It’s called “explantation” in the medical community, and women are electing it in increasing numbers. According to the American Society for Aesthetic Plastic Surgery (ASAPS), it’s now the 8th most popular surgical procedure in the United States, with nearly 50,000 women choosing to have their breast implants removed in 2018.
We hear it occasionally from women in New York: is breast implant removal something I should consider?
When We Would Lean Toward “No”
• If you worry about cancer. Don’t misunderstand; we are well aware that a connection has been established between breast implants and a rare form of cancer. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a form of cancer found in the immune system, has been associated with breast implants, particularly those with textured shells. Even so, the risk is extremely low—characterized as somewhere between one in 4,000 to one in 30,000.
For patients having no trouble with their implants, meaning no signs of swelling, lumps, capsular contracture or asymmetry, we would advise no action other than paying attention to any changes that arise. Of course if you have any concerns at all, you should schedule an appointment with your plastic surgeon. Read more about BIA-ALCL here.
• If you’re concerned about breast implant illness (BII). Unfortunately, we’re seeing signs that some of the old hysteria around silicone filling in breast implants may be returning. Today, implants are being blamed for health concerns ranging from headaches to weight gain to choking. Social media spreads the notion that breast implants may cause health issues, even though no studies, whether performed decades ago or more recently, have revealed a valid cause for concern.
We are watching the situation closely and sharing what we know. It’s notable that some researchers believe there may be a connection between silicone breast implants and an autoimmune/inflammatory issue. We join the ASAPS and the American Society of Plastic Surgeons (ASPS) in calling for more research.
We are glad that not one of our patients in New York has asked for breast implant removal due to fears of BII. If a woman with odd health symptoms does ask us about explantation, we will work with her to determine the right course of action for her health and peace of mind. But until scientific research proves that silicone implants can cause problems, we remain unconvinced that BII is real.
When Explantation Might Make Sense
Health worries aren’t the only reason women consider breast implant removal. In New York, we do work with women interested in explantation, most often because:
• They are tired of extra-large implants. A few years ago, very large, even unnatural looking implants were sought after by some. Many of those patients eventually grow tired of lugging huge implants around—physically tired in their shoulders and backs and psychologically ready to attract less attention on the street. Not to mention dismayed by the extra saggy skin inevitable with increased weight.
• The years are making their mark. As skin gives up its youthful elasticity with the passing years, many body features tend to head south. Breasts are no exception, and sometimes women are ready for explantation to have a slimmer, less saggy appearance.
• To “upgrade” to newer breast implant models. Patients with saline-filled implants as well as women with older style liquid silicone implants sometimes elect to swap them out for the newest silicone gel implants. Silicone gel implants feel more like natural breast tissue, especially compared to saline implants, and can help minimize other issues such as rippling and sloshing. Today’s silicone gel is termed “cohesive,” meaning that if an implant shell should rupture, the material will most likely stay within the breast capsule and not migrate elsewhere.
Statistics from the professional societies don’t tell us is what women choose to do after breast implant removal. In New York, we work very closely with our patients to determine the option that makes the most sense. Some women decide not to do anything at all; in other words, to simply remove the implants. That’s perfectly fine with us, as long as they understand and accept the fact that their breasts may not have much of a rounded, smooth appearance after healing. Other options include:
• Implant replacement
• New implants and a breast lift
• Fat transfer
Bodies change over time, like it or not, and women’s attitudes and desires about their breasts can change too. If you’re considering breast implant removal in New York for whatever reason, give us a call at 212-570-6080. We would be pleased to help you reach your goals of good health and satisfaction with your appearance for years to come.