While breast augmentation has given countless women the ability to enhance and refine their breast contours, implants are not meant to be lifetime devices. Whether for personal reasons, complications that have developed since surgery, or a shift in lifestyle or preferences, patients make the decision to revise or completely remove their breast implants for a myriad of reasons.
The most important part of identifying the best path forward is to talk about your concerns with a board-certified plastic surgeon, which is why Dr. Neal Goldberg makes patient education a top priority. Below, he outlines candidacy factors for implant removal and breast revision, respectively, and how women considering a secondary procedure can gauge the best possible option for their needs.
Distinguishing Between Implant Removal and Revision
Breast revision (or replacement) involves exchanging implants and/or addressing complications. With breast revision — also called secondary breast augmentation — patients often update the implant size, fill material, shape, surface texture, or placement location according to their current preferences.
Breast implant removal, also called explant surgery, involves removing implants (and, often, the entire scar capsule) without replacing them. Since implants stretch the skin and tissue over time, many patients combine removal with complementary techniques like a breast lift to restore and rejuvenate their natural contours. Another option after implant removal involves fat transfer, wherein excess fat is harvested from another area of the body and injected into the breasts to add softness and fullness. The right treatment plan for each patient depends on motivations, anatomical factors, and overall goals.
Reasons for Breast Revision
Over time, women may revisit their breast implants for a variety of reasons, such as:
- Capsular contracture: Scar tissue around the implant tightens and causes firmness, distortion, or pain
- Rupture: An implant suffers a leak, tear, or break
- Rippling: Obvious implant edges that are seen or felt through the skin
- Changes in preferences: Some women upgrade from saline implants to more natural-looking options, such as silicone and form-stable devices, or simply desire a change in size/shape
- BIA-ALCL symptoms: BIA-ALCL is a rare cancer of the immune system that has been linked primarily to textured implants. Those who notice potential BIA-ALCL symptoms, such as swelling, changes in their breasts’ appearance, or pain, may choose to switch to smooth-textured implants for medical reasons. Dr. Goldberg only utilizes smooth, FDA-approved implant options to maximize patient safety and can exchange textured implants for smooth implants if a patient desires.
Reasons for Breast Implant Removal
As life moves forward and individuals enter different life stages, patients often consider explantation due to:
- Shifting preferences: Many people experience changes in their body, lifestyle, or preferences over time and may no longer think their breast implants feel authentic
- Health concerns: In some cases, patients may feel concerns about the potential for BIA-ALCL (breast implant-associated anaplastic large cell lymphoma) and prefer to remove their implants altogether for their own peace of mind
- Suspected Breast Implant Illness (BII): Breast Implant Illness involves systemic symptoms such as fatigue, joint pain, and cognitive difficulties, which are sometimes suspected to be caused by implant placement through a process of elimination. Although there’s no formal diagnosis for the condition and research is ongoing, some patients report reduced or eliminated symptoms after removing their implants.
Key Takeaway — Consult with an Experienced Plastic Surgeon
There is no universally correct choice between implant removal and replacement. If you value the appearance of your implants and need to address a complication or want a change in type/style, breast revision with implant exchange may be the best option. For those who prefer to live without implants for health, lifestyle, or personal reasons, breast implant removal may be a more ideal solution. We encourage you to consult with Dr. Goldberg and spend time reflecting on your reasons for surgery so you can reach a decision that feels right for you.
Unlike other plastic surgeons, Dr. Neal Goldberg has completed training in both aesthetic and reconstructive procedures, giving him the unique skillset necessary to perform breast implant removal and revision surgery. The first step in determining the right solution is an open, transparent consultation. Don’t hesitate to contact Dr. Goldberg today to book an appointment or to learn more about our services.