Breast Implant Removal

The breast implants are removed through the same incisions created for the breast augmentation surgery. The existing scar in the inframammary fold is excised, the capsule surrounding the implant is opened (capsulotomy) and the implant is removed. The pocket is washed out and the skin incision is closed.

If the implant has ruptured or there is capsular contracture, then the capsule surrounding the implant is removed with the implant inside (this is called a capsulectomy). A capsulectomy is not routinely performed with breast implant removal as there is no evidence it makes a difference to the outcome, but it does increase the risk of complications.

The procedure takes less than one hour to perform and is commonly performed under a general anaesthetic (you will be fully unconscious during the procedure). Providing there are no complications, you can expect to go home on the day of surgery.

This is not a particularly painful procedure, and you should only require simple analgesia, such as Tylenol and Ibuprofen, for a few days.

Having cosmetic surgery should be a very positive experience and decisions about surgery should never be rushed.

Complications are infrequent and usually minor. However, all surgery has risk, and it is important that you are aware of the possible complications. All the risks will be discussed in detail with you at your consultation. However, if you have further questions or concerns, please do not hesitate to discuss them with me.

These risks can be divided into those specific to the surgery and those that relate to the anaesthesia.

General Anaesthetic risks: An anaesthetic is very safe, however, should a complication arise, the relevant medical expertise is immediately available to deal with this.

The risks increase if you have certain medical problems, which will be discussed at length during the consultation. The risks include:

• Unintended intraoperative awareness, which is very rare.
• Dizziness and nausea.
• Sore throat.
• Damage to teeth or mouth.
• Nerve injury due to body positioning.
• Allergic reaction or anaphylaxis.
• Malignant hyperthermia, which is a rare life-threatening condition.

The anaesthetist will go through these risks in more detail prior to your surgery.

Scars: These are hidden in the crease under the breast, using the existing scar from the original breast implant insertion. They normally settle remarkably well, so that the scars are barely perceptible. However, some patients heal with thick, thin or stretched scars, which can be noticeable.

Bruising and swelling: A degree of swelling and bruising is normal, and this may take approximately 2 weeks to settle.

Haematoma: This is clotted blood that collects in the breast. It occurs in 1 to 4 percent of women who undergo a breast reduction. If a haematoma develops, it is likely to do so within 4 to 6 hours post-surgery.

Any increase in swelling or pain should be reported immediately for assessment. Should the haematoma be significant, it will have to be washed out in theatre and any bleeding vessel(s) identified and cauterised. This does not normally delay your recovery or change the cosmetic result.

Infection: The risk of infection is inherent with any surgical procedure, albeit very uncommon in elective breast procedures. Antibiotics are administered during surgery and for 7 days after surgery to minimise the risks. Less than 1% of patients develop an infection post-operatively and rarely require any intervention, apart from further antibiotic treatment.

Numbness, reduced sensation or oversensitivity: A reduction in nipple sensation may occur in most patients who have implants, which often improves to some degree with time. However, this may never completely return to normal. Nipple sensation should not change significantly after implant removal.

Asymmetry: Each breast is slightly different and will continue to be so following surgery; remember that they are “‘sisters and not ‘twins” However, if you have noticeable asymmetry prior to your surgery, then this can be corrected as part of the surgery as discussed with you.

Wound healing problems: These are rare but can occur, and healing difficulties range from minor problems, such as small scabs or areas of wound separation, to more significant issues that may require scar revision.

Patients who have diabetes, smoke, are obese or elderly are at an increased risk of delayed healing.

Fat necrosis: Sometimes areas of fat within the flap scar form hard lumps called fat necrosis. Usually, no specific treatment is required, and the problem settles down over approximately a 12-month period.

Breastfeeding: This will not be affected by implant removal but can be affected if you choose to have an uplift (mastopexy).

Deep Vein Thrombosis/Pulmonary Embolism (DVT/PE): Following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and travel to your lungs. If the blood clot is large enough, it could prove fatal.

The overall risk for cosmetic surgery is less than 1%, but in order to reduce any risks of a DVT/PE, you will be provided with special stockings to wear in bed together with a blood thinning injection, if you are not mobile or have previously had a DVT or PE.

All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to discuss these with me. Decisions about cosmetic surgery must never be rushed and requires personal research.

Your incisions will be closed with dissolvable sutures, which do not require removal.

I use a waterproof dressing which will be removed after 1 to 2 weeks following surgery.

You can shower as soon as you like after surgery, and you will be given spare dressings in case they become wet and need changing.

I will prescribe you 7 days of antibiotics to be taken after surgery to reduce any risks of infection as the incision heals.

You must wear a support bra for 6 weeks and that you purchase 2 bras, so you have one to wear and one in the wash. These are worn day and night for approximately 6 weeks post-surgery, before returning to any bra of your choice. You will need to purchase these prior to your surgery, and I will provide the relevant details in clinic. Details can also be found in the compression garment guide below.

Initially, your breasts may seem larger than you expected. This is normal and it is partly due to swelling and it takes time for you to get used to your new appearance.

Before you leave the hospital, you will be given a follow up appointment to see the nurses at one week to check your incisions and an appointment to see me in 2 weeks. You will not be able to drive yourself home from hospital and, ideally, you should have someone to stay with you for a few days to assist you. If you have any concerns during this period, do contact the clinic for advice.

Scar advice
Once the dressings are removed, I recommend that you massage the incisions, using small circular motions at least twice a day for 5 minutes. You can use any moisturising cream of your choice and apply firm pressure until it blanches.

The scars will also benefit from silicone scar gel (ScarAway® or Kelo-Cote®) twice a day, which will soften and fade them, as well as applying sunblock for 12 months to provide sun protection.

The ScarAway® can be purchased from Healthcare Pharmacy at Governors Square in Grand Cayman.

When you get home, you should take things easy for the first week. Most people take a few days off from work. You should be able to drive by one week, return to the gym for lower body work after 2 weeks and begin upper body exercises at 3 weeks.

Remember, to help shape and support your breasts as they settle, you will need to wear your support bra continuously for 6 weeks.

If you have any concerns during this period, do contact the clinic for advice.

Surgical fees are a combination of the hospital costs, the surgeon and anaesthetic fees and any consumables such as implants. I do not charge an additional fee for post-op appointments. The fee is based on the surgical time rather than procedure. This means that the costs are calculated fairly, and complex patients may have higher costs than routine patients. You will be given a quotation for surgery within 48 hours of your consultation.

Breast Implant Removal - Patient Information

Breast Implant Removal - Nicotine and Surgery

Breast Implant Removal - Pre-Op Instructions

Breast Implant Removal - Post-Op Instructions