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Dr Tim Neavin
Surgery with Symmetry
Dr Tim Neavin

Breast Implant Removal in Beverly Hills

Breast implant removal is becoming more popular among women. For some, breast implants are removed for purely cosmetic reasons. Many women who have had large breasts decide they are a point in their life where they would like to be smaller chested. For others, particularly women with silicone breast implants illness is attributed to the device. This is often referred to breast implant disease (BII). Symptoms of breast implant disease can range from fatigue to pain and mimic automimmune or inflammatory related symptoms.

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Breast Implant Illness (BII)

Breast implant illness (BII) describes a wide range of symptoms that can be related to breast implants that were placed either for cosmetic or reconstructive purposes.   Some doctors and patients also refer to it as autoimmune/inflammatory syndrome (ASIA).  The list of symptoms can include:

  • Fatigue and headaches
  • Hair loss or rashes
  • Muscle or joint pains
  • Depression or anxiety
  • Memory and concentration problems or “brain fog”

It is not entirely clear what causes BII as the illness is not that well understood.  Symptoms can occur shortly after surgery to years later.  They can occur with silicone or saline breast implants in all different sizes.  Symptoms often resolve after breast implant removal (explantation).  Of note, the FDA continues to monitor medical device reports including breast implants and BII.

Ideal Candidates

Patients may want their breast implants removed for any number of reasons whether it be for purely aesthetic reasons or because of related illness.

Breast Implant Removal for Cosmetic Reasons

The desire to have smaller breasts has been trending. Maybe your C or D cups were fantastic when you were younger, but you are at a different stage of your life and large breasts no longer fits your lifestyle. Or, perhaps they have dropped and look terrible. Conversely, maybe one moved higher and got harder as is the case with capsular contracture. Whatever the reason, the decision has been made: remove my implants.

Reasons for Breast Implant Removal

Breast implants aren’t immune from problems. While the satisfaction rate remains one of the highest among all plastic surgeries performed, many patients develop complications or wish to just downsize to look different.

How Breast Implants Alter Tissue

After years of carrying around breast implants, there are certain changes to the breast and surrounding tissues. For one, the breast tissue atrophies, or shrinks. This phenomenon is related to the pressure of the implant against the tissues for a prolonged period of time. It is interesting, that even after the removal of breast implants, the tissue can continue to shrink albeit at a slower rate than if the implants remained. The shrinking of breast tissue is not the only area that thins out. The chest wall also can develop concave deformities over the ribs. This is not noticeable when the implants are in the body. However, sometimes with explanation in women who are very thin there could be a slight depression. In women with reasonable amount of breast tissue and who have slight to moderate chest wall atrophy, there may be no visible depression.

Another way breast implants alter tissue is when the scar tissue around the breast implant becomes hard. This tissue reaction is called a capsular contracture and can cause pain or breast implant malposition. More on capsular contracture here.

What is the Cost of Breast Implant Removal (Explantation)

Because the procedure can sometimes be performed under local anesthesia or general anesthesia, the operating room costs can very.   In addition, depending on whether a breast lift is included or if significant internal scar tissue needs to be removed the surgeon fee can vary widely.  Please inquire within and feel free to share photos for a rough price estimate.

To learn more about Dr. Neavin and his credentials click here.

What Happens if my Breast Implants are Removed but not Replaced?

Breast implants are generally removed from the same incision where they were placed. An exception is implant removal from the transumbilical approach (TUBA) since the scar with this surgery is within the belly button. Sometimes the scar needs to be slightly enlarged if extensive internal scar needs to be removed. But most of the time, there are no new scars placed on the breast unless a breast lift is performed with the explantation. If breast implants are removed and not replaced, the skin will tighten to a certain degree dependent on implant size and tissue properties of the individual. In many patient’s the breast after removal look perfectly fine and natural. In others, a lift may be required to restore a more pleasing shape.

Are my Breasts Going to Sag After Breast Implant Removal?

A common question that patients ask is, “Will my breasts sag after the breast implants are removed?’. The answer is sometimes yes and sometimes no. As a general rule, if the breasts were saggy with the implant they will likely sag after the breast implant is removed. If the breasts are not saggy during the time of breast implant removal then they probably won’t sag after surgery. It all really depends on the tissue and implant size.

Will Insurance Cover Breast Explant Surgery

Insurance companies sometimes will cover some or all of the costs of breast implant removal. It depends on the reasons behind the removal as well as the insurance plan. For purely cosmetic reasons, it is unlikely that explanation surgery will be covered. An exception may be implants that were placed for reconstructive reasons.

Fat Transfer to the Breast

Many women who have breast implants removed will like their shape improved or still retain some volume. Fat transfer to the breast is a wonderful way to satisfy those goals. The patient, however, must have adequate fat for transfer. This can be a challenge in thin women.

Fat transfer to the breast can be combined with breast implant removal or it can be performed after the breasts heal. Sometimes, it is better to wait a few months after the breasts heal because the healing process often tightens the breast tissue.

Breast Implant Removal Surgery: What to Expect

Saline and silicone breast implants can sometimes be removed under local anesthesia in the office. But internal scar tissue (capsule) cannot be removed while the patient is awake. For implant removal and capsulectomy general anesthesia is required.

When capsulectomy is performed along with explantation the surgery may take two hours or longer. Temporary drains are placed and the chest is wrapped. The drains are generally removed (painlessly) in the office in a week or less. The tissue will quickly start to tighten over the span of 3-6 months.

If a breast lift is performed along with the explantation, there may be additional incisions that need to heal and recovery time may be longer.

Consultation for Explantation

You will meet with Dr. Neavin either virtually or in person where he will review your medical history. Operative notes are helpful to have at hand but not mandatory. Dr. Neavin will examine your breasts and take measurements. Based on desires and expectations, options will be presented ranging from explanation only, to capsulectomy, and breast lift. One stage or more than one stage approaches will also be discussed.

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