers confirm that breast implants are not intended to last indefinitely. About half of all patients who receive breast implants, regardless of type, need to have them removed or replaced within seven years. Understanding that some implants may last for well over a decade and some may not last nearly that long, manufacturers limit their warranties to 10 years.

Reasons for Breast Implant Revision

There are several reasons why breast implant revision may be necessary. Patients need to understand that implants are foreign bodies. As such, the body creates a barrier of scar tissue around them to prevent the migration of a foreign substance from the breast capsule to other parts of the body. Sometimes, this capsule of scar tissue becomes hard and inflexible, resulting in pain and, sometimes, breast deformation. This is referred to as capsular contracture and it is one of the most common reasons for breast implant revision.

In addition to capsular contracture, breast implant revision may occur due to infection, rupture of the implant, or extrusion, which involves skin erosion. These are less common complications that may be addressed with implant removal or replacement. Becoming more common is the concern that breast implants may cause illness or anaplastic large-cell lymphoma. In this instance, patients are choosing to remove breast implants altogether rather than replace them.

Breast Implant Explantation Techniques

Breast implant removal typically occurs in one of two ways. It is important that patients are educated regarding breast implant removal (explantation) techniques so they can make the best decision regarding their care.

A complete capsulectomy is a precise and time-consuming procedure during which the implant, as well as the entire capsule of scar tissue, is removed. An en bloc capsulectomy removes the entire capsule in one piece. Some of the tissue that is removed during this procedure may be attached to the ribs or the chest wall.

To reduce the risk of surgical complications such as lung injury, many surgeons leave some or all of the capsule tissue intact. The capsulotomy procedure breaks up and softens scar tissue through small incisions but leaves that tissue in place. Because capsular material may include inflammatory cells, bacteria, or fragments of silicone, many women prefer to have the entire capsule removed.

Breast explantation techniques are important to differentiate. Based on the reason for breast implant removal, the technique used can have a profound effect on the outcome.

Education is an integral aspect of the patient-centered care we believe in. To discuss your options for breast implant removal, call 805.969.9004 and schedule a consultation in our Santa Barbara office.

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