Breast implant removal (“explant”) surgery removes the breast implants or revises the shape and size of them. Some common reasons women choose to have their breast implants removed include:
To learn more about breast explant surgery at Fox Valley Plastic Surgery, request a consultation using our online form or contact us at (920) 233-1540. The non-refundable $80 cosmetic consultation fee can be applied towards the cost of the procedure. Some breast implant removal consultations may be covered by insurance. Our office will let you know if it thinks the visit may be insurance covered. Our surgeons have performed many explant surgeries for our patients from all over Wisconsin, Michigan, and Illinois, and can help you determine the best course of action.
The FDA is taking another look at the safety of breast implants, but for now, it is not proposing any new restrictions or warnings. The agency’s longstanding position is that implants are essentially safe as long as women understand they can have complications, including scarring, pain, swelling and implant rupture. However, the FDA is investigating a recently confirmed link to a rare cancer and unconfirmed complaints of other health problems. The FDA finds it impossible to determine how frequently the cancer occurs because the U.S. does not track the total number of implants on the market. Estimates of the frequency of the disease range from 1 in 3,000 women to 1 in 30,000. Although we have tested several patients for BIA-ALCL, we have not yet had a case of this disease.
Most confirmed cases of the disease, known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), have involved a particular style of implants with a textured surface, designed to reduce scar tissue and slippage. The salt loss type of texturing used by Allergan is more commonly associated with this problem. The disease is not breast cancer, but a form of cancer that attacks the immune system and usually forms in the capsular tissue surrounding implants. It grows slowly and can be successfully treated by surgically removing the implants with the body’s self-created capsule. More research and studies need to be conducted, but right now, the FDA is not recommending removal of implants unless there are adverse symptoms. It would appear that all BIA-ALCL patients present first with hyperinflation or a large fluid accumulation around the breast. Sampling the fluid with ultrasound guidance in our office and testing the fluid establishes the diagnosis.
The surgeon may not know if an en bloc procedure is truly possible until the actual surgery occurs. Sometimes a portion of the capsule is disturbed to avoid significant damage to the muscle, rib or lung. If the scar tissue capsule is very thin or tightly attached to the chest wall, en bloc removal may be attempted, but there is always a possibility of breaking into the capsule, especially along the ribs.
Textured implants were created for the dual purpose of stabilizing the implant in the breast pocket and reducing capsular contracture. However, they are the most confirmed with causing BIA-ALCL, a cancer of the immune system that in most cases develops in the capsules and creates fluid near the implant. En bloc removal of textured implants is the best way to keep the cancerous cells secured in the capsule as a sac until they are explanted out of the body, as a whole. According to the FDA, BIA-ALCL may develop in 1 in between 3,817 to 30,000 women with textured breast implants. Patients, who have textured implants removed, may request pathology to do the CD30 test for BIA-ALCL. In 25 years of practice, we have never seen a case of this disease. The En Bloc technique is best used when an implant is ruptured and we are trying to remove the capsule, implant, and tissue that contains silicone in one piece, i.e. “En Bloc”.
The most common breast implant removal surgery techniques include:
Unlike other surgeries, it is very difficult to give an estimate for implant removal or replacement because of the many options available. En bloc removal itself can cost up to $10,000, but cases vary considerably. Please call 920-233-1540 for a personal consultation. The non-refundable $80 cosmetic consultation fee can be applied towards the cost of the procedure.
Newer breast implants usually have a warranty of 10 years, but the coverage may be solely related to ruptures or capsular contractures. If the implant manufacturer is unknown, contact the implanting surgeon and request an operative report. The coverage is only for the implant itself, and does not cover any of the fees associated with the surgery such as the surgeon’s fee, facility fee, anesthesia fees, pathology, etc.
Insurance companies cover services that they determine to be “medically necessary” to treat a disease or illness. Although you or your doctor may believe a service is medically necessary, insurance companies do not always agree. Insurance companies generally do not cover the cost of breast implant removal for autoimmune or connective tissue diseases or other systemic complications.
Obtain a copy of the insurance policy and review it to see if they are likely to pay for the removal. Call your insurance company. Generally, the insurance company focuses on capsular contractures, ruptures, and pain. The process of getting approved can very difficult. Read more about insurance coverage here.
Prior to surgery, patients may be asked to:
A shirt that buttons up from the front or a zip up hoodie is helpful to prepare, so you don’t have to lift your arms up. You might want to purchase post-operative compression bras or front-close sport bras.
Patients will receive special instructions to cover what to do on the day of surgery, post-operative care and follow-up. Breast surgery may be performed in an accredited office-based surgical center, outpatient/ambulatory surgical center, or a hospital.
FVPS will notify patients if they are affected by this policy. At the pre-operative appointment which normally occurs two days before surgery, patients must take a cotinine test, which detects the presence of nicotine. Test results are immediately available with this quick blood test. If the test is positive, then surgery will be cancelled and the patient loses the 10% booking fee. If they cannot quit smoking, smokers should not schedule a surgery.
Following breast implant removal surgery, the breasts will not look the same as they did before the original breast implant surgery. This is because the volume of the breast implants stretches the tissue and can result in a deflated look. Having a breast lift can raise the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour.
While recovery from breast explant surgery varies from person to person, this surgery is usually smoother than the initial breast implant surgery. However, if there has been a breast lift after the breast implants have been removed, the breasts will feel tight and heavy for a few weeks.
In the first few days anticipate heavy constipation and bloating from the anesthesia and pain killers used during and after surgery. Narcotics slow down the intestines, even as they wear off. Water retention from the IV’s is also common. Antibiotics can also contribute to bloating. A compression bra can help minimize swelling. Maximum swelling is at 2 days after surgery and should resolve within 14 days.
Any breast revision surgery may require drains because fluid will be generated when operating on the scar capsule. Because there is a mechanism for the fluid to be removed with drains, the risk of getting a hematoma is lower. We prefer not to use drains unless absolutely needed.
Most women are able to return to work in five days and report experiencing minimal discomfort after the surgery. If breast implants were removed with the capsule, there will be more discomfort and the recovery time will be longer.
Breast implant removal scars typically heal very well and are often inconspicuous. While the scars will fade, they will never disappear entirely.
Avoid heavy lifting or exercising excessively for the first six weeks after surgery. It is usually safe to resume normal activity after six weeks. The breasts will take several months to settle into their new position.
Read about Amanda’s experience with her breast reconstruction and other real patient stories in the Real Patient Stories section of our website. No one, especially someone in her 20’s, expects to get breast cancer. When it happened to Amanda, she took control and made a full recovery. She became an advocate for breast cancer awareness and educates women on the importance of mammograms.
Patients will sign consent forms to ensure that they fully understand the procedure and any risks or potential complications. The risks of breast surgery include:
Without undergoing a personal consultation with a surgeon, and submitting a pre-authorization with the insurance company, it is not possible to determine if breast implant removal will be covered by insurance. Dr. David Janssen and Dr. William Doubek are highly experienced with breast explant surgery, and can help patients determine the best course of action. At the consultation, patients should be prepared to discuss:
The surgeon may also:
Contact Fox Valley Plastic Surgery at (920) 233-1540 or request your consultation online. The decision to remove or replace implants is not always clear cut. We have helped patients from Green Bay, Sheboygan, Appleton, Neenah, Oshkosh, Fond du Lac, and West Bend determine the best course of action regarding Breast Implant-Associated Anaplastic Large Cell Lymphoma. Our board certified Wisconsin plastic surgeons are helping women from all over the upper Midwest to perfect their personal Renaissance. Request your consultation today.