Breast Implant Removal (Explant Surgery) In Sydney & Canberra

For various different reasons, some women decide to have their breast implants removed. This could be due to weight gain or loss, or even a change in lifestyle choices that can affect the way that breasts age over time. A poor outcome from primary breast surgery and postoperative issues, such as capsular contracture or implant rupture, may necessitate removal of the implants.

When considering any elective surgery, it’s wise to put a lot of time and thought into deciding what you want. It is both a personal journey of self-discovery and a search for the options that most suit your needs. We stand at the ready to offer consult, advise and where appropriate offer surgery options, including breast augmentationabdominoplasty and breast lifts. Get in touch with us today to learn more about how we can help you achieve the look you’ve always wanted.

WHY CHOOSE OUR CLINIC?

Breast procedure is an area of Dr Farhadieh’s special interest and expertise. He brings a passion for surgical art, and uses techniques that are innovative and modern to achieve optimal results. As an internationally peer recognised plastic surgeon educator he has both provided expert commentary for international plastic surgery journals, as well as authored two chapter on this topic in an international plastic surgery textbooks: Plastic and Reconstructive Surgery: Approaches and Techniques.

CONSULTATION

For your consultation, it is always helpful to have documentation on the nature of your previous surgery with you (e.g. operation notes or record, or hospital discharge summary), although we can often retrieve these from colleagues where necessary. After a discussion about the nature of your concerns, Dr Farhadieh will discuss all the options available and how they could be tailored to your needs and wants. The risks of the operation will be explained to you.

THE PROCEDURE

On the day of surgery, your breasts are marked with a surgical marker while you are awake, and any final questions are addressed. Surgery will be performed under general anaesthetic. You may be discharged on the day of surgery or may stay overnight depending on the extent of surgery and, where appropriate, personal preference. Long-lasting local anaesthetic infiltrated into the surgical sites at the time of surgery will help to alleviate immediate postoperative pain. Paracetamol is usually recommended for any discomfort during the early postoperative period. The incisions are closed with absorbable sutures and covered with tape. Any discolouration or swelling will disappear quickly and any residual swelling will normally resolve by 6 weeks. Straining, bending and lifting must be avoided during this time, and a supporting bra should also be worn.

You can usually go back to work within 7–10 days, but are advised to avoid strenuous physical exertion, particularly with respect to the upper body. Gentle lower body exercise can be resumed 1 week postoperatively. The breast will find its final shape within 6 months of surgery.

There is risk associated with all surgery including asymmetry, infection, scarring, postoperative bleeding. Because of the previous surgery, revision surgery may be associated with added risks. Dr Farhadieh will discuss these with you fully during your consultation.

Frequently Asked Questions

BIA-ALCL is a rare but highly treatable type of lymphoma. It develops around breast implants and occurs most frequently in patients who have breast implants with textured surfaces. This is a cancer of the immune system, not a type of breast cancer. When caught early, BIA-ALCL is usually curable. Women who received textured implants should contact their plastic surgeon, particularly if you have experienced symptoms such as excessive swelling around the breast implants, pain, major asymmetry, breast enlargement, pain, lump in the breast or armpit, overlying skin rash and hardening of the breast. Any new swellings need to be investigated. 

To read more, head to our blog to view various articles on BIA-ALCL.

In essence this is treating the implant and its surrounding fibrous capsule as a lesion needing to be excised in full without breach. The body walls recognise the implants as inert medical material with no significant immunogenic response off as a foreign bodies. The capsule has three layers, flat synovial type fibrocyte cells, collagen bundles and blood supply. It is known that the biofilm surrounding the implant material may form a barrier that is impenetrable to antibiotics and other medications as well as body’s immune cells. Thereby forming a focus for ongoing inflammation not only locally but also more systemically it has been argued. The fibrous capsule has been shown to harbour antigens and even non virulent bacteria lending credence to this theory. The idea is that by excising the entire capsule and implant, much in the same way as say cancer would be, the risk of any contamination or ongoing source of inflammation would eradicated. 

Whilst technically this is possible, the pertinent question to be asked is how much wider spread tissue damage typically to the pectoralis major muscle in the cases of submuscular or dual plane implant placement or when the implant has ruptured with extracapsular leak of silicone.

In revisional surgery the rule of thumb is to replace the breast implant devices where an implant is necessary. Often this means creating new pockets not only to reshape the breast but also to reduce the capsular contracture rates.

There is some discomfort associated with surgery. Most patients report a ‘tightness’, rather than pain, due to the excellent modern anaesthetic pain control regimes, which includes local anaesthetic for the immediate postoperative period as well as powerful analgesics. However, its vital that you note that pain perception and recovery may be different with each individual.

This depends on the nature of breast surgery being considered. In some situations this helps to achieve an optimized final aesthetic outcome.

Within 2 weeks you will be back at work and able to resume most normal activities. During the subsequent weeks you will be able to return to your pre-surgery levels of activity.

As part of the preoperative assessment Dr Farhadieh will discuss and tailor the incision sites, often through previous surgery. The scars are not only camouflaged, but fade considerably within the first 12 months from surgery.

Dr Farhadieh believes that the relationship between doctor and patient is sacred and privileged. Our practice is based on compassion, honesty, transparency and, above all, patient welfare. We pride ourselves on making sure that you feel supported at all times. We will be available during all stages of your journey and will schedule short-, medium- and long-term follow-up appointments as part of our overall practice.

1. There are some general risks associated with ANY operation, which include:
a) Infection in surgical wound(s) with resultant redness, pain and possible discharge. In severe cases, wound(s) could break open and need to be re-sutured.
b) Possible bleeding in surgical wound(s) with swelling or bruising.
c) Secretions may accumulate in the lungs and cause a chest infection.
d) Deep vein thrombosis.
e) Death is possible during or after an operation following severe complications.
f) Smoking significantly increases the risk of complications. Therefore, you should completely stop smoking at least 4 weeks prior to surgery, and refrain from smoking for at least 4 weeks.

2. The following facts, risks and complications apply specifically to THIS operation:
a) Antibiotics are given during and after the operation to minimise the risk of infection. If infection occurs, it would be treated with the usual techniques. In severe cases, treatment may involve being admitted to hospital for intravenous antibiotics; and further surgery may be required.
b) Bruising and swelling is normal, but the severity can vary with each patient. If bleeding occurs in the implant space, a clot (haematoma) can occur and this may need to be removed surgically. The risk of this occurring within the first few days after surgery is about 0.5-1%. The risk of increased bruising or bleeding can be reduced by abstaining from medications such as aspirin, anti-inflammatory drugs, or other blood thinning agents, for at least 2 weeks prior to surgery.
c) A seroma is a collection of fluid around the implant, which may need to be drained. Clinically significant seromas requiring intervention occurs in less than 1% of patients and may occur many years after surgery.
d) The incisions will result in scar formation. Mr Farhadieh will endeavour to keep the incisions as small as possible, and these scars will soften and fade with time. You will be instructed as to how best care for scars to optimise results.
e) Postoperative pain experienced varies from very mild to significant discomfort. You will be given plenty of pain relieving medication following your surgery and this should keep you comfortable, no matter what your level of discomfort.
f) It is common to have intermittent mild discomfort, or intermittent sharp pains in the first few weeks after surgery, as the swelling resolves and the nerves recover. Some patients experience a temporary increase in the sensitivity of their nipples, which can be unpleasant, but usually settles down after a few weeks.
g) Numbness of the breasts and nipples is normal for a few weeks after this surgery. This usually recovers after 6-12 months, however it can be permanent. <1% will suffer nipple loss.
h) Most patients will need to take about a week off work. Heavy lifting, vigorous upper body exercise or any activity that involves ‘bouncing’ of the breasts should be avoided for 4-6 weeks. See Pre and Post-Op Instructions for more details.
i) The sutures used to close the incisions under your breasts are completely dissolvable, but they may be felt through the skin for up to 6-9 months after surgery.
j) Any surgery results in internal breast tissue scar tissue, which creates extra challenges for any secondary surgery, tissue are not as supple this may require additional procedures. This fact makes your outcomes from surgery less predictable, and no guarantees can be made in regards to your aesthetic outcomes.
k) During the time you have had breast implants, excess skin will have formed as a result of tissue expansion. Often a ‘breast lift’ procedure is required to achieve the best aesthetic outcomes following the removal of breast implants. If you choose not to undergo some form of ‘lift’ surgery, however, you can expect to be left with at least some level of skin redundancy and sagging. It is difficult to predict the level of skin sag and/or asymmetry you will be left with following this operation.
l) It is impossible to achieve ‘perfect’ breasts. In nature asymmetry is the norm rather than the exception. There is likely to be minor differences between each breast, as there are in all women. For women whose nipples are naturally at different heights, they will remain so following breast implant removal surgery, unless additional procedures are performed to correct this. This is also true for any other asymmetry between the breasts. If asymmetry was present before the primary augmentation, it will remain after implant removal unless further surgery is used to correct it.
m) The aim of breast implant removal surgery is improvement rather than perfection. Further operations may occasionally be required to improve the results.
n) Permanent keloid or hypertrophic scar may occur as a result of any surgery.
o) You may not be satisfied with the final aesthetic outcome.

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