When and why should I have my breast implants removed?

There are a number of situations where patients might wish to have their breast implants removed. Here to outline and explain the various reasons why patients may wish to do so is highly esteemed consultant aesthetic, oncoplastic and reconstructive surgeon, Mr Maisam Fazel. 

In our latest article, the revered doctor outlines when breast implants should be removed whilst also revealing what a capsulectomy is and why the procedure may be required when removing breast implants. 

When should breast implants be removed?

The most common reason why patients want their breast implants removed is simply because they no longer need them. Typically, patients would have had them placed when they were younger and then when they grew older, they may have felt as though they no longer needed or wanted them, and so they asked for them to be removed.

Sometimes, patients’ breast implants are removed if there is a concern. For example, if there is an infection, which is very rare, or if the implant has ruptured.

Also, patients might wish for their breast implants to be removed if there is a concern about ALCL. In such a case, the breast implant needs to be removed together with all of the capsule so that it can be sent off for analysis. Also, when a breast implant has become capsulated (significant scarring around the implant), patients may then opt to have their implants removed, and in some cases, exchanged.

In my practice, I have seen many patients who have been worried about breast implant illness. Although this is not a recognised medical condition, there are some patients who have had implants who have developed a variety of symptoms ranging from new allergies, hair loss, fatigue, joint pain and finding it difficult to concentrate.

Typically, blood tests don’t show anything, but such patients report feeling better as soon as they have their breast implants removed.

Is breast implant removal a safe procedure?

Any operation carries with it some element of risk, but yes, this is a safe procedure. In my practice, I would tend to perform this surgery as a day-case procedure, which typically takes about an hour even with an en bloc capsulectomy. I don’t use any drains and use dissolvable sutures.

There is a specific bra that I ask all patients to wear, which is designed to help mould the residual breast tissue back into shape. Overall, it is a very safe procedure but, as always, patients should be aware of the risks and limitations involved in any procedure.

How often is a capsulectomy needed?

A capsulectomy is needed if there is a notable capsule present. So, if the implant feels firm, painful, and/or deformed, then a capsulectomy would be recommended. If there is a concern about ALCL, then the patient definitely requires a capsulectomy in order for the capsule tissue to be analysed.

Occasionally, particularly in patients who are considering having their implants removed due to concerns over breast implant illness, they will ask for the capsule to be removed.

What are the different types of capsular contracture?

Capsular contracture is divided into four main grades. Grade one is where you have soft breasts with minimal symptoms. Grade two is when they are slightly firm but are not particularly painful. Grade three is when the breasts are firmer and deformed, and grade four is when the patient has hard, painful, distorted breasts.

How is a capsulectomy performed?

Capsulectomies can be performed in a variety of ways, and the manner in which it is performed depends entirely on why the procedure is being done and what the patient wants and is hoping to achieve.

So, in cases of capsulation, if we are performing a capsulectomy simply for symptom relief, then it would be reasonable to perform what is called an anterior capsulectomy, which is performed to remove the capsular tissue that is on the front of the implants.

If we are removing all of the capsule tissue, that would be a total capsulectomy. In my practice, the majority of the time, I perform an en bloc capsulectomy, where the entire implant is taken out with the whole capsule surrounding it. Then, once it is out of the patient, the capsule is then opened to take the implant out, and then, if necessary, we would send the capsule off for analysis if there was a concern.

Is a capsulectomy a safe procedure?

A capsulectomy is indeed a safe procedure and should be performed by a breast specialist and someone who regularly performs this kind of operation, rather than someone who dabbles in cosmetic breast surgery.

Mr Maisam Fazel is a revered consultant aesthetic, oncoplastic and reconstructive surgeon who specialises in breast reconstruction and breast implant removal. If you are considering having your breast implants removed or if you are considering a breast augmentation, make sure to check out Mr Fazel’s Top Doctors profile to book a consultation with him.