Breast Procedures » Breast Implant Removal

Breast Implant Removal

Your breast implants may have been your faithful companions for many years — but they don’t last forever and there will come a day when you may be considering implant removal.  I have a lot of experience with implant removal in my Seattle practice and have presented papers on this topic at various Washington State and Northwest plastic surgery forums.  As of 2016, I take out more implants that I put in.

Breast Implant Removal

Implant removal and breast lift.

Quick Facts about Breast Implant Removal

  • Costs: Simple removal under local anesthesia about $2700.  This is usually only appropriate for implants that have not been in for very long.    See the fine print.
  • Costs:  Implant removal and removal of scar tissue around implant under a general anesthetic $5700 – $7000 depending on the length of surgery.  Removal of scar tissue from around the implants is recommended for implants that have been in a long time and/or implants that have thickened scar tissue.   See the fine print.  Rarely insurance will cover this surgery.  I do not contract with any insurance companies but am happy to provide operating reports, photos, codes and such for patients seeking reimbursement from their insurance companies.  For more information on my financial policy, see this page.
  • Costs:   A breast lift done at the same time of implant removal adds about $7000 to the cost.
  • How much it hurts: Simple removal, not much.  More complex removal, quite a bit.
  • Time off work or school:  2 days – 2 weeks depending on extent of surgery and occupation.
  • Time until driving again: 2 – 7 days or until you are off narcotic pain meds.
  • Time in post-operative bra: 3 weeks.
  • Time off the gym:  usually 4 weeks.
  • Time off the slopes:  usually 4 weeks.
  • Time off the kite board:  usually 6 weeks.
  • Patient satisfaction:  all over the place from ecstatic to have them out to kind of depressed about having smaller breasts. 

Check out this video showing removal of 30+ year old leaking gel implant along with its capsule.

Check out this video showing a ruptured cohesive gel implant.  


Implant Removal

Implant removal and breast lift.

The fine print about breast implant removal.

There are many reasons why a woman may want to have her breast implants removed. The implants may be old first or second generation implants and have become hardened, distorted and uncomfortable over the years because of surrounding scar tissue . In other cases, the implants may have leaked or ruptured. Many women, even when thin and small breasted when young, put on weight during the menopausal years and that weight often goes to the chest. A woman with implants may find herself in the position of being too busty and feeling and looking a little matronly. Sometimes when women get older, they just feel silly having implants. I have even had patients who have a major life change (entering a nunnery, for example) and feel their implants no longer reflect their true selves.

I also see women who have perfectly intact and soft implants and a nice aesthetic result who are convinced their implants are ruining their health.  The controversy of breast implant illness is not a new one.  I started private practice in 1991, just as silicone breast implants were coming under fire for causing systemic disease, most notably autoimmune diseases.  I remember this time as one of great confusion and concern on the part of plastic surgeons and our patients.  It was also a media three ring circus and legal feeding frenzy.  Silicone gel implants were taken off the market only to return to the market in 2006 after many studies and some substantial improvement in their design and performance.  Current breast implants are more studied and scrutinized than any other medical device.  The difference with the current breast implant illness question is that both silicone gel implants and saline implants (which were never taken off the market) are under fire.  I have done implant surgery, both cosmetic and reconstruction, on hundreds of patients over the years and, to my knowledge, I have never had a patient develop breast implant illness.  I have had my share of implant problems such as rupture, hardening, malposition, too big, too small, too high, too low, etc. but never have I had one of my implant patients come in ill with a long list systemic complaints.  It may be that there is a very, very small subset of individuals who have an unusual sensitivity to silicone?   I try to keep an open mind.

Removal of implants can be fairly easy and straight forward or very difficult depending on the condition of the implant and scar tissue and the patient’s anatomy.  Paradoxically, sometimes the nastiest, ruptured implants with the thickest and hardest capsules are the easiest to remove!  I most cases, I think it is important to remove as much of the scar capsule around the implant as possible.  Leaving the capsule behind can result in a lump of scar tissue that can be felt and can make mammograms difficult to read.  If left behind, the scar tissue can result in fluid accumulations that require drainage. I think it’s best to get the scar tissue removed at the time of implant removal rather than having to go back later if there is a problem.  If an implant is ruptured, it is usually possible to minimize spillage of silicone gel.  Most of the disturbing photos of ruptured implants show the implant after it has been removed and spread out for a photo.  It is a very rare situation in which that big ugly mess is actually all spread out in the patient.

And a word about “en bloc” removal.  “En bloc” is a term most commonly used in cancer surgery.  It means that the tissue surrounding the cancer is removed without actually cutting into the tumor itself.   I often will remove implants and the capsules “en bloc” especially if the implants are ruptured gel implants.  “En bloc” removal means that there is no spillage of gel and nothing to mop up.  Also there is something very pleasant and satisfying about a clean “en bloc” removal that is hard to explain to a non surgeon.  So, yes, I go for an “en bloc” removal.  But sometimes, especially with saline implants, “en bloc” removal is just not possible.  The capsule is too thin and friable and adherent and it is just technically impossible to remove it in one piece without running the risk of collapsing a lung, causing major bleeding or killing a nipple.  In cases like these, I use a curette to scrape the adherent capsule away and do my very best to remove as much of it as possible.

And a word about the rare but very creepy Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL):  This malignancy is not breast cancer but rather cancer of the implant capsule.  How weird is that???  It appears to be limited to patients who have or who have had textured implants and/or tissue expanders.  The symptoms and signs of ALCL are seroma (fluid collection), a mass, breast pain and/or swollen lymph nodes.  As of 2020, I have sent 10 sets of capsules for BIA-ALCL testing (two of which I would have bet the farm (if I had a farm) that they would come back positive.   All 10 cases came back negative.  Proper explant and capsulectomy is usually curative for early BIA-ALCL although sometimes chemotherapy is recommended.  Early diagnosis and treatment, as with almost all cancers, is key.  For patients with textured implants, I am especially OCD about getting 100% of the capsule out and I have a very low threshold for sending the capsules for pathological analysis.  Any patient with fluid between their implant and capsule gets the fluid and the capsule sent off for analysis.  I occasionally have patients with smooth implants, no fluid and normal looking capsules insist on pathological analysis for BIA-ALCL.  I can certainly do this although it makes the receiving pathologist scratch his/her head and it is very expensive, $4000 or more.

A common concern is the appearance of the breasts after implant removal.  It is unrealistic to think a breasts will snap back to the way they were before implant surgery especially if the implants are large, have been in a long time or have resulted in a lot of scar tissue.  That being said, it is almost always possible to do something to help restore the breast to a pleasing appearance. This may involve replacing the old implant with a new one or it may involve lifting the deflated breast  and making it “perky”.   Sometimes fat transfer several months after removal of the implant can improve the shape and fullness of the breasts.  Sometimes women elect to have nothing done and are satisfied with just removal.  I have to say that it is a very, very rare patient who misses her implants.

I have had patients who have suffered for a decade or more with old, hard, painful implants and lived in fear that nothing short of removal of the implant and the breast could be done. This is not the case at all.  Some of my happiest patients are ladies in their 60’s and 70’s.  After years of rock hard breasts, they have their implants removed and a lift and find themselves implant free with a soft and youthful chest and maintenance free chest.

So, if you are at a time in your life where implants are either a nuisance or a worry, come on in.  We can discuss your options and get you on your way to that next stage in your life implant free.

Please see my gallery of photos for some examples of breast implant removal.

Here’s my blog on breast implant illness.

Check out my blog on this topic.

To schedule a consultation with me, please call 206 467-1101.

Follow me on Instagram:  @sowdermd and @breastimplantsanity.

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