Breast Implant Removal Surgery

There are a number of different treatment options available to you depending on your desired look and the condition of your current breast implants. During your initial consultation, your surgeon will discuss all of these options to see which approach will be suitable for you. You will need to consider different breast implant shapes and sizes and what look you wish to achieve with your new implants.

Signs that you should be considering Breast Implant Removal / Replacement

• Your implants are `bottoming out` (lateral displacement)
• Your implants have become hard to the touch and misshapen (capsular contracture)
• Your implants have started to move or rotate creating an uneven appearance
• Your implants have moved to creating a gap between your breasts
• You are unhappy with the size, shape or position

Breast Implant Removal Surgery

The procedure is similar to Breast Enlargement surgery. To minimise scarring your surgeon will use your existing scars to remove your old implants, along with any internal scar tissue. The implant pocket is repaired and, if you choose, new implants will be inserted into the pocket. If you choose to increase the size of your implants your surgeon may recommend a capsulectomy to allow room for the larger volume of the implant.

Breast Implant Removal Results

Breast Implant Removal results will vary depending on the type of procedure undertaken. Implant Removal without replacement implants will leave breasts looking smaller and deflated, so an uplift may be considered for smaller, pert breasts. Whereas, an Implant Removal with new replacement implants could have the same appearance ensuring only the people you tell about your surgery will ever know.

Your surgeon will discuss your expectations and potential results during your consultation.

Breast Implant Removal Recovery

Most patients find recovery for a change of breast implants more comfortable than their original surgery as the tissue and skin in the area has already been stretched. If you choose larger implants or combine your procedure with a Breast Uplift (Mastopexy) your recovery will be similar to your initial Breast Enlargement surgery.

Your nurse will advise your about your post-operative recovery guidance before your surgery, however you should be able to return to a light version of your normal daily routine within a few days. We strongly recommend 2 weeks off work following your surgery and avoiding any strenuous exercise for 5-6 weeks.

Breast Implant Removal Options

Following Implant Removal surgery the breast will have a deflated appearance, which is why many women choose to undergo a two-stage procedure. At The Harley Medical Group we have a variety of options available to achieve the desired result.

• Breast Implant Removal: your breast implants are removed and not replaced; no further surgery is performed
• Breast Implant Replacement (Breast Re-Augmentation): your breast implants are removed and replaced with new implants. Depending on your breast tissue and following a conversation with your surgeon your new implants can be the same size, larger or smaller.
• Breast Implant Removal and Uplift (Mastopexy): if your breast tissue has stretched as a result of pregnancy, weight loss, from a large breast implant or as part of the natural ageing process a Breast Implant Removal and Uplift might be the recommended by your surgeon. Your breast implants are removed and new implants are not re-inserted, but the breast tissue is lifted to give a pert natural result.
• Breast Implant Removal and Enlargement with Uplift (Breast Re-Augmented Mastopexy): a combination procedure for those who want to lift and enlarged breasts with stretched tissue.
• Breast Capsulectomy: Capsular Contracture can cause pain and distortion in the appearance of your bust. A capsulectomy procedure removes the capsule which is the lining around your implant and then you can either have the original implant removed or replaced.

When choosing the right procedure we recommend considering:

• The shape of the breast - round or anatomical implants. Do you want your breast lifted or are you happy with the way they sit?
• Size of breast - would you like to be larger, smaller or the same
• Potential risk factors including Capsular Contracture

There are also financial considerations. At The Harley Medical Group we understand that life throws the unexpected at you, and this often comes at a cost. We believe that you shouldn't have to choose between your well-being and life's little surprises which is why we offer bespoke financial packages to suit your circumstances, speak to your practitioner during your consultation who will be able to provide more information.

Following Breast Enlargement surgery, your body will usually form a layer of healthy tissue around the implant to make it a part of your body. This thin layer of natural breast tissue is called the capsule, formed of scar tissue and collagen) and is a natural and healthy part of the healing process.

Capsular Contracture is when, in time, the capsule thickens and hardens the breast causing discomfort and for the breasts to look misshapen and feel hard.

There is a grading system for capsular contracture called The Baker System. Baker I and Baker II are normal and do not require treatment.

• Baker I / Grade 1 – Formation of scar tissue around the implant is not causing firmness or a change to the size, shape or texture of the breasts. Breasts are soft and look natural.
• Baker II / Grade 2 – Patient has some firmness around the implant, but there is no distortion in the appearance of the breast.
• Baker III / Grade 3 – Breasts are firm and may appear abnormal in shape such as round, high, and bulgy on top.
• Baker IV / Grade 4 – Very similar to Grade 3 but patients will also experience breast soreness and may find their breasts tender and painful to touch.

Capsular Contracture is often diagnosed on physical examination and doesn’t usually require any other special tests.

It can occur on one or both implants and generally occurs during the healing process, however it is not unusual however to have Capsular Contracture occur within the first 2 years of the implants being placed.

Capsular Contracture is one of the most common reasons for Breast Augmentation revision surgery and will involve removing the entire capsule which is the lining around your implant and then you can either have the original implant removed or replaced.

If you’re experiencing redness, inflammation or pain, you should always contact your clinic immediately.

• A rupture is where the implant can split; whilst this is rare it can happen so just to make you aware. Ruptured implants are a common cause of late-onset capsular contraction
• Capsular Contracture is where the body builds up too much scar tissue around the implant; this happens in a small number of patients.

If either of these occur, it is more likely to be within the first 3 years; that is why we cover you completely free of charge to have the implants removed and replaced for 3 years from the date of your surgery.

You may not have to replace them but, eventually, they will need to be removed.

Mentor, the world's leading cosmetic brand, with over 25 years of experience in Breast Implant manufacture, places the lifespan of a breast implant at 10-15 years. At The Harley Medical Group we recommend checking your breast implants with an MRI scan, after 10 years and then again annually to ensure the correct state of the implant. After 15 years of having your breast implants we recommend, if you have not already, that you consider Breast Implant Removal and / or Breast Implant Replacement surgery.

Following Breast Enlargement surgery your body gradually accepts the breast implant, however it is a foreign object and your body will react to it in time, in most cases, by rejecting it. The average lifespan of a breast implant is 10-15 years. At this point, the internal scar tissue, that was formed around the implant in the healing process of your initial surgery, will contract.

The scar tissue is known as a 'capsule'. As the capsule contracts it may shrink or become thick or calcified and will impact the shape and feel of the implant – this is when removal or replacement is required.

We cannot say whether Breast Implant Removal is right for you as this is your choice. Yet, if you can say yes to one or more of the following, we recommend you consider undergoing Breast Implant Replacement/Removal:

• Your breast implants are over 10 years old
• You have experienced shifting, sagging, or changes due to age, weight fluctuations, or pregnancy.
• The look of your breasts may have changed since having children or breastfeeding
• You're not happy with the way your implants look or feel
• You have developed a Capsular Contracture where the scar tissue around the implants is getting harder or tighter.
• One or both implants have leaked or ruptured.
• You feel as though you initially choose implants that were too large or too small and you want to change the size of your breasts.
• You want to return to your original breast size.
• You want to change the shape of your breasts, for example, from round implants to a more natural looking teardrop shaped implants.

With the exception of medical need the decision to remove and/or replace your breast implants is one only you can make. If you choose to go ahead our team of breast experts will explain all options available to you and answer any questions that you might have.

In part this will depend on the procedure you opt for.

If you have your implants removed and not replaced then in most cases you will find that the skin retracts to some extent to how they were before your boob job, depending on how much your skin stretch to accommodate your implants. However you may find that you feel they look empty or deflated post-surgery, particularly during the healing process.

If you originally opted for large implants your skin may have stretched too much to return to their original, pre-surgery, appearance. In this instance your surgeon may recommend a breast uplift to remove any excess skin and to give a natural pert appearance following surgery.

If you choose to have your implants replaced you may have a very similar appearance to your current breasts, if this is the result you want.

The help you understand your potential results our specialist breast surgeons will be happy to assess you and discuss what results you can look to achieve

Breast Implant Replacement surgery carries the same risks as Breast Enlargement surgery. The main risks are

• Capsular Contracture is the most common complication following Breast Implant surgery and is one of the most common reasons to re-operate. Following surgery, the body forms a protective capsule of fibrous scar tissue around the implant, which it recognises as a foreign object. This tissue capsule is usually soft or slightly firm and not noticeable, it helps to keep the implant in place. In some women however, a tissue capsule forms that is unusually hard and dense. The capsule tightens around and squeezes the implant, this condition is called Capsular Contracture. Mentor has developed a process to reduce the risk of Capsular Contracture. The implant shell is vulcanised, which means no glue or adhesive is used to make the implant. As there is no seal on the implant so the risk of rupture and capsular contracture is significantly reduced, and this process is so successful it's been patented!
• ALCL stands for Anaplastic Large Cell Lymphoma, the full title is Breast Implant Associate Anaplastic Large Cell Lymphoma (BIA-ALCL), and is an extremely rare cancerous tumour that can potentially grow around breast implants. The occurrence of ALCL affects is estimated at 1 in 24,000 breast implants (Source: Medicines and Healthcare products Regulatory Agency (MHRA) July 2018). It usually appears with a sudden swelling in the breast surrounding the implant, although it can present with a mass. It usually happens many years after the implants have been placed, an average of 8 years. Most cases are easily treated by having the implant removed, along with the capsule that surrounds it (a procedure called Total Capsulectomy).
• Illness refers to a range of systemic symptoms reported by some breast implant patients. Manufacturers track and monitor the systemic symptoms reported to them and report them to the proper regulatory authorities. Whilst the current body of scientific evidence does not support claims that breast implants cause systemic illness, the FDA, in partnership with industry and medical and plastic surgery societies, is taking steps to better characterise the set of conditions and its risk factors and researchers are working to understand the origins of the symptoms.
• Rupture is most commonly caused by trauma to the chest, for example from a car accident or a needle puncture during a biopsy; a human error during surgery. The experienced surgeon will identify and replace or remove the defective implant. Our Mentor Breast Implants® are both FDA approved and CE marked, and have over 20 years of clinical data demonstrating their safety. Mentor is the only implant manufacturer that used an automated machine to dip the implant shell to ensure shell thickness is consistent for all three layers and human error removed.

If you have any questions or concerns please speak to a member of our team at your earliest convenience.

If you are looking to address ruptured implants or implants that have developed Capsular Contracture then usually the doctor you see will be your original breast surgeon.

If you are having a revision surgery not long after your initial Breast Enlargement procedure, we recommend that you at talk to your original surgeon, before going with another surgeon who will perform the procedure. If you want to change your surgeon, try to obtain details such as the size and type of your current implants.

If your surgery is not revision surgery, or you are unable to return to you with your original surgeon, you can choose any surgeon and any organisation to perform your Breast Implant Replacement or Breast Implant Removal surgery.

You used to be able to take your implants following explantation surgery. Nowadays, as a result of recent regulation, medical devices such as breast implants need to be disposed of in a safe and hygienic manner. As breast implants are a type of medical device that could potentially be contaminated, they are disposed of with any other medical waste from your operation.

Once your breast implants have been removed they will be inspected carefully for any signs of damage, if damage is identified we aim to return them to their manufacturer for closer inspection.