Breast Implant Removal

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 reaplace them but, eventually, they will need to be removed.

Mentor, the world's leading brand with over 25 years of experience in breast implant manufacture places the lifespan of a breast implant at 10-15 years, and at The Harley Medical Group we recommend checking your breast implants, with an MRI scan, after 10 years and then annually to ensure the integrity of the implant. After 15 years of having your breast implants we recommend, if you have not already, considering breast implant removal and / or breast implant replacement surgery.  

Following breast enlargement surgery your body gradually accepts the breast implant, however is a foreign object and your body will react to it by gradually, in most cases, rejecting it. The average lifespan of a breast implant is 10-15 years. at which 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 know as a 'capsule'. As the capsule contracts it may 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, however if you can say yes to one or more of the following we recommend you consider undergoing breast implant replacement:

• 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 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 repalcement surgery carries the same risks as breast enlargement surgery. The main risks are 

• Casular contracture is the most common complication following breast implant surgery and is one of the most common reasons for the need 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 an 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 (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 commonl caused by trauma to the chest, for example from a car accident or a needle puncture during a biopsy; human error during surgery, which a n experienced surgeon will identify and replace or through implant defect. 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 has an automated machine to dip the 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 we would advise that you see your original breast surgeon.

If you are having revision surgery not longer after your initial breast enlargement procedure we recommend that you at least talk to your original surgeon in the first instance and 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.