Top 5 Reasons for Breast Implant Removal in North Carolina

Many women decide to remove their breast implants without replacement.  I do a large number of explantations and had found that the reasons for my patient's decision varies.  Although there are a number of more recent concerns about implant safety, the majority of women choosing explantation do not have those as a primary concern.

The top 5 reasons women choose to remove their breast implants include:

 #1; 

Age changes and weight gain: A fairly large percentage of women will gain weight as they age and even if they don't, aging changes causing laxity of the breast and breast ptosis occur with patients feeling that their breasts are no longer attractive and are either too big or too droopy.  Many of these women have sufficient breast tissue to allow explantation with mastopexy

#2: Local problems and capsular contracture:

Over the years especially with some of the older types of implants, capsular contracture, rupture and implant malposition occur resulting in deformed and distorted-appearing breasts.  I find women frequently do not want to have to deal with the potential of this occurring again so at the time of removal of ruptured implants or encapsulated implants, they choose explantation alone with or without mastopexy

#3:Fear or concerns about breast implant illness: 

Over the last 4-5 years there has been a rise in the number of women concerned about breast implant illness.  This is a fairly controversial entity with little validation in the literature.  However there are certain circumstances where breast implants whether contracted or ruptured or not -may affect some women and result in the stimulation of their body's immune system or cause inflammation  reacting  to the implant material.  Many women choose explantation of the breast implants with capsulectomy in an effort to alleviate potential problems that affect their overall health. The majority of women report some improvement in symptoms although it is rare that their entire list of concerns gets better.

#4

Concerns about implant integrity: Saline implants offer some degree of increased safety over gel implants in that, if they rupture -it is immediately apparent with flattening of the breasts.  The saline is harmlessly absorbed by the body and the situation is not immediately dangerous and can be electively treated.  Silicone gel implants- which can leak nearly as frequently as saline implants, do not typically have outward and immediate symptoms or physical signs of rupture.  In fact, silent rupture or undetectable rupture is felt to occur in many ruptured gel implants.  MRI is the best test to determine implant integrity and ultrasound may be helpful as well.  Many women have concerns about long-term monitoring and decide  to have the implants removed for that reason.

#5 Potential ALCL

Anaplastic Large Cell lymphoma associated with breast implants-is also known as Breast Implant Associated-ALCL.  This is a relatively newly discovered phenomena where textured breast implants are believed to incite the bodies own immune system because of the chronic irritation from textured implants.  One type of implant, commonly used in the past,  was found to have a highest incidence and have been withdrawn from the breast implant market.  Patients with these implants generally had been notified by the company if they are in their database and frequently request removal.  Although the condition is fairly rare, the disease usually does not present itself till 7-8 years after implantation so many women choose to have them removed electively.  Treatment for ALCL involves complete capsulectomy and implant removal and further treatment with chemotherapy.

In summary, implant removal is becoming a more frequent procedure for a variety of reasons.  The vast majority of women are happy with her decision and seek out experience plastic surgeons to help them make the best decisions about the procedure and potential techniques to overcome the common adverse effects of explantation.