Surgical Removal of Implants

Removal of an intact implant

Removal of an intact implant is generally not recommended due to the risks involved in having surgery, such as infection, bleeding and reaction to the anaesthesia. However, women whose implants are intact but who are ill from other complications sometimes find that their health improves dramatically after removal. A study of removed implants that were not replaced, carried out by Noreen Aziz and her colleagues, found that 97% of women with pain and other rheumatology symptoms felt better after their implants were removed and not replaced. Many symptoms lessened or disappeared over the next few months. In contrast, 96% of the women who did not have their implants removed became even more ill.

Removing intact implants is not always complicated, but it can be very difficult to remove certain kinds of implants, such as foam-covered implants (polyurethane), implants with hard capsules surrounding them, and implants that have ruptured. This kind of explanation sometimes involves removal of not just the implants, but also removal of some of the tissue and muscle surrounding the implant.

Removal of a silicone gel implant is more complicated than having it put in. This is particularly true if the implant is leaking or has ruptured, because it’s very important to ensure that silicone gel from a broken implant does not spill or remain in the body.

The surgeon who performed the original surgery is not necessarily the best choice for removing the implants. Explantation (removal of a breast implant) results can be excellent or disastrous. Some plastic or cosmetic surgeons are very experienced at implantation, but not explantation. However, there are some plastic surgeons who are very experienced at removal and are especially skilled at getting the best possible cosmetic result. The surgeon you choose should be experienced with explantation, specialist registered as a plastic surgeon, and should be willing to show you pictures of many patients with post-explantation results, or better still, offer to have former patients talk to you. Find out if they were happy with their doctor and with their results.

Removal of implants en bloc

Most experts believe that removing the implants ‘en bloc’ is very important. This means that the entire implant and the entire scar tissue capsule surrounding it are all removed together. Although it is more difficult than removing just the implants, it makes it easier to remove any silicone that may have leaked from a broken gel implant, and also helps remove silicone or other chemicals that may have bled from the silicone outer envelope. You should ask your surgeon if he/she would use this procedure.

Removing implants en bloc is particularly recommended by experts if you have become sick since receiving your implants. Some experts believe that symptoms such as joint pains, chronic flu-like symptoms, memory loss, confusion, or a burning sensation could be a result of silicone that has leaked from your implant, and perhaps outside the scar tissue capsule. If this is the case, leaving the scar tissue capsules, or part of them, and/or silicone in your body, probably isn’t going to let you recover as well as you might. It is also possible that while the silicone did not make you sick before, silicone that is left behind after explantation could make you sick later, because your body will respond to this foreign material.

Some surgeons discourage patients from removing their implants without replacing them, because they believe implants are safe and because they’re concerned that the patient will be very unhappy with her appearance after the implant is removed. The breast tissue stretches from the implant, and if the surgeon isn’t skilled in explantation without replacement, the breast is unlikely to be as attractive as it was before the implant surgery. If the surgeon is not skilled at removing ruptured implants, the silicone can spill into healthy breast tissue, which then may need to be removed as part of the surgery. However, after an experienced explant surgeon removes implants, many women are very pleased with the way their breasts look and feel.

An expert’s point of view

Ruth Waters, Consultant Plastic Surgeon at Queen Elizabeth Hospital, Birmingham, gives her view on PIP implants:

‘If I had a PIP implants, I would want them removed even if there wasn’t a rupture because they are not a good quality implant and the shell of the implant is not strong so it could lead to problems in the future. There is no risk to a patient’s general health if there is a small leak of silicone. However, if it is left for a long period, the surgery can get more complicated to do.’