More and more women are choosing to have their implants removed — because they have breast implant illness (BII), because they’ve decided they just don’t want anything foreign in their body, because they want to be smaller, or maybe they’re just tired of them! All of these are valid reasons, and none require justification. My job is to help you figure out the right approach for your goals and anatomy.
Implant removal is done under general anesthesia, usually through your existing incision scar. The implant comes out, and then we decide — based on your preoperative plan — what to do about the capsule. The capsule is the layer of scar tissue your body naturally forms around any implant; it’s not a complication, it’s just what bodies do.
Whether and how much capsule to remove depends on several factors: why you’re removing the implants, the condition of your capsule, your anatomy, and your goals. This is something we’ll discuss in detail at your consultation. The range of options goes from a simple implant removal with the capsule left in place, all the way to a total en bloc capsulectomy where the implant and capsule are removed as a single unit.
If we’re also doing a lift or fat grafting at the same time, the total surgery time will be longer. We’ll plan everything out together so you know exactly what to expect before you walk into the OR.
The implant is removed and the capsule is left in place. The capsule typically collapses and softens on its own over time. This is the least invasive option and makes sense when the capsule is thin, soft, and there are no concerns about the capsule itself.
Part of the capsule is removed — often the anterior (front) portion — while leaving some behind. This is a reasonable middle ground when full removal isn’t necessary but we want to address areas of concern.
The entire capsule is removed, though not necessarily in one piece. This is indicated when the capsule is thickened, calcified, or causing symptoms — or when a patient strongly prefers complete removal for peace of mind.
The implant and surrounding capsule are removed together as a single intact unit, without opening the capsule during surgery. This is the most technically demanding approach, requires a larger incision, and is not always possible depending on where the capsule is located relative to the chest wall. It’s most commonly discussed in the context of BII or BIA-ALCL (a rare lymphoma associated with textured implants). We’ll talk through whether this approach makes sense for you.
This is almost always the first question, and it’s the right one to ask. The honest answer: it depends on how much breast tissue you have, how long you’ve had implants, and how much skin laxity you’ve developed over time. Some women remove implants and are happy with how their natural breasts look and feel. Others want to address the shape or position. Here’s what we can do:
If you have skin laxity or ptosis (drooping) after removal, a lift can reshape and elevate the breast using your own tissue. This can be done at the same time as the explant or as a staged second procedure. I often recommend doing it simultaneously when we have a clear plan, because it saves you a second surgery and anesthesia. The tradeoff is a longer operation and a bit more to recover from — we’ll weigh that together.
Fat grafting involves harvesting fat from one area of your body (usually the abdomen, flanks, or thighs) and transferring it to the breasts to restore some volume. It’s a great option for women who want to maintain some fullness without another implant. The results are natural, permanent (though some fat is always reabsorbed in the early months), and come with the bonus of contouring wherever the fat came from. It does have limits — we can’t transfer unlimited volume — so it’s best for women looking to maintain a modest size rather than going significantly larger.
If you love having implants but want to downsize, we can remove your current implants and place smaller ones. This is a great option if your main goal is reducing size or weight while keeping some of the shape. We’d go through implant sizing together the same way we would for a primary augmentation.
BII is a term used to describe a constellation of symptoms — fatigue, brain fog, joint pain, hair loss, anxiety, and others — that some women with implants attribute to their implants. It is not currently a formal medical diagnosis, and the research is still evolving. I want to be honest with you about that.
What I also want you to know is that your experience is real. The women I’ve spoken with who feel that their implants are making them sick are not imagining it. Whether the causal relationship will eventually be formally established or not, if you feel better after having your implants removed, that matters.
I will never dismiss what you’re experiencing or talk you out of explantation if that’s what you’ve decided. My role is to make sure you have accurate information about what surgery can and cannot do, and then support whatever decision is right for you.
Recovery from implant removal alone is typically shorter and easier than the original augmentation. Most women feel pretty functional within a few days and return to desk work within a week. If we’re adding a capsulectomy, lift, or fat grafting, plan for a longer recovery — more like 2–4 weeks before feeling back to normal, and 6 weeks before returning to full exercise.
You’ll wear a surgical bra for 4–6 weeks. Drains are sometimes placed after a capsulectomy and are usually removed within the first 1–2 weeks. If we did fat grafting, you’ll also be wearing a compression garment on the donor site.
Many women who remove implants for BII-related symptoms report feeling noticeably better within weeks to a few months. I hope that is your experience too.
Your breasts will be swollen and may look different than you expect immediately after surgery. Give your body time. Most of the swelling resolves within 6–8 weeks, and the final shape settles in over 3–6 months.
If we added fat grafting, expect some initial volume loss in the first 3 months as a portion of transferred fat is reabsorbed — this is normal. What remains at 3 months is what you can expect to keep long-term.
Probably not — but it depends. En bloc is one specific technique, and it’s not always the right choice or even technically feasible. The posterior capsule (the part up against the chest wall) can be very adherent to the ribs, making en bloc removal risky. A total capsulectomy — removing all of the capsule, carefully, without necessarily keeping it in one piece — achieves the same goal of complete capsule removal with a lower risk profile. I’ll be honest with you about what’s possible and what I recommend based on your specific situation.
It’s a real concern, and I won’t sugarcoat it — some women do experience significant skin laxity after removal, especially if they’ve had large implants for many years. How your breasts look after will depend on how much natural tissue you have, how long you’ve had implants, your skin quality, and whether you’ve been pregnant. At your consultation I can give you a realistic sense of what to expect and what options (lift, fat grafting) might help.
There are good arguments for both. Doing it simultaneously means one surgery, one anesthesia, one recovery. The tradeoff is that it’s harder to predict exactly how much lift you’ll need until the implants are out. Staging the procedures — removing the implants first, waiting a few months, then lifting — gives us a cleaner picture of your native tissue, but means two surgeries. For most patients in good health with a clear idea of their goals, I lean toward combining them if the plan is straightforward. We’ll talk through which approach makes more sense for you.
Yes. Removing your implants now doesn’t permanently close that door. If we remove the capsule, a new one will form around any future implant — that’s just how the body works. Some women remove their implants and never look back; others decide down the road that they want them again. You’re not making a forever decision either way.