EXPLANTATION OF BREAST IMPLANTS
After a previous breast enlargement, it is possible to remove the breast implants. The removal of breast implants after a previous enlargement may be necessary for various reasons, such as pain, an abnormal shape of the breast, an unnatural appearance, or other physical complaints. After the removal, one may choose not to take any further steps, or to replace the implants with lipofilling or new implants.
Points of attention
Over time, problems can arise from the use of a breast prosthesis. The prosthesis exerts pressure on the surrounding tissues. Research has shown that a prosthesis, when placed in front of the muscle, can lead to a volume reduction of the breast gland of approximately 30%. If the prosthesis is placed behind the breast muscle, this can even result in atrophy or a volume reduction of the breast muscle of up to 50%. This leads to the muscle becoming thinner. The larger the prosthesis, the greater the consequences of this.
A breast implant placed behind the pectoral muscle can, over time, adhere to the rib cage and the muscle due to capsule formation. However, the breast gland that lies in front of the muscle remains flexible and gradually sags downwards due to gravity. This leads to the "waterfall effect," where the breast gland hangs at the bottom of the breast, while there is an excess of volume at the top.
In some cases, the prosthesis may be visible or there may be rippling of the skin. This often occurs when the prosthesis is not sufficiently covered by your own tissue. This is often the result of the position of the muscle and the thin layers of subcutaneous tissue. Leaning forward can further accentuate this rippling.
A prosthesis is a foreign object to your body. It does not recognise this and will attempt to isolate it from the surrounding tissues. This leads to the formation of a capsule around the prosthesis. Over time, this capsule can harden, which may result in distortion of the breast or painful sensations. Complications after the placement of prostheses (haemorrhage, infection) or your lifestyle (smoking) can negatively affect capsule formation.
Breast Implant Illness (BII) is an exclusion diagnosis. This condition - which is still the subject of much debate - is characterised by vague complaints following the placement of breast implants: fatigue, concentration difficulties, joint pain, headaches, etc. It is only through the removal of the breast implants and the subsequent resolution of the symptoms that the diagnosis can be made. Often, a psychological factor also plays a role; the idea of having a foreign material is linked to vague complaints.
Implants placed behind the muscle can cause uncomfortable contractions in the chest area. When the pectoral muscle is tensed, the implant can shift outward and upward, which is not aesthetically pleasing.
Various options are possible for the removal of breast implants.
The implants are removed and the breast is left alone.
The implant is removed and no further steps are taken. This may apply to implants with a small volume that cause few complaints. The breast will then (partially) naturally return to shape after a few months when the swelling has subsided. One can always opt for a possible correction with, for example, lipofilling afterwards.
The implants are removed and a lipofilling procedure is performed to improve the contours and restore some volume.
After the removal of the breast implants, there will be a reduction in volume. This can be resolved by injecting one's own fat tissue into the subcutaneous tissue layers. It is necessary to have sufficient fat tissue for this. Injecting fat tissue not only improves the contours of the breast but also optimises the skin quality.
After the removal of the breast implants, the breast may sag, which sometimes makes a lift necessary to improve the shape.
When the breast sags significantly after the removal of the breast implants, a breast lift necessary. This restores harmony and improves the breast contours. This can be combined with lipofilling. After previously placing large implants, this is often necessary. One can also wait after the removal of the implants and if necessary three months later perform a lift. However, a lift does bring scars on the breast (anchor formation).
One can opt to place new prostheses to avoid any loss of volume.
One can choose for a prosthesis exchange. In this case, the old prostheses and scar tissue are removed and new prostheses are placed, so that there is no loss of volume after the procedure. This can be combined with a lift or lipofilling procedure. For prostheses that were previously placed behind the breast muscle, it can now be considered to place the prostheses in front of the muscle. This is more comfortable and allows for natural movements of the breast.
When removing prostheses, the capsule around the prostheses is always removed. This capsule is examined if necessary. A flexible capsule does not need to be completely removed (especially on the rib cage to prevent unnecessary complications). For prostheses behind the breast muscle, it is checked whether the muscle can be repositioned or restored. If new prostheses are placed, we also look at whether a new position in front of the muscle possible. The complete removal of the prosthesis and the capsule is called "en bloc" removal.
The main reasons for the removal of breast implants are discomfort, pain, distortion of the breasts, personal preference, or issues arising from breast implant illness. Since a prosthesis is made of foreign material, the body responds with an inflammatory reaction. Over time, a capsule may form around the prosthesis, which can show hardening and lead to problems such as distortion, discomfort, or excessive muscle activity.
The implants are removed and, if necessary, the capsule surrounding them is also removed. A soft capsule usually does not need to be removed, whereas a thickened and often calcified capsule will always be removed and further examined. In the case of implants placed behind the muscle, the breast muscle is returned to its original position: the anatomy is restored. In most cases, we prefer a one-night hospital stay for the comfort of the patient. Often, a drain is also placed in the breast, which is removed the following day.
After the removal of breast implants, there may naturally be a loss of volume or sagging of the breasts. One option is to have new implants placed, if desired. Alternatively, one might consider the lipofilling technique, which can help restore some of the lost volume. For breasts that have begun to sag, a breast lift can be a valuable option.
In most cases, the capsule around the implants is removed. This is especially necessary in cases of severe capsule formation with hardening (calcification) or when there are fluid accumulations around the implant. However, if the capsule is very soft, removal is not always necessary. In implants placed behind the muscle, the capsule may be attached to the rib cage; this can complicate the procedure. Therefore, it is advisable to stay one night in the hospital for your comfort and to minimise the risk of bleeding (a drain will be placed).
On average, a breast implant has a lifespan of 10 to 15 years. The durability of the implant is influenced by the quality and various factors, including lifestyle (such as smoking) and the size of the implant.
Our medical team is happy to answer your questions, including those about treatments and fees.
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