The macom® Ultimate Guide To Explant Surgery
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The macom® Ultimate Guide To Explant Surgery

Breast explant surgery is a common procedure that is undertaken for a number of reasons, both cosmetic and medical, related to breast implants. Explantation is relatively simple but requires careful consideration and patients benefit from a clear understanding of the surgery, potential complications and recovery. 

In this Ultimate Guide, we look at all aspects of explantation surgery, from the reasons why patients have their breast implants removed, to how the procedure is carried out, and how macom® bras and vests can help to support recovery. 

What is Explant Surgery?

Explant surgery is a procedure also known as breast implant removal. Whether for personal reasons or due to issues with their implants, a person may need to have their breast implants surgically removed.

Why is Breast Implant Removal Needed?

There are a variety of reasons why someone may decide to have their implants removed. This could be for personal or aesthetic reasons, or it may be medically necessary due to issues with the breast implants themselves.

Personal reasons for explant surgery:

  • Body shape has changed – breast implants no longer "fit" with preferred body shape.
  • Return to natural breast size – some people choose to return to their original breast size.
  • No longer want to maintain implants – implants should be replaced every 15 years.

Breast implants can be chosen by a patient to increase their own breast size or to replace the breast tissue lost due to a mastectomy. In both situations, breast implants can have complications or cause issues that necessitate their removal.

Issues that lead to breast implant removal include:

  • Asymmetry – one reason for breast implants is to create the appearance of symmetry between breasts; this is a consideration also with breast augmentation to increase breast size. However, the tissue within each breast can differ and so once inserted breast implants may create asymmetry and need removal or replacing.
  • Implant rippling – most common with saline or silicone breast implants, the folds of the implant can show under the skin in a way that seems unsightly, making the patient want to remove the implants.
  • Implant rupture – a hole or tear in an implant or leak in the value of a saline breast implant will cause it to deflate, and so require removal. This chance of this occurring increases the longer an implant is in.
  • Capsular contracture (capsule formation)– stiffening of internal scar tissues, from the initial breast implant surgery, can lead to a feeling of stiffness or pain in the breast area. A constricted implant can therefore need removing to alleviate discomfort and pain.
  • Breast Implant Illness (BII) – this can range in intensity and symptoms (discussed in more detail below).
  • Anaplastic Large Cell Lymphoma (BIA-ALCL) – a very rare but serious cancer of the immune system (discussed in more detail below).

Breast Implant Illness (BII) 

BII is the name used for a range of symptoms that patients feel as a result of their breast implants, which can range in intensity from mild to severe. Common symptoms include:

  • anxiety
  • breathing problems
  • chronic fatigue
  • depression
  • dry mouth and/or eyes
  • gastrointestinal problems
  • hair loss
  • headaches
  • joint and/or muscle fatigue
  • skin problems, such as rashes
  • sleep disturbance

While some symptoms are simply uncomfortable, others can be signs of, or lead to, an autoimmune/inflammatory syndrome, such as:

  • lupus – inflammation of joints, skin and other organs.
  • rheumatoid arthritis – stiffening, swelling and pain in joints, specifically ankles and wrists.
  • scleroderma – hard/thick skin, leading to issues with internal organs and blood vessels.

Since there are so many symptoms and potential complications, it can be hard to identify BII. The solution to most issues is to have breast implants removed, though additional treatment may be necessary. 

More information on Breast Implant Illness can be found on one of the dedicated sites:

Anaplastic Large Cell Lymphoma (ALCL)

ALCL is a very rare form of cancer of the immune system. It is found in few cases of breast implants and is remedied by breast explant surgery. While this is a highly uncommon condition, which would necessitate breast implant removal, some patients choose to have explantation simply due to the fear of developing this condition.

Explant Surgery: How Does it Work

Breast implant removal is normally an outpatient procedure, meaning it can be undertaken in a day with no overnight stay required. Naturally, if you have any other existing conditions or a previous medical history, it may be necessary to stay longer to ensure a healthy and safe recovery. 

For explantation surgery, a general anaesthetic will be administered. While you are under, the implants will be removed with incisions at the same point where your breast implants were added. This helps to minimise scarring. 

En Bloc Removal Technique

The preferred explant surgery technique, En Bloc removal, extracts the implant and breast capsule in one. A breast capsule is the scar tissue that forms around breast implants. For leaking implants and silicone implants (where you want to avoid contamination from even microscopic amounts of silicon), removing the capsule with the implant at once is very important.

Breast Implant Removal: With or Without Replacement

Depending on the reason for breast implant removal, patients may want to replace the removed implants with new ones. This can occur when a different variety of implant is wanted, such as switching from silicone to saline implants. Breast implant removal without replacement is equally likely, especially if there are any underlying issues which have led to the explantation surgery.

Recovery From Explant Surgery

After breast implant removal, even though it is not a complex or long procedure in most cases, there is a significant recovery time. The most important part is rest and while patients may return home on the same day as their surgery, they must rest for at least 24 hours. You will have to attend follow up appointments to ensure healing is taking place without further complications.

To ensure a fast and safe recovery, patients should avoid lifting or carrying for at least 2 weeks. You should also aim to sit upright whenever possible to minimise swelling.

After Implant Removal: Side Effects

There are a few side effects from explant surgery to be aware of, and most are common with this level of surgery rather than specific to breast implant removal. Patients can expect:

  • Bruising – not common with explantation surgery but possible.
  • Scarring – this will be minimised as implants are removed at the same incision point as they were introduced.
  • Swelling – since your body is healing, you can expect some swelling around the surgical area.
  • Haematoma – an increase in pain or swelling within the first few hours after surgery can be the sign of a haematoma, a blood clot caused by internal bleeding. It can be remedied with a short surgery.
  • Pain – general soreness around the surgical area will be minimal
  • Infection – though rare, infection is always a risk with any surgery. It can be treated with antibiotics.

Explant Surgery Bras & Vests to Support Recovery

Compression garments can be a valuable part of breast implant removal recovery. Available as bras and vests to suit your needs, these help you feel supported while adapting to your new breast size. All of macom®'s compression bras and vests have been created in collaboration with surgeons to ensure they are not only using medical grade technology but that they are comfortable and supporting.

So why might you want to invest in an explant vest and/or bra? Here are 5 reasons:

  1. The compression helps to mould your breast tissue to their pre-implant shape.
  2. Cups are designed for optimal healing by retracting to accommodate swelling.
  3. They are made from breathable materials that wick moisture.
  4. A seamless design prevents irritation and rubbing against skin and under clothes.
  5. Sizeable to your new cup size, based on high street sizes.

For breast implant removal without replacement, our most popular garments are:

Do You Have Further Questions About Explant Surgery?

Hopefully, the above has given you an in-depth overview of what to expect from breast implant removal, the recovery process and how you can make your recovery quick and comfortable. Please don't hesitate to get in touch if you have questions about how our bras and vests can help with your explant surgery. 

You can also find more information on cosmetic breast surgery in our ultimate guide.

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