EXPLANTATION OF BREAST IMPLANTS
Removal of breast implants
What is an explantation?
After a previous breast enlargement, it is possible to remove the breast implants. These can potentially be replaced with new implants, or one can opt for lipofilling to optimise the contours. 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 can choose not to take any further steps, or to replace the implants with lipofilling or new implants.
POINTS OF ATTENTION
Removal of breast implants
01
The impact of a prosthesis
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.
02
The "waterfall effect"...
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.
03
Rippling of the skin
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.
04
Capsule formation
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.
05
ASIA syndrome, Breast Implant Illness
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.
06
Muscle animation
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.
TECHNIQUE
Breast prosthesis explantation
De gemiddelde levensduur van een prothese bedraagt ongeveer 10 tot 15 jaar. Na een eerdere borstvergroting kunnen er in de loop der tijd complicaties ontstaan. Dit kan leiden tot ongemak of een afwijkende vorm van de borst door kapselvorming. Het syndroom van "breast implant illness" (BII) omvat een scala aan algemene klachten zoals gewrichtspijn, problemen met de concentratie, vermoeidheid en een algemeen gevoel van malaise. BII is echter een diagnose die alleen kan worden bevestigd door de implantaten te verwijderen; pas dan weet men of de klachten daadwerkelijk door de protheses worden veroorzaakt. Bovendien kan iemand ervoor kiezen om de protheses om persoonlijke redenen te laten verwijderen.
Frequently Asked Questions
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).
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