What is Breast Implant Removal and Capsulectomy?

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; this surgery is called a capsulectomy. There is a certain type of capsulectomy, called an “En-Bloc” capsulectomy which entails removing the entire capsule and implant in once piece in an attempt to alleviate concerns of breast implant illness. Around 1% of women with implants feel that their implants are a source of concern (Breast Implant Illness or BII) and that they have negative effects on their health and state that by having them removed their varying ailments improve. If you believe you may have breast implant illness or have any concerns about your current implants, it is highly encouraged that you visit with your primary care doctor and a plastic surgeon to discuss removal. Dr. Ridgway is highly trained in this area of implant/capsule removal and will gladly discuss reconstruction options available for those wishing for removal without replacement.

Breast implants are not lifelong devices and it is important to have them exchanged or removed when necessary due to rupture, health risks, and other complications. 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.

Dealing with complications

On occasion, breast implants may leak, rupture or deflate, or cause other health concerns. Other times, women are just not happy with their implants. When this is the case and explantation or capsulectomy is required, patients may feel concerned that if they do not replace the implants, their breasts won’t appear or feel attractive anymore. This is not necessarily the case. In the hands of a talented surgeon such as Dr. Ridgway, you can expect gorgeous, seamless results that you can enjoy just as much as you once did the implants. Depending on your expectations and anatomy, Dr. Ridgway can create a plan to safely remove your implants and give you an aesthetically pleasing outcome after implants.

Naturally if the client requires breast implant revision rather than strict implant removal, Dr. Ridgway is more than qualified to perform this procedure as well.

Textured or anatomic shaped implants

On July 24, 2019, the implant device company Allergan issued a recall on BioCell textured implants and tissue expanders. This was done based on concerns that textured implants are associated with a very rare type of cancer called BIA-ALCL (Breast Implant Associated Anaplastic Large Cell Lymphoma) that can occur in and around the tissues surrounding a textured implant. Dr. Ridgway has never placed a textured silicone implant but has placed textured expanders.

It is important to stress that ALCL is extremely rare, even if someone had reconstruction or augmentation with textured implants or tissue expanders. To date, 573 cases of BIA-ALCL have been described worldwide, which includes 33 deaths related to this specific type of ALCL. This is out of approximately 25 million women in the world with breast implants. Fortunately, if caught at the first sign of swelling, BIA-ALCL is curable by removing the implant and the connective tissue capsule that forms around the implant.

So what does this mean for you? Currently, given how rare BIA-ALCL is, the U.S. Food and Drug Administration (FDA) does not recommend removing textured implants for prevention only. Instead, it is important to follow-up regularly with your plastic surgeon: either with Dr. Ridgway, or another board-certified plastic surgeon. However, if you do decide that you would prefer to have your implants removed, Allergan has offered to replace their textured implants for smooth implants for free of charge (this does not include surgery costs).

What should you be on the lookout for? Signs and symptoms of BIA-ALCL include swelling, pain, asymmetry, or lumps or masses. Though gradual changes in breast shape do occur over time with time and gravity, any changes that seem abnormal, sudden, or strange should prompt a call to our office so we can schedule you to come in for a check-up. The vast majority of the time, these findings do not represent anything serious; however, it is always smart to be vigilant and follow-up.

Your health and safety are and always have been the most important thing to Dr. Ridgway as your plastic surgeon. Please feel welcome to call the office any time with questions or concerns. If you currently have a silicone breast implants, textured or smooth, please ensure you have a regular follow-up visit scheduled.