Undoing a breast augmentation takes an operation of its own. The reasons patients give for it range from a change in taste to scar tissue that has hardened around an implant, and the decision that follows removal, whether to lift, replace or leave the breasts as they are, shapes the result as much as the removal does.
A Houston practice’s guide to breast implant removal, published for patients of triple board certified plastic surgeon Leo Lapuerta, MD, FACS, lists those reasons and sets out what patients can expect afterward. The summary below stays close to the practice’s own guidance.
The reasons patients give
The practice groups the concerns it hears into several categories. In the order the practice lists them, patients ask for removal because of:
- Aesthetic preferences. A wish to return to a more natural breast size or appearance. Some patients enjoyed their implants for years before deciding they preferred their original size, and others want a smaller or larger implant or a different shape.
- Capsular contracture. Hardening of the scar tissue around the implant, which can cause discomfort or distort the breast.
- Implant rupture or deflation. Leaking or damaged implants.
- Lifestyle changes. Shifts in physical activity or personal priorities.
- Breast implant illness. The practice describes this as concerns about health symptoms potentially related to implants, and it does not go further.
- Aging implants. Many women, the practice says, choose removal or replacement after having implants for 10 to 20 years. Its guidance adds that implants usually last 10 to 15 years and that the risk of rupture rises the longer they stay in. That is a general expectation, not a fixed deadline, and a surgeon can advise on timing after an exam.
Comfort runs through several of these. The practice notes that implants that have moved out of place, or that are surrounded by scar tissue, can limit movement and cause pain, and that some patients feel the weight of their implants is unwanted.
Dr. Lapuerta, who has more than 30 years of experience, works through each patient’s reasons at the consultation and builds the surgical plan around their health and aesthetic goals.
The surgery itself
Implant removal is an outpatient procedure. Patients receive either an intravenous or a general anesthetic, and Dr. Lapuerta uses incisions similar to those made when the implants went in, either in the fold beneath the breast or around the areola, depending on the patient’s anatomy. He closes them with tape, clips, sutures or adhesives as the case requires.
Patients leave with bandages or dressings, and some have drains. Depending on how recovery goes, Dr. Lapuerta may provide a post-surgical bra or compression garment. The practice tells patients to protect the incisions while they heal and to return for follow-up appointments.
The practice singles out one risk: in rare cases, patients can experience respiratory or cardiovascular complications after the procedure, which require medical attention. As with any operation, the consultation is the place to review risks in detail.
Options after removal
The practice is candid about how breasts can look once the implants come out. Volume drops. Patients may notice sagging or a deflated look, loose skin with wrinkling, a shape or volume that differs from the breasts they had before implants, and indentations, which the practice attributes in many cases to scar tissue from the original surgery. Implant size and the condition of the remaining breast tissue both affect the outcome.
With that in mind, the practice describes three paths:
- Removal alone. The breasts return to the patient’s natural size, with the changes described above.
- Removal with a lift. Some patients worry about losing the perkiness they had with implants. A breast lift after removal can restore a firmer, more lifted shape with a more natural appearance.
- Replacement. Patients whose implants have reached the end of their lifespan, or who want a different size or shape, can have new implants placed.
The timeline
Patients can resume regular activities well before healing is complete, but the practice says it can take a full year before they are healed and the final result shows. Recovery differs a great deal from one patient to the next, so Dr. Lapuerta lays out a recovery plan at the consultation that covers the weeks after surgery.
That year-long horizon makes the before-surgery conversation the decisive one. A patient deciding between removal alone and removal with a lift is choosing between two different shapes she will live with long after the dressings come off, and at Dr. Lapuerta’s practice, the surgery date is set only once that plan is in place.
This article is for general information only and is not medical advice. Results vary from patient to patient. Consult a board-certified plastic surgeon or your physician about your own situation. Written in partnership with Joseph Lambert, a publicist working with Leo Lapuerta, MD Plastic Surgery.