Comment Reasons for Explantation, Raleigh,NC*

Removal of breast implants or explantation has become more and more common in the last 5-10 years. The most common reasons for explanation Include: #1 size too large #2 implant-related problems like capsular contracture or implant malposition #3 discomfort or breast pain #4 concerns for breast implant illness #5 leakage of breast implant. This patient had 350 cc subglandular breast implants placed by another physician. She always felt her implants were too large . She was never comfortable with them. Over several years she started to have discomfort from the weight of the implant. She decided she no longer wanted the breast implants but noted that her nipples are starting to droop. She realized that with removal of her implant without any replacement, she would have even worse sagging or ptosis of the breast. She underwent bilateral explantation of her breast implants with mastopexy. This can be a challenging procedure. For one thing, the blood supply to the nipple areola complex has been altered by the placement of the implant and actually is even at more risk with subglandular placement. Mastopexy in the setting of explantation must be done with skill and knowledge of a variety of techniques to achieve a good outcome. In some patients, aggressive capsulectomy or even en bloc capsulectomy may be necessary based on the condition of the capsule and breast implant. This can further compromise blood flow and nerve supply to the nipple