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by Dr. Gregory T. Lynam

Implant Removal

Breast implants are not lifelong devices and it is
important to have them exchanged or removed
approximately every 10-15 years.

Should I have my breast implants removed?

The goal of breast implant removal surgery is to remove breast implants from breast augmentation or breast reconstruction patients. During these procedures, the surgeon may also remove silicone material from implant leaks and the breast capsule, which is the scar tissue that forms after the placement of a breast implant.

Often, the scar tissue that forms after the placement of an implant is soft and does not need to be removed, but it may harden, causing pain and discomfort. This is often a reason to have the implants and scar tissue removed.

Breast implants are not lifelong devices and it is important to have them exchanged or removed approximately every 10-15 years. This decision is typically based on the individual and the patient’s needs and desires.

In some cases, the outside shell of the implant breaks down causing silicone to leak and the scar tissue around the implant to harden. It is important to understand that your implants should be removed for this reason.

Who is a good candidate for breast implant removal?

Breast implant removal surgery is a highly individualized procedure. It should be performed if you have capsular contracture (hardening of the breast), pain with implants, imaging has shown a leak of the capsule and/or if you no longer desire implants or wish to exchange them.

In general, you may be a good candidate for breast implant removal if:
• You are physically healthy and at a stable weight
• You have realistic expectations
• You are a nonsmoker
• You are bothered by the appearance of your implants
• You have experienced discomfort or pain
• You feel your breasts are too heavy
• You are starting to feel your breast scar tissue is getting harder or tighter
• Imaging suggests a leak or rupture of implants
• You have experienced a rupture or leak of implants

If you’re considering surgery, spend some time reviewing before and after photos and learning about what to expect during recovery. Preparation ahead of time helps patients have reasonable expectations and a smoother recovery.

What is the cost of breast implant removal?

The average cost of breast implant removal surgery is $2,357, according to 2017 statistics from the American Society of Plastic Surgeons.

Breast implant removal costs can widely vary. The average fee referenced above is only part of the total cost – it does not include anesthesia, operating room facilities or other related expenses.

A surgeon’s fee for breast implant removal will be based on his or her experience, the type of procedure used and the geographic office location.

Many plastic surgeons offer patient financing plans for breast implant removal in instances where health insurance does not cover it, so be sure to ask.

Breast implant removal costs may include:
• Surgeon’s fee
• Hospital or surgical facility costs
• Anesthesia fees
• Prescriptions for medication
• Post-surgery garments
• Medical tests and x-rays

When choosing a board-certified plastic surgeon for breast implant removal surgery, remember that the surgeon’s experience and your comfort with the physician are just as important as the final cost of the surgery.

What should I expect during a consultation for breast implant removal?

During your breast implant removal consultation, be prepared to discuss:
• Your surgical goals
• Medical conditions, drug allergies and medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
• Previous surgeries

Your plastic surgeon will also:
• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine your breasts
• Take photographs
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of breast implant removal surgery and any risks or potential complications

The success and safety of your breast implant removal procedure depend very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Be sure to ask your plastic surgeon questions. It’s very important to understand all aspects of your breast implant removal surgery. To help, we have prepared a checklist of questions to ask your plastic surgeon that you can take with you to your consultation.

It’s natural to feel some anxiety. Don’t be shy about discussing these feelings with your plastic surgeon.

What questions should I ask my plastic surgeon about breast implant removal?

Use this checklist as a guide during your breast implant removal consultation:
• Are you certified by the American Board of Plastic Surgery?
• Were you trained specifically in the field of plastic surgery?
• What specific training do you have in breast implant revision techniques?
• How many years of plastic surgery training have you had?
• Do you have hospital privileges to perform this procedure? If so, at which hospitals?
• Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
• Am I a good candidate for this procedure?
• What will be expected of me to get the best results?
• Where and how will you perform my procedure?
• What surgical technique is recommended for me?
• How long of a recovery period can I expect, and what kind of help will I need during my recovery?
• What are the risks and complications associated with my procedure?
• How are complications handled?
• How can I expect my breast implant removal procedure to look over time?
• What are my options if I am dissatisfied with the outcome?
• Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?

Risks and Safety – What are the risks of breast implant removal?

The decision to have breast implant removal surgery is dependent on many factors, including your overall health, if the implant is leaking, if the implant has ruptured and your personal desire. You’ll have to decide if the benefits will achieve your goals and if the risks and potential complications of breast implant removal are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedures you will undergo and any risks or potential complications.

The possible risks of breast implant removal surgery include, but are not limited to:
• Bleeding
• Infection
• Poor healing of incisions
• Hematoma
• Anesthesia risks
• Fluid accumulation (seroma)
• Skin loss
• Numbness or other changes in skin sensation
• Numbness or other changes in nipple/areola sensation
• Skin discoloration and/or prolonged swelling
• Unfavorable scarring
• Recurrent looseness of skin
• Fatty tissue found deep in the skin might die (fat necrosis)
• Deep vein thrombosis, cardiac and pulmonary complications
• Asymmetry
• Suboptimal aesthetic result
• Possibility of revision surgery
• Persistent pain
• Scarring

These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions directly with your plastic surgeon.
https://www.plasticsurgery.org/cosmetic-procedures/breast-implant-removal/safety

According to the National Center for Health Research, “Since 2015, the National Center for Health Research has been contacted by more than 4,500 women who had breast implants that they wanted to remove because of rupture, breast pain, or medical symptoms that they believed to be related to their implants. Most of the women could not afford explant surgery and asked for NCHR’s assistance in persuading their health insurance, Medicare, or Medicaid to cover the cost of implant removal without replacement. NCHR has a project to assist these women if they have insurance but have had difficulty getting coverage for explant surgery. Most health insurance policies will cover the cost of breast implant removal when it meets the policy’s criteria for medical necessity. In almost all cases, medical necessity is defined as a leaking silicone gel breast implant or severe capsular contracture that causes breast hardness and pain. We are not aware of any policies that will cover removal due to systemic illnesses caused by implants, such as those described by thousands of women with breast implants. However, in many cases women have systemic illness in addition to having capsular contracture and a leaking silicone gel implant.”

http://www.center4research.org/breast-implant-illnesses-whats-evidence/

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