04 February 2026 | 16 minute read
Introduction
I am seeing an increasing number of women seeking advice on breast implant removal, both in my London practice in Harley Street, as well as in Tunbridge Wells. There are all sorts of reasons that might be underlying this – from simply reaching a new chapter or stage in life, due to the weight of the implants, due to the change in body shape with age (I often hear the phrase, “I am looking matronly”) or due to changes in the relationship between the breast and the implant. Of course, there may be issues more directly related to the breast implants themselves, whether due to a device rupture or thickening and hardening of the scar tissue around the implant, capsular contracture.
For any of the reasons, one significant consideration is how the breasts might appear after removing the implants, and whether other adjunctive procedures, such as a breast lift, might be indicated. Sometimes, a wise decision is to proceed in 2-stages – a first operation to remove the breast implants with or without the surrounding scar capsules and then to give time to see how the breasts may settle down, with a view to decide on whether a further procedure would be indicated after 9-12 months following the initial surgery.
Fundamentally, any surgery needs to be as safe and predictable as possible, therefore there is no one set procedure for everyone, and decisions must be tailored for you as an individual. This also includes considerations about recovery, downtime and long-term outcomes.
Reflecting on what you are hoping to achieve from breast implant removal surgery is key to maximising the chance of being satisfied with the results of your surgery.
What Is Breast Implant Removal?
Explant surgery, or breast implant removal surgery, often involves more than simply removing the device. This of course is implicit in the surgery, and allowances must be made if the implant is ruptured, and decisions need to be made regarding the capsules, the surrounding scar tissue. Depending on the state of the scar tissue it might be removed or left behind. Sometimes, the scar tissue is incredibly thin and more damage could be done in trying to remove it than leaving it behind. In other situations, particularly in the presence of thickened and hard scar tissue, it is better to remove it if possible.
Sometimes the thought of having breast implants removed brings back all the psychological and emotional anxiety that led to that patient having the implants put in in the first place. In these situations, this is incredibly important to discuss – it might be that instead of removing the implants, replacing them would be the better consideration. The pros and cons of that person’s particular situation therefore need to be understood to help collaboratively make the best decision for them.
As mentioned above, removing a breast implant does not necessarily preclude further surgery in the future. It might be that an “implant holiday”, the term used for having a period of a few months without breast implants, is an appropriate approach. This enables an understanding of what you breasts are like without implants and then often helps make the best decision about whether or not to have further implants or any other breast procedure (such as a lift or implants with a lift). Of course, I understand that ideally no one really wants to have two operations with two sets of recovery and two sets of costs to consider, but for the long-term, this may be a very sensible approach.
Why Do Patients Choose Breast Implant Removal?
There is no “right or wrong” reason for having breast implants removed – it is often a very personal decision and one that any woman she be empowered to make.
Breast implant related reasons might be the cause – either capsular contracture, when the surrounding scar tissue thickens and hardens, or if the implants start to become uncomfortable or start to feel heavy. A tear in the shell of an implant can sometimes result in discomfort or change the shape of the breast, and this too might be a reason.
We all go through phases and chapters of our lives, and it might be that having breast implants was the right decision for that person at an earlier stage of life, but, for whatever personal reasons, after a period of time has passed, they do not feel that they want to continue with their implants. This is something I hear from time to time – no regrets about having them (indeed, often very positive reflections), btu simply that at this next stage in life, implants are no longer wanted.
Breast implants are not lifetime devices – they will not last forever. Whilst we still quote an average lifespan of an implant to be 10-15 years, some will last a lot longer and some will not last that long. Also, it is important to remember that even if there is no issue with the implants, your breasts will likely be quite different in 15-years time compared with when the implants were inserted. As a rule, the longer an implant is in place, the higher the risk of rupture, and understandably, some women will have concerns over the state of an implant that has been in for many years – no matter whether a scan suggests there are no issues.
Finally, there are the psychological and emotional considerations regarding body image, and how these might change over time. Around the time of the menopause, fat distribution often changes, and body proportions might change. Breasts might enlarge due to hormonal influence, and if there are already implants in place, they may become too large and heavy. It is common to hear that this is a reason for considering implant removal.
Breast Implant Removal vs Implant Replacement
On some occasions a woman might feel that she no longer wishes to have breast implants, and therefore the goal of the operation would be to remove the implants as well as making a decision on the surrounding breast implant capsule. On other occasions, it might be that the decision is to downsize and use smaller replacement implants – in this situation a determination needs to be made regarding the breast skin “envelope” and nipple position – it is common in this situation to perform a breast lift at the same time to ensure a better relationship between the breast and the implant.
All of these topics are fundamental discussion points during the consultation process. The pros and cons of replacing vs removing implants, down-sizing and accepting the scars of a mastopexy are all important decisions to reflect on after your original consultation.
Is Breast Implant Removal Safe?
The surgery itself for breast implant removal, and then any additional procedures will most likely take place under a general anaesthetic, and is normally performed as a day case in the operating theatre at Purity Bridge.
On the day of surgery, after reviewing the plans and seeing both nurses and anaesthetists, I will spend time with my patient on planning the surgery. This will involve various drawings on the patient’s breasts and chest to plan the surgery, and will incorporate any aspect of the different techniques agreed on, for example and additional breast lift.
Very occasionally, if the only manoeuvre required is to remove the implants, with no other additional procedure on the capsule or elsewhere, the surgery might be done under local anaesthetic.
What Happens During Breast Implant Removal Surgery?
Once you are asleep, the capsule will be identified around the breast implant. If the plan is to remove the capsule along with the breast implant, then often I will aim to dissect around as much of the capsule as possible, trying to keep it intact. After a certain amount of dissection, the implant will need to be removed from the capsule in order for me to remove the uppermost part of the capsule. In cases where the implant is ruptured, we can remove it without spilling its contents by sucking the implant (contents and shell) using large syringes attached to suction machines. This avoids contamination of the implant with the wound.
Once implant and capsule are removed, it is either the end of the operation, or in effect, the beginning of any next steps – inserting a new implant and/or performing a breast lift. As a result of the wide range of different combinations of surgery, the procedure may take anything from 1-3 hours.
As mentioned above, I normally perform this as day surgery at Purity Bridge in Tunbridge Wells.
Do You Need a Capsulectomy During Implant Removal?
An important question with implant revision surgery is what to do with the capsule. Sometimes, especially when the capsule is soft, it can be a very helpful decision to keep the capsule. It can act as support for different parts of the mastopexy, and “capsular flaps” can be created to reposition and support a new breast implant.
In cases where the capsule is thin and soft, it can actually be more difficult to remove than a thicker, harder capsule. In fact, sometimes it is an unwise decision to try to remove the capsule as the risk of bleeding and damaging healthy tissue can be higher.
In other situations, where the capsule has hardened, capsular contracture, we would always aim to remove all of the capsule if possible. This is because the evidence shows us that if we leave hard capsule behind, it increases the risk of re-development of capsular contracture.
What to Expect Before Breast Implant Removal Surgery
As with any plastic surgery journey, the first step starts with the initial consultation. This helps me understand your breast implant and medical history, your reasons for seeking further surgery, and incorporates a discussion both of the potential options and risks, but also an understanding of your goals and the different trade-offs each option requires.
In my practice, if we know we are going to be removing or replacing the implant, I do not think there is any requirement to scan the implants beforehand – after all, any scan result will not change our decision-making. On the other hand, if your decision about whether or not to proceed with surgery is contingent on whether the implants are ruptured, then a scan is essential. However, it is important to be aware that no scan is ever 100% accurate, and there can be false positives (where the scan suggests an implant rupture, but the implant is actually ok) and false negatives (the scan suggests no rupture, when in actual fact there is a rupture).
I feel strongly that your emotional and psychological support is as good as it can be, as it can be quite impactful having breast implants removed, or accepting new scars on your breasts after a breast lift. This is something both I, and our nurses, will discuss with you. There is rarely a true emergency with this type of surgery, so ensuring you are psychologically prepared for the surgery and the recovery is essential before we proceed.
What to Expect After Breast Implant Removal
Following surgery there will be discomfort and swelling. Many of my patients describe the feeling similar to that when the milk came in after childbirth. There might be additional discomfort around the breast crease area, depending on what other procedures occurred. Bruising and areas of numbness are normal, and many people experience feelings of electric shocks (“zings”) during the recovery process.
Nipple sensation might change – in some nipples become hypersensitive and requires desensitising, whilst in others they can become numb (or somewhere in between).
Our post-operative protocol usually involves you seeing the nurses at 1 and 2 weeks after surgery, with a subsequent appointment with me at around 4-weeks after surgery (and later appointments are then scheduled according to your situation).
Breast Implant Removal Recovery Timeline
Depending on the extent of your surgery, it might be that we advise no driving for two weeks, and we would normally recommend abstaining from sports and exercise for 6-weeks after surgery. Even if you feel well and ready to go back to exercise before this, it would be unwise, as your body still needs this time to heal. If you go back too early, you might suffer otherwise avoidable issues, such as a seroma (fluid build-up in the wound site).
A surgical bra would be provided for your post-surgery healing phase, and at 4-6 weeks we would often suggest changing to a regular bra, provided it offers good breast support.
As a rule, it will take at least 3-months before most of the swelling has settled on your breasts. Up to this point, your breasts will feel firmer than normal, especially in the upper part of the breasts. But to truly judge the final result it takes 9-12 months after the surgery.
How Will My Breasts Look After Implant Removal?
How your breasts will look after surgery depends on many factors. Initially it will be influenced by how long your implants have been in, what size the implants were, how much breast tissue you have, your skin and breast tissue quality, your nipple position and your age (as well as your pregnancy history and any period of past weight loss). As you can imagine, with all these factors at play, it is not possible to give a generic answer to this question.
Depending on the above, it might be that the additional procedures I mentioned above have been performed, such as a breast lift (mastopexy), fat grafting or new implants. All of these factors will influence the result achieved, and therefore having realistic expectations, with open discussions during the pre-operative consultations, and having the opportunity to view before and after photographs of others who have been in a similar position to you are all crucial.
Will My Breasts Sag After Implant Removal?
One truism in life, is we cannot stop ageing, nor can we stop gravity. These both will always have an effect on breasts, whether there is an implant in place or not. Sagging can occur, and inevitably will at some point, after a breast lift, again, whether or not there is an implant in place. Therefore, I recommend viewing implant revision surgery as a reset, as it is not permanent (nothing is). For this reason, during implant replacement surgery, especially if undergoing an uplift, I would normally recommend reducing the size of breast implant to take some of the weight off the breasts.
It might be that at some point in the future further procedures, such as fat grafting, can be considered to enhance the result of address other changes that have been experienced. There is virtually always a way forward, so it is important to continue having open discussions if you have any concerns.
Is a Breast Lift Needed After Implant Removal?
I have mentioned breast lifts above, and the indication for this will be related to various features of your breasts, and the predicted situation your breasts might be in once the implants are removed. Whilst I would normally perform a breast lift at the same time as removing the implant, a two stage approach can be very helpful – where in the first operation we remove the implant, then we wait around 6-months, before taking a view on the mastopexy. The reason this can be helpful, is that it gives you the opportunity to understand and live with your explanted breasts. If after a period of time you are still keen to undergo the uplift, then in all probability you will be more satisfied with the result than if you had not had that time with your explanted breasts.
If performing the explant and mastopexy at the same time, I normally allow 3-hours for the surgery. The recovery is slightly more involved than that without the mastopexy, but the same general rules regarding driving and exercise as mentioned above apply.
Pain, Comfort, and Symptom Relief After Implant Removal
For most of my patients, after a few days of being on codeine or similar pain relief, paracetamol is all that is needed. Occasionally there will be some people who will experience pain for more prolonged periods, but with time and painkillers, this is usually very manageable.
One group of patients I see seek breast implant removal in the hope that it will address breast pain and discomfort. Interestingly, when the implants and capsule are removed the pain relief is felt almost immediately after the surgery.
Practical Questions Patients Often Ask
Many people ask whether I use surgical drains for explant surgery, and the answer is no. I have not used drains in this sort of surgery for around 10-years and have never found a reason to change. This helps with comfort levels and recovery.
I would normally suggest a couple of weeks off work, or if you work from home and are desk-based, it might be that a week is all you need.
What Patients Often Wish They’d Known Before Breast Implant Removal
As I discussed above, one of the biggest considerations I ask my patients to reflect on is emotionally and psychologically being prepared for the change in their body image. In some, it can take quite a lot of psychological adjustment to their new breast, especially if their implants have been in for many years. Spending time reflecting on this really reaps benefits in the post-surgery recovery phase.
In continuity with this, is the importance of ensuring as best as possible, that whatever decision we make together about your breasts, is going to be the best decision for you. There is no right or wrong decision, but I will help guide you through the options and I will give you my opinion too.
Expert Perspective
Advice on Breast Implant Removal from Marc Pacifico
At the end of the day, approaching breast implant removal or replacement with an open mind, and figuring out what a good result looks like to you will help maximise the chance of a good outcome for you. Thinking about the medium to long term is crucial – not just thinking about the next few months or so.
Conclusion
Breast implant removal decisions are elective and should very much involve you. There will be situations where the medical aspects will inform our plans, but in many cases, the emotional and psychological aspects of giving you the best result possible most influence our decision.
Seeking expert consultation with a surgeon with many years of breast implant revision surgery is fundamentally important, and together breast implant removal can be a positive, empowering decision.To schedule your consultation at Mr Pacifico’s practice in Tunbridge Wells or on Harley Street in London, use our online contact form or call +44 (0) 1892 536960.