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Last year, over 235,000 women had breast augmentation
surgery and over 40,000 had breast implant removal (ASPS
statistics). While breast implants can enhance a woman's
figure, self-confidence, and sensuality, there are occasions
when breast implant removal (explantation) is either
desired or required.
The 3 most common reasons for breast implant removal
surgery are: change in size or shape, implant leakage
or rupture, and capsular contracture. These 3 reasons
comprise over 75% of all implant removal surgery. Other,
less common reasons for implant removal are implant
wrinkling, infection, asymmetry, hematoma, seroma, sagging,
scarring, health concerns, or diagnosis of breast cancer.
For implant removal surgery, IV sedation or general
anesthesia is typically used. An incision is made either
under the fold of the breast or around the areola. The
capsule around the implant is incised (cut into) and
the implant is carefully removed. If the implant is
filled with saline, the surgeon may choose to deflate
the implant to facilitate removal. If the implant is
silicone-filled, it is inspected for any signs of damage
before removal.
The capsule (scar tissue) that was present around the
implant may also be removed (known as capsulectomy)
if the implant is not going to be replaced, if it will
be replaced in a different position (over versus under
the muscle), if it will be replaced with a larger implant,
or if it will be replaced with a breast implant of a
different surface (textured versus smooth).
Other reasons for capsulectomy are silicone implant
leakage, infection, or concerns about the clarity and
accuracy of mammograms if the capsule is not removed.
In many cases, part of the capsule is removed, and some
is not. (The capsule adhering to the chest wall may
be left in place.) This is known as a partial capsulectomy.
Implant removal surgery without capsulectomy may take
about 30 minutes, and with capsulectomy it may take
about an hour. Recovery is fairly quick. Most patients
are back to everyday activities within a few days, and
full activity within 2 to 3 weeks.
NOTE: Implant removal without replacement may produce
psychological distress in some (but not all) women similar
to having had a mastectomy. This is due to the fact
that their formerly large breasts are now much smaller.
They may be even smaller than before the implants were
placed due to hormone changes or loss of weight. In
addition, breast sagging may become more noticeable
after removing breast implants.
This will take some time to get used to, but remember
that it is normal to feel sad or upset after implant
removal, even if you chose to have your breast implants
removed. Sometimes, after a few months the skin over
the breast tissue may contract and the breasts will
not be as saggy and will appear fuller. Depending on
your circumstances and personal preferences, you may
opt for implant replacement either at the same time
as removal, or several months or years later.
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