Breast Implant Removal and Lift: What You Need to Know Before Surgery

Many women choose to combine breast implant removal with a breast lift to tighten the stretched tissues left behind after the implants are removed. Whether you’re dealing with complications, experiencing discomfort, or simply want to return to a more natural silhouette, understanding this combined procedure helps you make an informed decision about your body.

This guide breaks down the reasons women pursue explant surgery, the different capsulectomy techniques, when a lift is necessary, and what recovery actually looks like.

Why Women Choose Breast Implant Removal

Patients may request breast implant removal for various reasons, including rupture, deflation, capsular contracture, pain, or lifestyle changes. The decision is deeply personal and often involves multiple factors.

Common motivations include:

Capsular contracture occurs when thick scar tissue forms around a breast implant, which can lead to firmness, distortion, and causing pain—prompting some patients to seek removal. This condition can develop with both textured implants and smooth varieties.

Breast Implant Illness (BII) is a term used to describe a range of symptoms that some patients attribute to their breast implants, leading them to consider removal as a treatment option. While scientific consensus on causation remains limited, many women report symptom improvement after having implants removed.

Removal of breast implants can alleviate chronic neck, back, and shoulder pain caused by the weight of larger implants—particularly for women who received breast augmentation years ago and whose body has changed.

Understanding Capsulectomy Options

When you remove breast implants, your surgeon must decide what to do with the scar capsule—the layer of scar tissue your body naturally forms around any implant. Several factors determine the approach.

Three primary techniques exist:

• Simple removal: The implant is extracted through an incision in the scar capsule, leaving the thin capsule to dissolve naturally. Best for uncomplicated cases.

• Partial capsulectomy: Only problematic portions of the scar tissue capsule are excised, preserving healthy surrounding tissues.

• Total capsulectomy: Complete removal of both the implant and the entire capsule. This can be done en bloc or in sections.

A total capsulectomy involves the complete removal of the breast implant and the surrounding scar tissue capsule, which can be done en bloc or in pieces depending on the situation.

En bloc capsulectomy refers to the removal of the breast implant and the capsule in one piece, which is preferred when there is a risk of silicone leakage or biofilm contamination. This technique keeps everything intact during extraction from the chest wall.

Capsulectomy can be performed during breast implant removal surgery if the capsule is firm, calcified, or associated with pain, while soft capsules are generally left in place. Your plastic surgeon will assess capsule condition during consultation to determine the best surgical plan.

Note that textured implants have been associated with a rare cancer called BIA-ALCL, making thorough capsule removal particularly important in these cases.

When to Add a Breast Lift

Not everyone needs a lift after removing implants, but many patients benefit from combining both procedures during the same surgery.

A breast lift, also known as mastopexy, can reposition and reshape the breast after implant removal, especially if the implants were larger or if the patient has lost skin elasticity with age. The procedure addresses the nipple position and removes excess skin.

The decision to undergo a breast lift after implant removal often depends on the size of the implants and the patient’s tissue characteristics, with many women experiencing a deflated appearance post-removal.

Key factors that determine if you need a lift:

• Implant size (larger = more stretched tissue)

• Duration implants were in place

• Natural breast tissue volume

• Current skin elasticity

• Age and skin quality

If skin is less elastic due to large implants, it may not return to its original state after removal, necessitating a lift. Without addressing this, you may end up with a deflated or droopy breast appearance.

Surgeons may use fat grafting to restore volume if the breast appears deflated after implant removal. This can be performed during the same procedure, transferring fat from other areas of your body to add natural fullness.

The Surgical Process

Consultations for breast implant removal should include discussions on skin elasticity, capsule condition, and desired volume. This assessment helps your doctor create an appropriate surgical plan.

What to expect during surgery:

1. Anesthesia: Most procedures use general anesthesia, though sedation may be an option for simpler cases

2. Incision placement: Surgeons often use the original augmentation incision sites to minimize new scarring. Common locations include the breast crease (inframammary fold) or around the areola

3. Implant and capsule removal: Based on your consultation, the surgeon performs simple removal, partial capsulectomy, or total capsulectomy

4. Lift (if combined): The surgeon will remove excess skin, tighten breast tissue, and reposition the nipple

5. Closure: Layered sutures close the incision, with drains placed to drain excess fluid

Surgery typically takes 1-3 hours depending on complexity, implant type, and whether additional procedures like fat grafting are included. Combining breast implant removal with a lift during the same surgery adds approximately one hour.

The procedure works for both silicone or saline implants, though surgical approach may vary slightly based on implant type.

Recovery Timeline and What to Expect

Patients typically go home the same day after breast implant removal, with soreness and swelling expected. Recovery time varies based on the extent of your procedure.

After breast implant removal, drains are often placed to prevent fluid accumulation, usually remaining in place for 1-3 days post-surgery. These help drain excess fluid and reduce complications from fluid accumulation.

Recovery milestones:

Patients commonly report that their breasts appear deflated in the first 2-3 weeks following implant removal, with some rebound of breast tissue occurring afterward. This settling process is normal.

Recovery from breast implant removal surgery typically lasts from two to six weeks, depending on whether one or two implants were removed and if additional procedures were performed. Adding a lift doesn’t significantly extend this timeline despite additional incisions.

Strenuous exercise should be avoided for 4–6 weeks following breast implant removal surgery. Your surgeon will provide specific guidance based on your healing progress.

Risks and Considerations

Like any cosmetic surgery, this procedure carries potential complications. Risks associated with breast implant removal include bleeding, infection, hematoma, and adverse reactions to anesthesia.

Additional risks specific to this procedure include:

• Asymmetry between breasts

• Changes in nipple sensation

• Incomplete capsule removal

• Persistent sagging if skin elasticity is poor

• Need for future revisions

Discuss all potential complications with your board certified plastic surgeon during your consultation.

Making an Informed Decision

It is important to ensure that a surgeon is certified by the American Board of Plastic Surgery when considering breast implant removal. Board certified plastic surgeons have completed extensive training in these specific procedures.

Insurance considerations:

A portion of the removal may be covered by insurance if it is medically necessary, but insurance does not cover the breast lift. Insurance coverage for breast implant removal is limited and typically does not include elective cosmetic procedures. Document any medical symptoms and discuss coverage with your provider before scheduling.

Key Takeaways

• Women choose to have implants removed for various reasons—from capsular contracture to personal preference

• Capsulectomy technique depends on capsule condition and individual factors

• Many women benefit from combining implant removal with a lift during the same procedure

• Recovery takes 2-6 weeks, with most patients returning home the same day

• Always verify your surgeon is board certified before proceeding

The decision to undergo breast implant removal and lift is significant. Schedule a consultation with a qualified surgeon to discuss your goals, evaluate your breast tissue, and develop a personalized approach. The right surgical team can help you achieve comfortable, natural results that align with your lifestyle.