Breast Implant Removal
There are many reasons why a woman may want to remove her breast implants without replacing them. Breast implant removal can be as simple as just removing the implants through the original scar site, but often other considerations need to be addressed. If the implants are large, or there is already some laxity of the skin and native breast tissue, a mastopexy may be necessary to achieve a nice cosmetic result after breast implant removal. Some women might consider removal, followed later by fat transfer breast augmentation.
Breast Augmentation with Autologous Fat
Not nearly as common as implant breast augmentation, breast augmentation with autologous fat is an option for some women. The procedure involves harvesting fat with liposuction, isolating the fat, and then injecting the fat into the breasts. A modest result can be expected, as well as usually needing to repeat the procedure once or twice as the amount that can be injected at one time is generally limited. The availability of fat limits the procedure: lean women are not good candidates!
En Bloc Capsulectomy
Although a controversial topic, some women have systemic problems and a concern that their breast implants may have triggered or contributed to these issues. Some may refer to this as “breast implant illness”. These symptoms may defy traditional rheumatological diagnosis and testing yet in my experience patients typically improve, often dramatically, after breast implant removal surgery. Many of these health concerns were addressed during the US silicone breast implant moratorium (1992-2006) when silicone breast implants underwent extensive epidemiological scrutiny and then were brought back for primary cosmetic breast augmentation in 2006 after these studies failed to support a link to breast implants. However, epidemiological studies have limitations, and other scientific evidence supports the plausibility that in some women, silicone implants could cause autoimmune issues. Other contamination or chronic infections could also be at play and resolve or improve with implant and capsule removal. A so-called En Bloc Capsulectomy is typically performed if possible, to remove the breast implant capsule and all the implant material in “one piece”. This is a distinction between a Total Capsulectomy, that also removes the entire capsule, but not necessarily in one piece with the implant material inside. Partial Capsulectomy is usually only done when no systemic issues are present, and the problem is primarily cosmetic.