BREAST IMPLANT REMOVAL (BREAST EXPLANT SURGERY)

After having a breast augmentation, most women choose to have breast implants for the remainder of their lives, nonetheless there are times when the removal or repositioning of breast implants is desired and/or necessary. A woman in Orange County who has had a breast augmentation procedure may ask for Dr. Farbod Esmailian to perform breast implant removal surgery or explant surgery to take her implants out without replacing them or to remove and then replace her breast implants with a different size, shape and/or type of implant.

WHY WOULD A WOMAN CHOOSE TO HAVE BREAST IMPLANT REMOVAL IN ORANGE COUNTY?

A woman’s motivation for implant removal varies. As a double board-certified plastic surgeon in Orange County who specializes in performing procedures relating to the breast, Dr. Farbod Esmailian can perform breast explant surgery for women who would like their current implants removed and replaced or for women who would like have their breast implants removed altogether.

REASONS A WOMAN IN ORANGE COUNTY MAY CHOOSE TO HAVE BREAST EXPLANT SURGERY INCLUDE:

  • At the current stage of her life, she may be experiencing discomfort because of her larger, fuller breasts, which now feel too heavy.
  • A woman may want to have a breast explant procedure due to dissatisfaction with her augmentation results. These women may choose to have their current implants removed and replaced by Orange County breast specialist Dr. Farbod Esmailian.
  • A patient may want Dr. Esmailian to switch out her implants for a different size, shape or type.
  • A woman’s breasts may be getting in the way of her personal life, especially if she is active.
  • A patient may want her implants removed because they have moved to an undesirable location.
  • The patient would like to return to her natural cup size. Dr. Esmailian can address this with a breast explant procedure in conjunction with a breast lift or a fat grafting procedure. During breast removal surgery, Dr. Esmailian can reshape the patient’s breasts, restoring them to their natural appearance.
  • Patient may be experiencing some signs or symptoms (Breast Implant Illness, BII) that can not be attributed to any other medical condition and a complete work up has been performed.

MEDICAL ISSUES REQUIRING BREAST IMPLANT REMOVAL

There are also medical issues that could require breast implant removal. These medical issues include breast implant complications, infection, issues related to the tissue surrounding an implant such as capsular contracture, pain and necrosis may require breast explant surgery.

MEDICAL ISSUES THAT MAY LEAD TO BREAST EXPLANT SURGERY INCLUDE:

IMPLANT LEAKS OR RUPTURES

Saline and silicone implants can both leak and/or rupture. These complications occur when the outer silicone shell of an implant is broken down or has a hole in it.

Silicone implants may have what is referred to as a ‘silent rupture.’ If silicone implants rupture or shell breaks down, due to the thick consistency of the silicone used in the implants today, the silicone remains within the implant’s capsule and in one form. For this reason, ruptures to silicone breast implants are diagnosed with the use of magnetic resonance imaging (MRI). In most instances, the rupture is silent and no physical exam could diagnose it. However, in certain cases, there may be subtle changes.

SUBTLE CHANGES OF A COMPROMISED SILICONE BREAST IMPLANT CAN INCLUDE:

  • Lumps over the chest area and/or implant (silicone granulomas). More with the older silicone implants.
  • A breast that feels smaller.
  • Inflammation.
  • Pain.
  • Changes in breast sensation.
  • Tenderness.
  • A burning sensation.
  • A change in the shape of the implant.
  • Uneven looking breasts.

SOME OF THE REASONS IMPLANTS LEAK OR RUPTURE INCLUDE:

  • Damage caused by surgical instruments during procedures involving the breasts (e.g., biopsies, fluid drainage, etc.).
  • The pressure resulting from squeezing the implant during a mammogram.
  • The development of excess scar tissue around the implant (capsular contracture).
  • A defective implant.
  • The underfilling or overfilling of a saline implant.
  • Physical trauma or intense pressure.
  • The normal deterioration of the implant due to its age.
  • Fold flaw. More common when an inappropriately large sized implant is placed in a smaller breast.

RIPPLING OF A SALINE IMPLANT

Rippling occurs when a layer of tissue has thinned out and you can see and/or feel the shell of the implant. This is more common in patients with saline implants.

SALINE IMPLANT DEFLATION

Deflation occurs when the implant’s shell becomes compromised and the saline exits. The saline is safe and naturally absorbed by the body.

COMPLICATIONS DUE TO CONSTRICTION AND DISPLACEMENT

If an augmentation was performed by an inexperienced surgeon resulting in complications, breast explant surgery may be necessary. Dr. Farbod Esmailian can perform an Orange County breast implant removal to address implants that are constricted or displaced.

Constriction and displacement may result due to improper placement of the implant or because there is a strain being placed on the implant by the excess scar tissue that has developed around it. This complication is referred to as capsular contracture.

CAPSULAR CONTRACTURE

When excess scar tissue develops, it squeezes the breast implant as well as pulling on the surrounding tissues. This eventually results in the breast itself becoming firm, appearing irregularly shaped and sitting higher on the patient’s chest. Dr. Esmailian can address capsular contracture by performing a an en bloc capsulectomy or an open capsulotomy with permanent removal of the breast implant or replacement.

ADDRESSING CAPSULAR CONTRACTURE:

  • En Bloc Capsulectomy – During a capsulectomy, Dr. Esmailian removes all the excess scar tissue that has formed around the implant’s capsule as well as the implant all together. Once the scar tissue is removed, patients that are not having implants placed may benefit from a lift and/or fat transfer to restore some of the volume, especially in the upper pole. In patients who are undergoing implant placement, in certain cases a new implant will be placed with placement of a dermal matrix, Strattice. Strattice has been shown to decrease the chance of recurrent capsular contracture. This dermal matrix adds an extra layer of protection and, since the body naturally produces collagen, patients do not have to worry about having a reaction to this innovative product.
  • Open capsulotomy – An open capsulotomy involves Dr. Esmailian cutting the scar tissue capsule that has developed around the breast implant open. He accomplishes this by creating small incisions. Some of the capsule itself may be removed. Dr. Esmailian’s goal is to have the capsule pop open to give the implant additional room to move around within the capsule. Sometimes, he replaces the existing implant with a new one. This procedure is more commonly performed with patient with a tighter capsule with no thickening and in patients who are going larger.

INFECTION

If an infection develops, the breast implants may need to be removed. Replacement can happen in 4-6 months. This is a very rare incident.

PAIN

As time passes, some women with large breast implants begin experiencing pain in their necks, backs and shoulders. Breast explant surgery in Orange County can be used to decrease or eliminate these symptoms.

NECROSIS

If the tissue surrounding an implant dies, breast implant removal is required. Tissue death may result from infection, the use of products that contain nicotine and smoking (vaping), excessive hot or cold therapy as well as from chemotherapy/radiation.

BREAST IMPLANT ILLNESS (BII)

This rare condition results when the patient’s body adversely reacts to the presence of her breast implants.

SYMPTOMS OF IMPLANT ILLNESS (BII):

  • Hair loss.
  • Fatigue.
  • Thinning skin.
  • Pain in the ribs and chest.
  • Brain fog.
  • Depression.
  • Dry skin.
  • Memory loss.
  • Pain in the muscles and joints.
  • Decreased energy levels.
  • Digestive and gastrointestinal problems.
  • Abnormal thyroid function.

A woman who has one or more of the symptoms listed above does not necessarily have breast implant illness. However, women who suspect they have this condition need to be examined by their primary physician. BII is a diagnosis of exclusion. This means that a thorough exam, as well as a workup with all the necessary tests has been performed and all the tests have come back negative. This means that there is no other medical reason for the patient to have the symptoms they are having. Dr. Farbod Esmailian can perform a breast implant removal in Orange County to take the patient’s implants out. This can be done En Bloc (remove all the capsule and implant together) or a simple removal of implants can be removed. Which procedure is chosen depends on the circumstances at hand. Dr. Esmailian can discuss this further with each individual and determine which approach is best for each patient.

A BREAST IMPLANT REMOVAL PROCEDURE IN ORANGE COUNTY

Dr. Farbod Esmailian performs breast implant removal surgery as an outpatient procedure.

This procedure lasts from one to three hours.

Patients receive general anesthesia during their breast explant surgery. As such, once their surgery is complete, patients are not permitted to drive. Therefore, on the day of her procedure, the patient must arrive at the surgery center with a licensed driver. If a patient neglects to arrive with her driver, her breast implant removal surgery will need to be rescheduled.

1. ANESTHESIA

Once the patient is comfortable and asleep, Dr. Esmailian can begin her breast implant removal procedure.

2. INCISION CREATION

An incision is created near the scar from her initial breast augmentation. This scar is typically located around or below her nipple-areolar complex, or along her inframammary fold.

3. IMPLANT REMOVAL

Dr. Esmailian will remove the breast implant. If the patient is experiencing capsular contracture, he will also perform a capsulectomy or capsulotomy if a larger implant is being placed.

  • REMOVING A SALINE BREAST IMPLANT

    If Dr. Esmailian is removing a saline breast implant, he may decide to deflate the implant before removing it, as this allows for an easier removal. After removing the implant, he will remove the scar tissue that developed following her original breast augmentation procedure, this is referred to as a capsulectomy.

  • REMOVING A SILICONE BREAST IMPLANT

    Prior to removing a silicone implant, Dr. Esmailian will examine it for signs of distress or rupture, usually diagnosed by MRI. Removing a silicone implant can be more complicated than the patient’s primary augmentation was. This is especially true when the outer shell of the implant is covered with foam or the shell itself is textured. During the removal of silicone breast implants the procedure can be done either: En Bloc or by removing the implant first and then the capsule. En Bloc is usually performed when there is a suspected rupture as to avoid any silicone spillage.

4. CLOSING THE INCISIONS

Dr. Esmailian uses internal absorbable sutures to close the incisions.

5. SOME PATIENTS RECEIVE A DRAINAGE TUBE

Some patients will receive a drainage tube. This tube allows excess blood and fluid to exit the body, which reduces swelling. This is more common when a complete or En Bloc capsulectomy is performed as well as when an ADM (acellular dermal matrix) is placed like Strattice.

6. A SURGICAL DRESSING IS APPLIED

After breast implant removal, the patient will wear a surgical garment. This dressing provides support for her newly shaped breasts.

ADDITIONAL PROCEDURES THAT CAN BE PERFORMED DURING THE SAME SURGICAL SESSION:

  • Scar revision.
  • Implant replacement
  • In addition, Dr. Esmailian can perform a breast lift to address the sagging that results following implant removal. A breast lift provides the patient with perkier, more youthful-looking breasts.
  • Fat Transfer

RECOVERING FOLLOWING BREAST IMPLANT REMOVAL

A patient’s recovery experience depends on the extent of her breast implant removal procedure. However, for the most part, recovery from breast explant surgery is much easier than the recovery she experienced following her initial breast augmentation.

Patients typically experience minimal discomfort following their breast implant removal procedure and most are able to return to work within 3-5 days after their procedure.

Performing strenuous exercises and lifting heavy items must be avoided for four to six weeks.

As an experienced breast surgeon, Dr. Esmailian knows how to strategically create incisions to ensure the patient has the least scarring possible. Any resulting scars will remain hidden beneath the patient’s clothing.

These scars will fade with time. The type of incision that Dr. Esmailian uses to remove the implants commonly is determined from the previous surgery and the incision used for that procedure, unless a lift or mastopexy is needed.

Inflammation and bruising are common following breast explant surgery. However, both should resolve within just a few weeks.

WHO IS AN IDEAL CANDIDATE FOR BREAST IMPLANT REMOVAL?

An ideal candidate for breast explant surgery is someone in good health with realistic expectations as to what removing her implants can accomplish.

Patients who are in overall good health.

Patients who use nicotine-containing products will need to discontinue using these items for at least four weeks before and four weeks after their breast implant removal surgery.

AN INITIAL CONSULTATION FOR BREAST IMPLANT REMOVAL IN ORANGE COUNTY

During a consultation with Dr. Farbod Esmailian for breast implant removal, the patient needs to inform him what she would like addressed during her breast implant removal procedure. Once Dr. Esmailian knows what the patient would like him to accomplish, he will create her an individualized surgical plan.

A patient who is interested in removing her breast implants will need to let Dr. Esmailian know what she expects her breasts to look like following her breast explant procedure.

Dr. Farbod Esmailian is a breast specialist with an office in Los Alamitos, California. He is dedicated to helping women attain the beautiful, natural-looking breasts that they desire. If you are experiencing issues with your breast implants and would like to find out more about breast implant removal, please contact Dr. Farbod Esmailian’s office today by calling (562) 430-7373 to schedule your initial consultation. If you prefer, you can use the online form to request a consultation. To use this form, please click here. Dr. Esmailian’s office is located at 10861 Cherry Street, Suite 108.

 

 

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