For various reasons, some women wish to have their implants removed and not replaced. Consequently, they wonder what their breasts will look like once the implants have been removed.
What is a breast explant procedure?
A breast explant procedure involves removing the implants. This surgical procedure in its own right is generally definitive, in other words, the idea is to keep a feminine bust without implants. Otherwise, it is breast implant revision.
Patients who wish to definitively have their implants removed often worry about how their chest will look after explant surgery. What do breasts look like after the removal of breast implants? Do they recover their initial shape? What solutions are available to recover beautiful natural breasts without implants after explant surgery?
Why and when should you have your breast implants removed?
We will address here the case of patients who wish to have their implants removed without replacing them with new ones. So goodbye to the replacement of breast implants inherent to their life span or changing for implants of different size or shape.
- One of the main reasons is simply a desire or personal need. How we perceive ourselves and the image we wish to portray can change over time. After a certain number of years, women sometimes wish to recover a natural chest. A syndrome known as Breast Implant Illness (BII) has been reported for some years now. It concerns patients with breast implants presenting bothersome clinical signs for which no cause can be identified. These clinical signs can include dry syndrome, joint pain, and digestive disorders and patients are intimately convinced that their implants are the cause. Breast explant surgery seems to be the only solution to their unexplained ailments.
- Women’s breasts can also change throughout their life. An increase in volume can be observed in the years following breast augmentation due to pregnancies, weight gain, or hormonal changes linked to the menopause for instance, and in this case, the appearance of the breasts no longer corresponds to expectations.
- Although they are rare, complications can also result in the definitive removal (or revision) of breast implants for example due to the formation of an unsightly and/or painful periprosthetic capsular contracture, or if the implant has ruptured (this is more particularly the case with implants filled with saline solution and the breast « deflates ») or leakage of the silicone. To avoid any risk of further complications, the patient can thus decide to have the implants removed definitively.
- Finally, when the implant is too old, it is necessary to remove it: the patient can decide whether or not to undergo another breast augmentation with implants. The life span of an implant is about 10 years but that does not mean it should automatically be changed at that time. The life span of a healthy implant with no anomaly confirmed by an MRI can be longer. Regular monitoring is essential to know when breast implant revision is necessary or not.
However, there are « false good reasons » to want to have the implants removed. Indeed, having breast implants does not prevent breastfeeding or detecting breast cancer, and no link has been established between the insertion of implants and mammary carcinomas.
The PIP breast implant scandal worried numerous women who did not have this type of implant but who, anxious about the associated risks, thought it was better to have their implants removed.
For this reason, and as a precautionary measure, the ANSM (French National Agency for Medicines and Health Products) decided to ban macro-textured and polyurethane-coated implants. However, preventive removal was not recommended except for women with PIP implants.
Breast explant surgery: with or without capsulectomy?
A capsulectomy involves also removing the fibrous tissue, the implant capsule, that the body has created around the implant. It must be carried out in the case of complications or when the implants are suspected of causing issues (Breast Implant Illness). This is known as an en-bloc capsulectomy.
What will my breasts look like once the implants have been removed?
It all depends on the quality of your skin and even more so if there is excision of the implant with capsulectomy.
- If your skin is tonic and elastic, and with no capsulectomy, the capsule will eventually decrease and the breasts will recover approximately their initial size and shape. This is the case most of the time.
- If the skin is thinner, even damaged, then the breasts may look as if they are sagging, flat, and deflated.
Solutions exist to naturally reshape the breasts without requiring implants and, therefore, a foreign body.
How can the breasts be reshaped after removing breast implants?
If you do not like the appearance of your breasts once the implants have been removed, there are several solutions available to correct their appearance while avoiding the use of implants:
Breast lipofilling – or breast lipomodeling – can be used to increase the size of the breasts without breast implants. It is an autologous fat graft: the fat is harvested directly from the patient – abdomen or hips depending on areas available – filtered and purified, then reinjected into the breasts using an extremely fine cannula. With lipofilling you can gain one cup size in one session. This operation leaves no scars and the result is perfectly natural to look at and touch. However, it is strongly recommended you maintain a stable weight (if you lose weight you will also lose breast fat).
In the case of sagging breasts, it is possible to combine a breast lift with lipofilling, again with no addition of a foreign body: I remove the excess skin and lift the breasts thus restoring firmer, more harmonious-looking breasts. Depending on the severity of the ptosis (slackening of the skin), the incision can be areolar (circular around the areola), areolar and vertical, or areolar vertical and horizontal along the fold under the breast.
In any case, if you are thinking about having your breast implants removed, a consultation is essential because each case is different. During the discussion, I will advise you on the best approach and the most suitable solutions depending on your case and your desires.