Breast Implant Removal in New York City
Introduction to Breast Implant Removal
At our state-of-the-art practice in New York City, breast implant removal is a delicate but thorough procedure that Dr. Chen performs with confidence. Almost all breast implants used in the United States have a 10-year warranty. While some implants can last for decades, many implants need to be changed in a much shorter period. Implants are not expected to last forever. According to data gathered by implant manufacturers, about half of breast implants need to be changed within seven years. Common reasons for implant problems include capsular contracture, rupture, and infection.
What is Breast Implant Removal?
Breast Implant Removal surgery removes unwanted breast implants from patients who have had breast implants placed for either breast augmentation or breast reconstruction. Dr. Chen removes breast implants with a complete en bloc capsulectomy, in which all of the capsule – or scar tissue – around the breast implant is also removed in its entirety.
Scar tissue that forms after the placement of an implant can be soft and does not need to be removed, but if it hardens, it can cause pain and discomfort. This is a primary reason to have the implants and scar tissue removed.
Capsular contracture is scarring that occurs around the breast implant. All breast implants – smooth, textured, round, shaped, above the muscle, below the muscle – will develop a capsule. The scar tissue – or capsule – is part of the normal healing process, and it is not possible to heal with a capsule. Since implants are a foreign body, the body tries to wall off the implant by creating a capsule around it as a barrier from the implant. The capsule can be soft and flimsy like a film that is not noticeable. Or it can become firm and painful like a hard shell that feels like it shrinks and contracts over time. When an implant develops a hard, painful capsular contracture, it is not dangerous in and of itself. The discomfort, however, may lead women to want the implant and the capsule removed in its entirety.
An en bloc capsulectomy can be performed to remove the implant and the capsule in one piece. A complete en bloc capsulectomy is a painstaking and meticulous procedure that removes every bit of the capsule, including the section that may be very adherent to the chest wall and ribs. A partial capsulectomy leaves pieces of the capsule in the breast pocket. The surgical dissection from an en bloc capsulectomy is an irritant to the remaining breast tissue and will stimulate fluid production from the body. After an en bloc capsulectomy, it is usually necessary to place drains to allow the fluid from the breast pocket to exit the body. If a new implant is being placed, it can be placed in a fresh space. In other words, if the original implant was placed under the pectoralis muscle, the new implant could be placed over the pectoralis muscle. If the breast implant was originally placed underneath the pectoralis muscle, the pectoralis muscle has almost always been divided or damaged. In these cases, it is to repair the pectoralis muscle.
For patients who undergo implant removal and en bloc capsulectomy and who do not want new implant to replace the old implant, drains will need to be left to drain fluid from the breast because the body does not like empty spaces and will try to fill the potential space with fluid. Patients who still have breast tissue may eventually need a breast lift, or mastopexy, to rearrange any remaining breast tissue to recreate a breast mound. Otherwise, the stretched-out breast skin that has lost the volume from the implant may look empty, deflated, and unsightly. Some patients who do not want implants but need more volume may benefit from fat grafting to add bulk to their breast tissue. Fat grafting involves liposuction from another part of the body, processing and purifying the lipoaspirate, and then injecting the purified fat cells into the breast tissue to add volume.
Patients who have undergone mastectomies and thus have no breast tissue after implant removal and en bloc capsulectomies can decide to undergo breast reconstruction with new breast implants or with their own tissue. Autologous tissue breast reconstruction after a mastectomy is best performed with flaps, in which skin and fat from another part of the body are transferred to the chest with its own blood supply to create a new living breast. The gold standard in autologous tissue breast reconstruction is perforator flap breast reconstruction, a type of breast reconstruction that preserves the muscle from the donor site.
Both saline and silicone implants can rupture. All implants – even saline implants – have a silicone shell, and the silicone shell can wear out over time. When a saline implant ruptures, it is usually obvious as the implant simply deflates. In addition, the saline that spills into the tissues is considered safe, as saline is the same fluid that is used intravenously to rehydrate the body. When a silicone implant ruptures, however, it is usually silent. Furthermore, silicone is supposed to be inert, but the ruptured silicone gel can cause irritation to the surrounding breast tissue that can worsen over time so instead of deflating a breast with a ruptured silicone breast implant can grow larger due to inflammation.
Both ruptured saline and silicone breast implants should be removed and/or replaced. In the operating room, removing a ruptured saline implant is relatively straightforward. Removing a ruptured silicone implant, however, is more challenging because the thick sticky gel can be difficult or even impossible to remove entirely. If the silicone gel spills into the tissues, it may be necessary to resect some breast tissue. This can leave breasts appearing dimpled, wrinkled, sagging, and otherwise deformed, and the remaining breast tissue may not return to its original shape. If a ruptured silicone implant is replaced, there may be a higher risk of complications compared to the first time. If an implant is not replaced, it may be necessary to perform other procedures to recreate a breast shape.
Since breast implants are a foreign body, they do not have a blood supply. If a patient develops breast infection, the implant cannot bring white blood cells and other natural defenders of the body to fight the infection. If the infection is a skin infection only, such as redness from cellulitis, then it may be possible to control the infection with antibiotics. If a breast implant itself becomes infected, however, because bacteria is seeded on the implant, then it needs to be removed. An untreated infection from a breast implant can lead to life-threatening sepsis, which is the only true medical emergency associated with breast implants. Infection from breast implants can occur any time – days, years, and even decades – after the breast implant is placed. For this reason, patients with breast implants should take prophylactic antibiotics when undergoing invasive procedures such as teeth cleaning and colonoscopies.
Since breast implants are a foreign body, they can create pressure against the breast skin from the inside. This constant pressure occasionally leads to erosion of the breast skin so that the implant starts to push through the skin. When the breast implant pushes through the skin to the outside world, this is called extrusion. Although rare, extrusion is most common among women who have undergone radiation treatment for cancer. This is because radiation therapy damages the skin, and makes it more difficult to heal. Extrusion can also occur in breasts that have not undergone radiation if the patient or her skin has been otherwise compromised. If a breast implant extrudes through the skin, it is considered contaminated by the outside world and needs to be removed – with or without replacement.
Anaplastic Large Cell Lymphoma
In 2016, the World Health Organization determined that there was an association between breast implants and anaplastic large cell lymphoma (ALCL). ALCL is a rare type of non-Hodgkin lymphoma (NHL), cancer involving the cells of the immune system. The latest statistics on Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) places the incidence as approximately 1 in 450 women with textured breast implants or 0.2% of women with textured breast implants. The pathognomonic signs of BIA-ALCL are a capsular mass and/or fluid around the breast implant, with CD40 markers on pathologic or cytologic analysis indicating ALCL. For early stages of BIA-ALCL, removal of the breast implant with complete en bloc capsulectomy is curative. For more advanced stages of BIA-ALCL, chemotherapy or radiation therapy may be necessary. Worldwide, 35 patients have died of BIA-ALCL.
BIA-ALCL is extremely rare, and it is not a breast cancer but instead, it is a cancer of the scar tissue or capsule around the breast implant. Thus, women with breast implants may have a very small but increased risk of developing ALCL in the scar capsule surrounding the breast implant. There is currently no trend of implant type (saline vs silicone) or implant reason (aesthetic augmentation vs reconstruction) associated with a smaller or greater risk of ALCL. 91% of BIA-ALCL cases were in textured breast implants made by Allergan, which were taken off the market worldwide in 2019. There have been rare reports of BIA-ALCL in smooth breast implants, however. When ALCL occurs with breast implants, it is identified most frequently in patients undergoing implant revisions for late-onset, persistent seroma, which is a fluid collection that develops around the implant. Thus, the FDA does not currently recommend prophylactic breast implant removal in patients without symptoms or other abnormalities.
Breast Implant Illness
Breast implant Illness (BII) encompasses a constellation of autoimmune symptoms that includes chronic fatigue, brain fog, joint aches, food and drug allergies, skin and hair problems, and many other issues that affect women with breast implants. While BII is not recognized by the medical community, people who suffer from BII typically report developing problems after getting breast implants, and seeing numerous healthcare practitioners who are unable to pinpoint the source of their problems despite numerous tests. After their breast implants are removed, patients describe their symptoms as resolving. While there is no confirmation of BII as a medical diagnosis, there have been numerous studies that show a higher association of autoimmune problems in patients with breast implants.
For example, a 2019 study published by the University of Texas MD Anderson Cancer Center looked at long-term outcomes of almost 100,000 women with silicone breast implants and found up to 8 times the normal population rates of rare diseases like rheumatoid arthritis, scleroderma (a connective tissue disease), and Sjögren’s syndrome (an autoimmune disorder), as well as three to four times the incidence of stillbirth and melanoma. In 2018, an Israeli study compared 25,000 women with silicone breast implants to 100,000 women without implants and found that there was a 22 percent higher rate of risk of autoimmune or rheumatic disorders among the women with implants. While these studies do not prove a cause-and-effect relationship between breast implants and autoimmune issues, the association has caused concern among many women with breast implants – especially those whose unexplained symptoms only developed after getting breast implants.
What are the Benefits of Breast Implant Removal?
If you have decided that you no longer want your breast implants, Dr. Chen can remove your breast implants with a complete en bloc capsulectomy. Some of the benefits our New York City patients have seen are:
- Better Mammogram visibility
- Resolution of pain and discomfort from breast implants
- Resolution of BII symptoms
- No need to worry about breast implant complications
- No need for MRIs for ruptures
- No fear of ruptures
- No need for replacements
- Short recovery time
What’s the First Step?
The first step in getting Breast Implant Removal in NYC with Dr. Chen is to contact our office and schedule a consultation. During this one-on-one meeting with Dr. Chen, you will be able to ask questions and discuss your personal goals. Dr. Chen will assess your needs and develop a plan with you to address your concerns.
What to Expect on the Day of Breast Implant Removal?
On the day of your surgery, you will be met by a nurse, an anesthesiologist, and Dr. Chen. Your surgery will be performed under general anesthesia so you will not feel anything during surgery.
Dr. Chen will then almost always use your current scar to remove your breast implant. In rare cases, she may need to extend your current scar if it is extremely small or make an additional incision to gain access to the breast implant. Dr. Chen will remove the implants and any scar tissue through this incision, which is then closed with dissolving sutures.
Breast Implant Removal Recovery
Once you are finished with your surgery, you will be able to return home and begin your recovery on the same day. You may be wrapped in a compressive dressing, and you should avoid heavy lifting over 5 pounds for 6-8 weeks. If you have drains, they are usually removed in the first 1-2 weeks. You will be prescribed pain medication for any postoperative discomfort.
Why Choose Dr. Chen for a Breast Implant Removal
Dr. Constance Chen is a board-certified plastic surgeon with special expertise in using innovative, natural techniques to optimize medical and cosmetic outcomes for women. She understands that every woman has her unique concerns and treatment preferences, and prides herself on being able to give every patient highly individualized attention. She is experienced in removing breast implants with a complete en bloc capsulectomy – even underneath the pectoralis muscle. In addition, she is one of the few plastic surgeons who are capable of performing implant removal with a complete en bloc capsulectomy through a small incision.
How Much Does a Breast Implant Removal Cost in NYC?
The cost of Breast Implant Removal in NYC will vary from patient to patient. A consultation is necessary to formulate a surgical plan. Once a plan is determined, Dr. Chen’s staff will put together a cost estimate for you.
Schedule Your Consultation
When you feel that a Breast Implant Removal in New York City is best for you, we encourage you to contact our Manhattan office and schedule your one-on-one consultation with Dr. Chen. She looks forward to meeting with you and helping you find the comfort and aesthetic appearance you want.REACH OUT TO US
Breast Implant Removal FAQs
Is Breast Implant Removal painful?
The surgery itself is performed under general anesthesia, so there is no pain during the procedure itself. Dr. Chen usually uses a regional anesthetic in the chest wall that keeps the surgical site numb for 3-5 days. She also prescribes postoperative pain medication if there is any additional discomfort after surgery.
How many appointments will I need?
After your initial consultation, Dr. Chen will typically see you 1 month prior to surgery, 2 weeks prior to surgery, and just prior to surgery for preoperative marking. Following your surgery, Dr. Chen will have you return for some follow-up visits to ensure that your recovery is going well. Usually, she will see you 1 week after surgery, then 2 weeks, 1 month, 3 months, 6 months, and 1 year after surgery.
How long until I see results?
Patients who are removing their breast implants due to pain and discomfort will usually notice a difference immediately after surgery. That is, they will almost always notice that their symptoms have either improved or even disappeared entirely. The appearance of their breasts, however, will evolve over time. Breast Implant Removal is a surgery that can have a variety of results as swelling and postoperative changes need time to see post-operative results. The skin will contract and any remaining breast tissue will reexpand. The results also depend on the size of the implants being removed, as well as the quantity and quality of the breast tissue that is left. It can take 6 months to a year for patients to see their final aesthetic results.
Can I combine Breast Implant Removal with other procedures?
Yes, some patients combine Breast Implant Removal with a Breast Lift or fat grafting for optimal appearance. Other patients have chosen to have other cosmetic procedures such as Liposuctions, Tummy Tuck, or mommy makeovers. If you are interested in additional procedures performed, please discuss this with Dr. Chen during your consultation.
What are the risks associated with Breast Implant Removal?
As with any surgery, there are possible risks associated with breast implant removal surgery. These risks include, but are not limited to:
- Anesthesia risks
- Cardiac and pulmonary complications
- Deep vein thrombosis
- Deflated, unattractive breasts
- Fatty tissue found deep in the skin might die
- Fluid accumulation
- Numbness or other changes in nipple/areola sensation
- Numbness or other changes in skin sensation
- Persistent pain
- Poor healing of incisions
- Possibility of revision surgery
- Prolonged swelling
- Recurrent looseness of skin
- Skin discoloration
- Suboptimal aesthetic result
- Unfavorable scarring