Breast implant removal

Breast implants are an effective way of improving the aesthetic form of the breast and bring a high degree of satisfaction to many. Some individuals may seek removal of breast implants many years later for a variety of reasons.

Why are breast implants removed?

Implants may be removed for a variety of reasons:

  • Presence of capsular contracture (abnormal scarring around the implant periphery)
  • Implant rupture
  • Infection
  • Breast cancer. Breast cancer is unrelated to breast implants, but may occur in previously implanted breasts. Implant removal may be performed at the same time as mastectomy surgery
  • Breast lymphoma. Breast implants have been associated with development of a rare lymphoma (breast implant associated- anaplastic large cell lymphoma, BIA-ALCL). A detailed patient advisory on BIA-ALCL published by the Singapore Association of Plastic Surgeons may be found here
  • Individual desire for implant removal for non-medical reasons

    Breast Implant Removal in Singapore by an Experienced Plastic Surgeon

What is breast capsular contracture?

Breast capsular contracture is abnormal scarring that occurs around the edges of the implant. It manifests as firm scars that are sometimes visible and are occasionally painful. Scarring occurs due to an immune reaction at the edge of the implant causing abnormally high levels of collagen production. The possible causes of capsular contracture include hematoma (blood accumulation), infection and leakage of silicone from the implant.

What is breast implant rupture?

Breast implant rupture may occur due to implant aging or accidental trauma. It presents as changes in breast size and shape, pain, development of firmness and swelling. Saline-filled implants deflate quickly and the saline is absorbed by the body, leaving only the implant shell. Ruptures of saline-filled implants therefore often present with sudden loss of breast volume. Silicone gel-filled implants tend to form firm nodules around the leaked silicone (silicone granulomas) or stimulate formation of scar tissue (capsular contracture). Silicone gel-filled implants tend to present with gradual change in shape and firmness instead.

 

What are the preoperative investigations required?

Prior to breast implant removal, it is routine to perform routine breast cancer screening with mammography, ultrasound or MRI scan.

Breast explantation surgery

Breast explantation alone results in reduction of breast volume and will lead to varying degrees of breast drooping (ptosis). Mastopexy (breasts lift surgery) is then required to elevate the droopy breast and restore it to its youthful and natural position and may be performed at the time of explantation or at a later time.

Successful breast explantation and mastopexy recreate a youthful and aesthetic breast form. Breast explantation surgery, with optional mastopexy, is usually performed under intravenous sedation or short general anaesthesia.

 

Breast explantation may be performed through the previous incision in most cases and no new scar is created. Individuals who desire correction of breast drooping (mastopexy) surgery may require excision of excess loose skin and thus additional incisions. These incisions are well-placed and well-concealed. Breast explantation and mastopexy will restore the breasts to their youthful position, improve breast projection and reduce redundant skin.

Individuals are advised to stop herbal supplements and traditional medicine and start special medications 7 days prior to surgery to minimize bruising and swelling.

Breast explantation is performed through the previous incisions used for breast augmentation. The implant is removed and the capsule, if present, is then partially or completely removed following explantation. Capsulectomy is performed by meticulously dissecting it away from the surrounding breast gland, pectoralis muscle, as well as chest wall.

In cases where mastopexy is planned, a few common skin incisions may be used:

  • The circumvertical (lollipop) incision. This technique is appropriate for the correction of moderate degrees of breast and nipple-areola complex ptosis and horizontal skin excess. The incision is performed around the areola and in a vertical line connecting the bottom of the areola to the IMF
  • The J- or L- incision. This technique is appropriate for correction of moderate degrees of breast and nipple-areola complex ptosis. This incision is similar to the lollipop incision with a slight side extension and is appropriate for reduction of vertical and horizontal skin excess
  • The inverted T incision. This technique is appropriate severe breast and nipple-areola complex drooping and permits complete breast gland repositioning and resuspension to the chest wall with sutures

A detailed explanation of mastopexy surgery .

Individuals requiring mastopexy may require insertion of drainage tubes and these are usually removed in the outpatient clinic on the 1st or 2nd postoperative day. Mild bruising and swelling is expected after surgery, which will mostly resolve by the 7th postoperative day. Many individuals are able to resume work on the 5th postoperative day. Stitch removal is not required as they are self-dissolving.

Showering is normally possible following removal of drainage tubes. Individuals may require compressive dressings to collapse the inner cavity to accelerate wound healing. Strenuous physical activity is avoided for the first 2 weeks postoperatively.

Showering is normally possible following removal of drainage tubes. Individuals may require compressive dressings to collapse the inner cavity to accelerate wound healing. Strenuous physical activity is avoided for the first 2 weeks postoperatively.

The Picasso Advantage

Our clinic has an en suite operating facility that has MOH certification as an Ambulatory Surgical Center (ASC). This assures your maximal privacy and convenience while keeping facility and equipment costs contained.