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Breast implant removal, often called explant surgery, is an operation to take out breast implants permanently. It is frequently combined with a capsulectomy, in which the scar capsule that the body has formed around the implant is removed as well. After removal, the breasts can be left as they are, lifted, or restored with a modest amount of your own fat. The aim is breasts that are healthy, comfortable and as natural in shape as your tissue allows.
More women are choosing to have their implants removed than in the past. The reasons are varied, and every one of them is valid. Some have complications such as capsular contracture or rupture. Some no longer want the size they chose years ago. Some have concerns about the long-term safety of implants or have symptoms they associate with them. Others simply want to live without implants.
Common reasons for implant removal
- capsular contracture causing firmness, distortion or pain
- implant rupture, confirmed on ultrasound or MRI
- a wish to return to a more natural size
- concerns about textured implants and BIA-ALCL
- symptoms described as breast implant illness
- lifestyle changes, sport or a desire not to have future implant surgery
Types of capsule surgery
| Procedure | What is done | When it is used |
|---|---|---|
| Implant removal only | The implant is removed, the capsule left | Thin, soft, healthy capsule |
| Partial capsulectomy | Part of the capsule is removed | Localised thickening or to help the pocket close |
| Total capsulectomy | The entire capsule is removed | Capsular contracture, calcification, silicone contamination |
| En bloc capsulectomy | Implant and capsule removed together, unopened | Suspected BIA-ALCL, some ruptures |
En bloc removal is sometimes marketed as the only correct approach. In reality, it is important in specific situations, such as suspected BIA-ALCL, but it is not always necessary, and in implants placed behind the muscle it can involve dissection close to the ribs and lungs. The most appropriate approach is decided according to your diagnosis and anatomy, and explained to you in detail before surgery.
BIA-ALCL and breast implant illness
BIA-ALCL (breast implant associated anaplastic large cell lymphoma) is a rare cancer of the immune system linked mainly to textured implants. It usually appears as a sudden swelling of one breast caused by fluid, often years after surgery. When it is suspected, fluid is tested and the implant and entire capsule are removed together. In most cases diagnosed early, this is curative. Removing textured implants in women without symptoms is a personal decision and is not routinely required by current guidance.
Breast implant illness is a term used by women who report symptoms such as fatigue, joint pain, brain fog or skin problems that they attribute to their implants. It is not yet well defined medically, and research is ongoing. Some women report improvement after removal, and others do not. We take these concerns seriously, discuss them openly and support women who choose removal, while being honest that the outcome for symptoms cannot be predicted.
What will my breasts look like?
This is the question most women ask, and the answer depends on:
- the size of the implants relative to your own breast tissue
- how long you have had them
- your skin elasticity and age
- whether the implant was above or below the muscle
- previous pregnancies and weight changes
Women who had small implants and good tissue often have a natural, slightly smaller breast shape after removal. Women who had large implants, or thin skin and little breast tissue, are more likely to have loose skin, flattening or sagging.
Restoring shape after removal
- No additional procedure: some women are content with their natural breasts once the swelling settles.
- Breast lift: a lift reshapes the breast tissue and removes loose skin. It can often be done at the same time as removal or a few months later.
- Fat transfer: fat transfer restores a modest amount of volume using your own fat, often best as a second stage once the tissues have settled.
- Replacement with smaller implants: for those who want to keep implants but at a smaller size, see implant replacement.
Preparing for surgery
Bring your implant card or any information about your implants and previous surgery. Imaging with ultrasound or MRI is often requested to check the implants, the capsule and any fluid. Stop smoking at least four weeks before and after surgery, and stop blood-thinning medicines and supplements two weeks beforehand after checking with your doctor.
The operation
The operation is performed under general anaesthesia and usually takes one and a half to three hours. The previous incision is usually used. Depending on the plan, the implant is removed on its own, with part of the capsule, with the whole capsule, or together with the capsule as a single unit. Removed capsules can be sent for examination under a microscope, and implants can be returned to you on request. When a lift is performed, the breast tissue is reshaped and the nipple repositioned. Drains may be placed for a few days, especially after a total capsulectomy.
Recovery
- Days 1–3: soreness and tightness; drains if used; rest with the upper body raised
- Days 3–7: discomfort improving; support bra or compression worn
- Weeks 1–2: return to desk work for most women
- Weeks 4–6: gradual return to exercise
- Months 6–12: the breasts settle into their final shape
After removal, the breasts may look flat or uneven at first. The tissue gradually fills the space left by the implant and the skin retracts, so the final shape is judged after several months.
Risks
Possible risks include bleeding, infection, seroma, asymmetry, loose skin, changes in nipple sensation, contour irregularities and dissatisfaction with the new shape. Total or en bloc capsulectomy behind the muscle involves more extensive dissection and a small risk of injury to the chest wall.
Emotional adjustment after explant
Removing implants is a physical change and, for many women, an emotional one. Some feel relief almost immediately. Others need time to get used to a smaller or different shape, particularly if they had implants for many years. Both reactions are normal. It helps to look at photographs of your breasts before augmentation, if you have them, and to give the tissue several months to settle before judging the result. If a lift or fat transfer is planned as a second stage, waiting allows you to decide calmly whether you want it.
Implant removal in Istanbul
International patients usually stay seven to eight days, allowing for imaging if needed, surgery, drain removal and a check-up before flying.
Dr. Mehmet Özdemir is a plastic, reconstructive and aesthetic surgeon holding the EBOPRAS qualification, with breast and reconstructive surgery among his main areas of focus. He trained in Germany, Poland and Brazil and practises in Bakırköy, Istanbul, consulting in Turkish, Kurdish, English and German.
