Breast Implant Removal (Explant) - American Board of Cosmetic Surgery

Procedure Insights

Permanently removes silicone or saline implants (with or without capsule tissue) when aesthetic preferences change or a complication arises.
Incisions are usually placed over the original augmentation scar (i.e. inframammary fold or periareolar).
Straightforward implant removals may require very little downtime.
Some patients benefit from a combined or staged breast lift to address excess skin or nipple descent after implant removal.

Breast implants are not lifetime devices, and sometimes patients decide to have their implants removed without replacing them in a procedure called “explant” or breast implant removal.

Why Consider Explant Surgery?

Common motivations for removing breast implants include:

Aesthetic change—desiring a smaller, natural breast size or preferring a more athletic appearance
Device concerns—a rupture (saline implants deflate, while silicone ruptures are detected via MRI or ultrasound) or visible rippling
Capsular contracture—abnormally tight scar tissue that forms around the implant, causing firmness or pain
Systemic symptoms that a patient feels may be associated with breast implants, such as fatigue, joint pain, brain fog
Recall of textured breast implants due to concerns about BIA-ALCL, a rare lymphoma linked to certain textured breast implants

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Who Is a Candidate?

You are likely an explant candidate if you:

Have breast implants you no longer desire, regardless of reason or implant age
Experience implant-related pain, rupture, or capsular contracture
Are medically fit for outpatient surgery: a non-smoker in generally good health, with any medical conditions well-controlled
Understand that breast shape, skin quality, and nipple position may change after removal, sometimes necessitating a breast lift or fat transfer to achieve a natural, proportional post-op contour

Revision vs. removal: If you wish to replace implants or adjust size, see our Breast Implant Revision guide »

Explant Techniques Explained

Technique	What Is Removed?	Typical Uses	What to Expect
Simple explant	Implant only; capsule of scar tissue around the implant left in place	Intact implants without capsular contracture	Shortest surgery & recovery
Partial capsulectomy	Implant + select portions of scar capsule	Capsular contracture	Reduces surgery time, compared with total removal
Total capsulectomy	Implant + entire capsule, in pieces	Dense capsules, certain silicone implant ruptures	Adds 15-30 minutes of operative time
“En bloc” capsulectomy	Implant & intact capsule removed together	Oncologic concerns	Requires larger incision and comes with more surgical risks; carries no proven advantage for BII symptom relief over partial removal; reserved primarily for rare BIA-ALCL cases

While there is much discussion online about the pros and cons of certain techniques, we recommend speaking with a trusted, board-certified cosmetic surgeon in a consultation to decide on an approach based on the types of implants you have, any symptoms that have led you to seek breast implant removal, and your personal priorities.

Benefits

Eliminates implant-related maintenance and future replacement costs
Resolves capsular contracture
Most symptomatic patients who attribute systemic, BII-type symptoms to their implants report partial or complete relief of symptoms within six months of removing their implants (regardless of the what type of capsulectomy, if any, was performed)

Limitations

Surgery may decrease breast volume and upper pole fullness; a breast lift or breast fat transfer may be needed to reach your desired shape
Post-surgical drains may be needed when extensive capsule tissue is removed
Scar tissue removal (capsulectomy of any kind) increases overall healing time compared with a simple explant
Explant will not address unrelated breast conditions (such as sagging due to weight fluctuations) without additional procedures

Acellular Dermal Matrix (ADM): A biologic scaffold used to reinforce the breast pocket or provide internal support after implant removal.

Animation Deformity: Unwanted breast movement or distortion with chest muscle flexing that may improve when implants are removed or the pocket is changed.

Anesthesia: Medication used for comfort during surgery; it may be local, local with sedation, or general.

Asymmetry: A difference in size, shape, or position between breasts that may be addressed during explant surgery.

Auto-Augmentation Mastopexy: A lift technique that reshapes and repositions your own breast tissue to restore fullness after implant removal.

Baker Grade: A four-level scale used to describe the severity of capsular contracture around an implant.

BIA-ALCL (Breast Implant–Associated Anaplastic Large Cell Lymphoma): A rare immune-system cancer most often linked to certain textured implants that can present with late swelling or fluid.

Biofilm: A layer of bacteria on implant surfaces that can trigger inflammation or contribute to capsular contracture.

Breast Implant Illness (BII): Not a formal diagnosis, but a patient-reported collection of systemic symptoms that some attribute to implants, with symptom improvement reported by many after removal; research is ongoing.

Breast Implant Removal (Explantation): Surgery to take out one or both implants, sometimes combined with capsule surgery, a lift, or fat grafting.

Breast Lift (Mastopexy): A procedure that raises and reshapes the breast and nipple position, commonly paired with implant removal to improve contour.

Breast Ptosis: Drooping of the breast due to tissue and skin laxity that may be more apparent after implants are removed.

Capsular Calcification: Hardening within the capsule from calcium deposits that can make the breast feel firm.

Capsular Contracture: Tightening of the scar capsule around an implant that can cause pain, firmness, or distortion.

Capsule: The natural layer of scar tissue the body forms around an implant.

Capsule Preservation: Leaving some or all of a healthy capsule in place when removal of the entire capsule is not necessary.

Capsulectomy: Surgical removal of part or all of the capsule surrounding an implant.

Capsulotomy: Surgical releasing or scoring of the capsule to soften it or adjust the pocket.

CC (Cubic Centimeters): The unit used to describe implant volume, often referenced during removal and optional replacement discussions.

Cohesive Gel (“Gummy Bear”) Implants: Form-stable silicone gel implants that retain shape even if the shell is ruptured.

Contour Irregularity: Dimpling or unevenness in breast shape that can occur after explant, often improved with a lift or fat grafting.

Drain: A temporary tube used to remove fluid after surgery and reduce seroma risk.

En Bloc Capsulectomy: Removal of the implant and its surrounding capsule as one unit when safe and indicated.

Explant With Lift: Removing implants and performing a mastopexy in the same operation to reshape the breast.

Fat Grafting to the Breast: Transferring your own purified fat to refine contour or add subtle volume after implant removal.

Fat Necrosis: Firm, sometimes tender areas that form when a portion of transferred fat does not survive.

General Anesthesia: Medications that keep you fully asleep and comfortable during surgery.

Hematoma: A collection of blood under the skin that may cause swelling, bruising, or pain after surgery.

IMF (Inframammary Fold): The natural crease under the breast that defines the lower contour.

Implant Malposition: An implant sitting too high, low, inward, or outward, often a reason patients choose removal or revision.

Incision Options: Common approaches include inframammary (in the fold) and periareolar (along the areola) for explant access.

Internal Bra: Reinforcement of the breast with sutures, ADM, or mesh to support shape after implant removal.

Local Anesthesia: Numbing medication used to desensitize a targeted area while you remain awake, sometimes paired with sedation.

Mesh (Resorbable Mesh): A temporary synthetic scaffold that supports tissues as they heal and gradually dissolves.

MRI (Magnetic Resonance Imaging): Detailed imaging often used to evaluate silicone implant integrity or late fluid collections.

Nipple-Areola Complex (NAC): The nipple and surrounding pigmented skin, which may be resized or repositioned during a lift.

Numbness (Sensory Changes): Temporary or sometimes lasting changes in nipple or skin sensation after surgery.

Outpatient Surgery: A procedure performed with same-day discharge to recover at home.

Pathology Evaluation: Laboratory testing of capsule tissue or fluid when indicated, such as to assess for BIA-ALCL.

Pectoralis Major: The chest muscle that may have covered the implant and can be released or reattached during pocket changes.

Pocket: The internal space that held the implant, which can be tightened, reshaped, or closed during explant.

Ptosis (Breast Droop): Downward descent of breast tissue that may call for a lift at the time of implant removal.

Rupture (Saline): A leak that causes noticeable deflation as the body absorbs the sterile saline fill.

Rupture (Silicone): A leak that may be “silent” without obvious changes and is often detected with MRI or ultrasound.

Scar Maturation: The process of scars softening and fading over 6–12 months after surgery.

Seroma: A pocket of clear fluid that can develop after surgery and may require drainage.

Silent Rupture: A silicone implant leak without visible changes, typically identified on imaging.

Silicone Gel Implants: Implants filled with silicone gel that offer a natural feel and varied profiles.

Smooth vs. Textured: Implant shell surface options.

Subglandular Placement: An implant position above the muscle and under the breast tissue, relevant to planning removal and lifts.

Submuscular Placement: An implant position under the chest muscle that may affect animation and pocket changes during explant.

Symmastia: A condition where tissues meet across the midline (“uniboob”), sometimes prompting implant removal and pocket repair.

Textured Implants: Implants with a roughened surface associated with reduced movement but also associated with most BIA-ALCL cases.

Total Capsulectomy: Removal of the entire capsule surrounding an implant in pieces.

Ultrasound: Imaging that can assess fluid collections, capsule thickness, or implant integrity.

Upper Pole Fullness: Roundness in the upper breast that often decreases after explant and may be restored with lift or fat grafting.

Volume Deflation: The flatter appearance that can occur after implant removal when natural breast tissue provides less projection.

Recovery & Expected Results

The first few days of recovery typically involve mild chest soreness. Sleeping elevated on your back and wearing a supportive bra 24/7 for the first month can help to minimize swelling. If you work at a desk, you will likely be cleared to resume work after 1 week. Patients are typically back to their full activity level after 4-6 weeks, and your new breast shape will become “final” over the course of 3-6 months as the skin retracts.

Note that the technique used for your explant surgery may shorten or lengthen recovery times, and that every individual heals differently.

Explant and Breast Implant Illness (BII)

The FDA continues to study systemic symptoms reported by some breast-implant patients. While there is no formal diagnostic criteria for this, many patients and physicians use the terms breast implant illness (BII) or unexplained systemic symptoms.

Still, multiple studies looking at patients who attribute their systemic symptoms to breast implants show symptoms resolution after implant removal. This improvement was noted whether or not the entire capsule of scar tissue around the implant was removed, debunking the myth that an en bloc capsulectomy procedure is required for patients with BII-like symptoms.

Currently, experts agree on the follow protocol for patients with systemic symptoms:

Physicians should conduct a thorough medical evaluation to rule out other causes of symptoms, such as autoimmune diseases.
Patients considering explant surgery should talk with their surgeon to develop realistic expectations for their outcomes, and understand that complete symptom resolution is not guaranteed.
When a patient desires breast implant removal, choose the least invasive surgical plan that accomplishes safe removal; intact “en bloc” excision is not often necessary.

Frequently Asked Questions

It is possible that breasts will appear deflated. Skin elasticity, implant size, and time since augmentation all influence the final appearance of your breasts after removal. Most patients lose upper pole fullness and cup size after breast implant removal, and for patients who are concerned about their appearance, a breast lift or fat grafting may help to restore shape.

Talk with your cosmetic surgeon about your goals for your breasts post-surgery; many patients choose to have a combined explant with a lift or fat transfer to avoid a deflated appearance and combine procedures under one anesthesia. Other patients may choose to wait to see the degree to which their tissues naturally “contract” before opting for a secondary procedure.

No, there is no evidence that en bloc capsulectomy is a safer implant removal technique, even if you are concerned about breast implant illness. On the contrary, many ethical surgeons will refuse to perform en bloc capsulectomies because they are riskier to the patient than partial or total capsulectomies, requiring lengthy incisions and extra risk due to the proximity of the breast implant to the lungs.

For most cases, partial or total capsulectomy resolves symptoms at the same rate with smaller incisions and faster recovery. Meet with a cosmetic surgeon to learn about their recommended approach that balances your removal needs with the least operative risk, and do not rule out the option of seeking a second opinion.

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Once you receive clearance from your cosmetic surgeon, typically around 4-6 weeks, you can resume the full exercise regimen you had before breast augmentation. If you are healing well, you may want to begin talking with your surgeon about resuming light cardio and exercises around 2 weeks post-op.

The thin scar tissue capsule usually contracts over time and becomes nearly invisible when viewed on medical imaging devices.

Health insurance is not likely to cover breast implant removal if the breast implants were originally placed for cosmetic reasons (versus reconstructive, i.e. after mastectomy). Still, a serious complication such as severe capsular contracture or breast implant-associated large cell lymphoma (BIA-ALCL) may prompt an insurer to cover explant surgery. Talk with your cosmetic surgeon and your insurer to learn if prior authorization may be possible based on the details of your unique case.

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