Specialized Procedure
Implant removal (explant)
Surgical removal of breast implants without replacement. Indications include BII symptoms, BIA-ALCL concern, aesthetic preference change, and lifestyle simplification. Often combined with mastopexy due to skin stretching.
Clinical summary
Implant removal (explant) is the surgical removal of breast implants without replacement. Common indications: BII symptoms, BIA-ALCL concern with BIOCELL implants, aesthetic preference change, complications, lifestyle simplification. The procedure can be simple (implant removal only) or include capsulectomy (partial, total, or en bloc) depending on indication. Many patients benefit from concurrent or staged mastopexy due to skin stretching from prior implants. Cost β¬3,500-β¬8,000 depending on complexity.
Indications for explant without replacement
| Indication | Considerations |
|---|
| Breast implant illness (BII) symptoms | Self-reported systemic symptoms; en bloc often requested |
| BIA-ALCL concern (BIOCELL implants) | En bloc capsulectomy indicated |
| Aesthetic preference change | Personal decision β supported |
| Implant complications without replacement preference | Capsular contracture, malposition, asymmetry |
| Lifestyle simplification | Athletic priorities, sport-specific needs |
| Failed implant warranty / cost considerations | Multiple complications without ongoing investment |
What to expect after explant
Immediate post-op appearance
- Significant deflation as implant volume removed.
- Stretched skin envelope without volume to fill it.
- Asymmetry as both breasts may not contract equally.
- Visible scarring from explant + any mastopexy.
3-6 month emerging appearance
- Skin partially retracts (degree depends on age, skin elasticity, time with implants).
- Breast tissue redistributes to fill the empty pocket.
- Final shape becomes apparent.
Long-term post-explant appearance
- Generally smaller than pre-implant breasts due to skin stretching.
- May appear sagged due to skin laxity.
- Asymmetry common β varies by individual healing.
- Patients with pre-existing children, weight changes, or aging during implant period have additional considerations.
Mastopexy combination decision
Many explant patients benefit from concurrent or staged mastopexy. The decision factors:
| Factor | Mastopexy benefit |
|---|
| Originally small breasts + larger implants for many years | Strong benefit β extensive skin stretching |
| Originally moderate breasts + smaller implants for shorter time | May not need lift |
| Patient with significant weight loss or pregnancy during implant time | Often benefits from lift |
| Patient prioritising natural-looking results | Lift typically helpful |
| Patient willing to accept some looseness for simpler operation | Explant only acceptable |
Single-stage vs two-stage
| Approach | Description | When chosen |
|---|
| Explant only | Single operation β implant removal | Patient accepting natural post-explant appearance |
| Explant + immediate mastopexy | Single operation β implant removal + lift | Most common for patients wanting lift |
| Explant first, mastopexy delayed 3-6 months | Two operations | Complex cases β extensive scarring, compromised tissue |
Cost and recovery
Simple explant
β¬3,500-β¬4,500
With total capsulectomy
β¬4,500-β¬6,000
En bloc capsulectomy
β¬5,500-β¬7,500
Explant + mastopexy
β¬6,000-β¬8,000
Recovery for simple explant typically faster than primary augmentation:
- Day 1-3: mild discomfort.
- Day 7-10: office work return.
- Week 2-3: light cardio.
- Week 4-6: full activity.
- Month 3-6: final tissue settling.
Combined explant + mastopexy has longer recovery similar to combined operations β Week 8-10 for full activity, Month 6-12 for final scar maturation.
Modern practice perspective. Patient choice to remove implants without replacement is fully supported by modern practice. The indications for explant β including BII, aesthetic preference, BIOCELL concern β are valid and respected. Honest discussion of post-explant appearance expectations and mastopexy considerations helps align surgical plan with patient goals. Direct WhatsApp surgeon access throughout 12-month follow-up.
Frequently asked questions
Why might I want to remove my implants without replacement?
Common reasons. (1) Breast implant illness (BII) symptoms β patients attributing systemic symptoms (fatigue, brain fog, joint pain, autoimmune-type symptoms) to their implants. (2) BIOCELL macrotextured implants and BIA-ALCL concern. (3) Aesthetic preference change β patient no longer wants implants, prefers natural breasts. (4) Implant complications without desire for replacement. (5) Lifestyle changes (athletic priorities, simplicity preference). Each reason is legitimate; the right answer depends on patient priorities. The decision to not replace is fully supported by modern practice.
What will my breasts look like after explant?
Depends on starting anatomy and how long implants were in place. Patients with: (1) Originally smaller breasts with implants for many years often have stretched skin and 'deflated' appearance β sagging, looseness. (2) Originally moderate breasts with implants for shorter time may have more natural-looking results. (3) Patients with weight changes, pregnancies, or aging during implant period have additional anatomic changes. Realistic expectation: post-explant breasts typically look smaller and more sagged than pre-implant breasts due to skin stretching by the implant. Some patients elect explant + mastopexy combination.
Will I need a lift after explant?
Often yes. Implants stretch the overlying skin; when implants are removed, the stretched skin may not retract sufficiently to produce natural-looking breasts. Patients with: (1) Smaller original breast size + larger implants for many years almost always benefit from mastopexy after explant. (2) Larger original breast size + smaller implants may have acceptable results without lift. (3) Mild stretching may resolve with time over 6-12 months. The decision is made based on intra-operative findings β a lift can be performed at the time of explant or as a delayed second stage. See
mastopexy page for technique.
Is explant + lift a single operation or two stages?
Both options exist. Single-stage (explant + immediate mastopexy): operates on the breast comprehensively in one operation; avoids second surgical recovery. Two-stage (explant first, mastopexy 3-6 months later): allows tissue to settle after explant before final lift planning; safer in patients with extensive scarring or compromised tissue. Single-stage is more common in modern practice for routine cases; two-stage reserved for complex situations. The decision is patient and anatomy specific.
How is recovery from explant only?
Typically faster and easier than primary augmentation or implant exchange β no new implant pocket healing required. Day 1-3: mild discomfort, less than primary aug. Day 7-10: office work return. Week 2-3: light cardio. Week 4-6: full activity. The simpler recovery reflects the simpler operation β implant removal without replacement involves less tissue manipulation than placement of new implants. Combined explant + mastopexy has longer recovery similar to combined operations.
How much does explant cost?
Cost is variable based on what's done. Simple explant only (without capsulectomy): β¬3,500-β¬4,500 in Turkey all-inclusive. Explant with total capsulectomy: β¬4,500-β¬6,000. Explant with en bloc capsulectomy: β¬5,500-β¬7,500. Combined explant + mastopexy: β¬6,000-β¬8,000. Includes surgeon, JCI hospital, anaesthesia, hotel 5-7 nights, transfers, all follow-up. The cost generally lower than implant exchange because no new implant cost is included.
Related references