Removal of Breast Implants

There are many reasons a woman may wish to have her breast implants removed. Whether you are experiencing a complication, have concerns about your implants, or have simply decided that implants are no longer right for you, removal is a safe and well-established procedure that our specialist breast surgeons perform regularly.

At Breast & Surgical Oncology at The Poche Centre, implant removal is approached with the same care and expertise as all breast surgery. We take the time to understand your concerns and goals, explain your options clearly, and ensure you know what to expect from the procedure and from the appearance of your breasts afterwards.

Reasons for Breast Implant Removal

Capsular contracture is the most common implant complication requiring surgery. The body naturally forms a capsule of scar tissue around any implant, which in most cases remains soft and causes no symptoms. In some patients, this capsule becomes abnormally thick, hard, and contracted, distorting the shape of the breast and causing firmness, discomfort, or pain. Capsular contracture is graded from mild (Grade I, soft and natural) to severe (Grade IV, hard, painful, and visibly distorted). Grades III and IV typically require surgical management.

Implant rupture or deflation — modern silicone gel implants are highly durable, but rupture can occur. With cohesive gel implants, a rupture may be silent and detected only on MRI or ultrasound. Saline implants deflate visibly when they rupture. Confirmed rupture is an indication for removal or replacement.

Implant malposition — over time, implants can shift from their original position, sitting too low, too lateral, or asymmetrically. This produces a visible change in breast shape and position that may warrant surgical correction.

Rippling or visible implant — where soft tissue coverage over the implant is thin, the edges or surface of the implant may become visible or palpable through the skin, particularly in the lower pole or lateral breast. This is more common with submuscular implants in women who have lost significant weight, and can be addressed with implant removal or replacement combined with fat transfer to improve coverage.

Breast implant illness (BII) — some women report a range of systemic symptoms including fatigue, cognitive difficulties, joint pain, and autoimmune-like symptoms that they attribute to their breast implants. While the scientific evidence for a direct causal relationship between implants and these symptoms remains under review, removal of implants in women with BII concerns is a reasonable and supported clinical choice. Some women report improvement in symptoms following explantation.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) — BIA-ALCL is a rare type of T-cell lymphoma associated with textured breast implants. It most commonly presents as a late seroma (fluid collection around the implant) or a palpable mass. Any unexplained fluid collection or swelling around a breast implant should be assessed promptly. Where BIA-ALCL is confirmed, surgical removal of the implant and its entire capsule (total capsulectomy) is the recommended treatment and is curative in the majority of cases when performed promptly.

Change in personal preference — many women choose implant removal without a specific medical complication, having decided over time that they no longer wish to have implants. This is a completely valid reason for explantation and is fully supported by our team.

Surgical Options

Implant Removal Alone (Explantation)

Straightforward removal of the implant without replacement is performed when the patient does not wish to have new implants and is comfortable with the natural appearance of the breast after removal. The breast appearance after explantation depends on the original breast size before augmentation, how long the implants have been in place, the degree of skin stretching that has occurred, age, and skin elasticity.

For women with a meaningful amount of natural breast tissue, explantation alone can produce a satisfactory result. For women who had very little natural breast tissue before augmentation, or where implants have been in place for many years with significant skin stretching, there may be significant ptosis (drooping) or deflation of the breast after removal. This can be addressed with a concurrent mastopexy (breast lift) if desired.

Explantation with Capsulectomy

Where capsular contracture is present, the contracted capsule is removed alongside the implant. This can be performed as a partial capsulectomy (removal of the portion of capsule causing the problem) or a total capsulectomy (en bloc removal of the entire capsule with the implant inside it), depending on the clinical indication.

En bloc capsulectomy is specifically recommended when BIA-ALCL is confirmed or suspected, to ensure complete removal of the capsule and any associated disease. It is a more involved procedure than standard explantation and requires careful planning to ensure the capsule is removed intact.

Explantation with Implant Replacement

Where the goal is to address an implant complication while maintaining augmented breast volume, the original implants are removed and replaced with new devices. This may involve changing implant size, profile, or type, addressing capsular contracture with capsulectomy before new implant placement, and revising the implant pocket position if malposition has occurred.

Explantation with Conversion to Autologous Reconstruction

For patients who have had implant-based breast reconstruction following mastectomy and have developed significant implant complications or are unhappy with the implant result, conversion to autologous reconstruction using the patient's own tissue (DIEP flap, LD flap, or other) is an option. This is a more complex surgical undertaking but can produce a durable, natural-feeling result for appropriate patients.

Fat Transfer Following Explantation

For patients who experience contour irregularities, deflation, or soft tissue deficit after implant removal, fat transfer (lipofilling) can be used to restore modest volume and improve the shape of the breast using the patient's own fat harvested from the abdomen or thighs by liposuction. Fat transfer can be performed at the time of explantation or as a subsequent procedure once healing is complete.

Medicare and Health Fund Rebates.

Revision surgery of breast Implants placed due to a breast cancer diagnosis is rebatable through medicare and most private health insurance policies.

Revision surgery of breast implants placed for cosmetic purposes alone do not attract rebates through medicare and health funds and are considered cosmetic surgery.  We are not a cosmetic surgical practice and will suggest seeing one of our plastic surgery colleagues if the desired procedure is purely cosmetic.

Simply removing cosmetic breast implantis not considered cosmetic  (and is rebated by medicare and most health insurance policies), but once the breasts are then lifted, or new implants are inserted the procedure is classified as cosmetic.

What to Expect After Implant Removal

The appearance of the breasts after implant removal varies considerably between patients and depends on the factors described above. We encourage every patient considering explantation to have a frank and detailed conversation with their surgeon about realistic expectations before proceeding.

Recovery from implant removal is generally straightforward. Most procedures are performed as day surgery or with one overnight stay. Bruising and swelling are expected for two to three weeks. Most patients can resume light activities within one week and return to full activity within four to six weeks. A supportive bra is worn throughout the recovery period.

Breast Implant Safety and Monitoring

Patients with breast implants are encouraged to monitor their breasts regularly and to seek assessment promptly for any new swelling, firmness, pain, or change in breast shape. Routine breast screening with mammogram and ultrasound is possible and recommended.   MRI surveillance of silicone implants can be considered, or performed when there is a question of rupture.  If you have concerns about your current implants, regardless of when they were placed or by whom, we welcome a consultation.

Booking an Appointment

A GP referral is required for a specialist consultation regarding implant removal. Medicare and private health insurance rebates apply to implant removal for medical indications including capsular contracture, rupture, and BIA-ALCL. Purely elective removal for personal preference may not attract a rebate, though your surgeon will advise on the rebate position for your specific situation at consultation.

This page is intended as a general guide only and does not replace personalised medical advice. The most appropriate approach for implant removal depends on your individual circumstances and should always be discussed with your specialist.