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Breast Implant Removal (Explant Surgery)

What Is Explant Surgery?

Explant surgery is a procedure that is performed to remove breast implants from patients who have previously had breast augmentation or breast reconstruction surgery. Explant surgery differs from breast revision surgery because revision patients typically receive new breast implants, while explant patients are seeking complete removal of any breast implants.

Dr. Lickstein is highly experienced in breast implant removal, including en bloc and total capsulectomy procedures. His extensive training and background in breast revision surgery have given him a deep understanding of the advanced techniques needed for successful breast implant removal. Dr. Lickstein has a compassionate and personalized approach to patient care, and he is understanding of patients who are seeking breast implant removal due to health concerns.

Reasons For Breast Implant Removal

Breast implant removal is a personal choice and one that women come to for a variety of reasons. Some of the common motivations for having breast implants removed include:

  • Appearance Some patients who were previously happy with their implants decide that they would now prefer the aesthetic of smaller, natural breasts.
  • Lifestyle Changes There are a number of variables, such as commitment to a more athletic lifestyle, that can cause women to reevaluate their breast implants.
  • Complications Breast implants can occasionally shift and become uncomfortably or unattractively malpositioned. There is also a minimal risk of complications such as capsular contraction or breast implant rupture, which patients may decide to treat with breast implant removal.
  • General Health Concerns There have been reports of breast augmentation patients experiencing auto-immune symptoms, such as joint pain and fatigue, that they attribute to a systemic disorder called breast implant illness. While there is limited clinical information available on breast implant illness, Dr. Lickstein supports women in making choices that they feel are most beneficial for their health.

Breast Implant Illness (BII) 

At Lickstein Plastic Surgery, we see patients and offer a variety of treatment options for women affected by Breast Implant Illness in the Palm Beach area. Breast Implant Illness, or BII, describes a range of symptoms that may vary from individual to individual.  Patients who feel they suffer from BII may be frustrated because there is no specific diagnostic test that can indicate the presence of the disease. Because it is often a diagnosis of exclusion, many patients are hopeful that explanting can provide relief.

It remains unclear why a small group of women with breast implants may feel they are affected and many others are not. Our surgeons believe it is important to find the right treatment option for you, and that there is not a “one fits all” solution. Our doctors have years of experience with breast surgery, mastopexy, and capsulectomy, both en bloc and total. They will listen and help you with a treatment plan to address your symptoms and concerns, taking into account the aesthetic result as well.

Throughout history, researchers have studied many types of Human Adjuvant Disease, which is a term used to describe symptoms that are triggered by a foreign object or substance in the body. The medical community has explored the possibility of this condition in relation to breast implants since 1964.1 Clinical studies on BII are limited — while some support a link between breast implants and autoimmune symptoms, others challenge the existence of such a condition, or focus on psychological factors.2,3,4 The most recent comprehensive analysis of the history and research of Breast Implant Illness concludes that a collaborative approach to studying Breast Implant Illness is needed in order to gain a more accurate and unbiased view of BII.5 The FDA urges women who experience potential BII symptoms to contact the FDA’s Safety Information and Adverse Event Reporting program.6

Breast Implant Illness symptoms include:7

  • Fatigue
  • Chronic pain
  • Rash
  • Depression, anxiety, and brain fog
  • Hair Loss
  • Hormonal Issues

If you are experiencing autoimmune symptoms after breast augmentation, or you have any questions about BII, please contact us and schedule a consultation.  

Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

Women with breast implants who have read recent news coverage of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) may be concerned about newfound risks associated with breast implants. BIA-ALCL is a type of cancer that has affected a small percentage of breast augmentation patients, most often those with textured implants. It is a form of non-Hodgkin’s lymphoma, not breast cancer, and has only been found in symptomatic patients who experience symptoms such as swelling and breast asymmetry after their breasts are healed from augmentation. While the FDA is currently investigating the link between BIA-ALCL and breast implants, they do not recommend preventative explant surgery. FDA recommendations for breast augmentation patients state that “If you have breast implants, there is no need to change your routine medical care and follow-up.” Dr. Lickstein is committed to remaining informed on all developments regarding clinical findings and FDA recommendations for BIA-ALCL, as well as educating patients on the risks and available choices for breast surgery. Dr. Lickstein encourages patients to be seen yearly for a follow up examination, and a discussion of the most up to date information regarding BIA-ALCL

What to Expect from Explant Surgery

Breast implant removal is a highly individualized process and our surgeons’ surgical approach will vary depending on a number of factors, such as the position and type of implants and your reasons for seeking removal. Your treatment plan will be discussed during your consultation and pre-surgical appointments. Explant surgery will typically be an outpatient procedure performed with general anesthesia. Depending on your surgical plan, our surgeons may be able to utilize the incision locations of your initial breast surgery. If new incisions are created, they will take care to minimize any visible scarring.

En Bloc Breast Implant Removal

While there are several techniques that can be used in breast implant removal surgery, the approach that is favored by many women’s health advocates is called an en bloc breast implant removal. When a patient has breast augmentation, the body responds by forming scar tissue around the breast implants. This scar tissue, which is typically a soft flexible sheet of tissue, is called a capsule. An en bloc breast implant removal will remove the complete intact capsule with the breast implant inside. Dr. Lickstein and Dr. Forleiter will explain your options for breast implant removal and help you decide if en bloc explant surgery is right for you.

Total Capsulectomy Breast Implant Removal

Occasionally an en bloc removal is not possible, in which case our surgeons may perform a total capsulectomy breast implant removal. While some people use the terms en bloc and total capsulectomy interchangeably, there is a difference between the two techniques. In the capsulectomy approach, our surgeons will make an incision to the scar tissue capsule in order to remove the breast implant. Once the implant is removed, he will then proceed to remove the capsule and any remaining scar tissue. Reasons that a capsulectomy may be performed instead of an en bloc removal include complications with implant repositioning or a patient’s desire for a smaller scar.

Explant Surgery With Breast Lift (Mastopexy)

Many patients who choose to have their breast implants removed are concerned that their breasts will sag or look deflated after explant surgery. Depending on your medical history and goals, a breast lift surgery (mastopexy) can be combined with explant surgery to ensure your natural breasts look full and perky. There are many considerations that will factor in to your appearance after implant removal, including your age, the elasticity of your skin, the length of time you had implants and the size of the implants. The surgeons at Lickstein Plastic Surgery can discuss all the options with you during your consultation appointment and help you decide if a breast lift or other additional procedures will be part of your treatment plan.

Am I A Candidate For Explant Surgery?

If you are considering breast implant removal, the first step is to schedule a consultation with a plastic surgeon who is experienced in explant surgery. While many plastic surgeons frequently perform breast augmentation surgery, there is a smaller number of board-certified plastic surgeons who are experienced with successful en bloc breast implant removal, and Dr. Lickstein is among them. During your initial consultation appointment at our Palm Beach Gardens office, he will take the time to listen to your concerns and work with you to develop a personalized treatment plan to remove your breast implants.

Recovery and Results After Breast Implant Removal

After your explant surgery, it is normal to experience temporary swelling and bruising and some discomfort, which can be treated with medication. You may be advised to take one week off of work, and any strenuous physical activity will be limited for 4 to 6 weeks. You will be given detailed post-operative instructions and scheduled for follow-up appointments with Dr. Lickstein or Dr. Forleiter. It can take several months for your natural breast tissue to completely heal, at which point you will be able to see your true results without any post-surgical swelling.

1 Miyoshi K, Miyamura T, Kobayashi Y. Hypergamma globulinemia by prolonged adjuvancity in man. Disorders developed after augmentation mammaplasty. Jap Med J. 1964;2122:9–14
2 van Nunen SA, Gatenby PA, Basten APost-mammoplasty connective tissue disease. Arthritis Rheum. 1982;25:694–697
3 Schusterman MA, Kroll SS, Reece GP, et al.Incidence of autoimmune disease in patients after breast reconstruction with silicone gel implants versus autogenous tissue: a preliminary report. Ann Plast Surg. 1993;31:1–6
4 Dush DMBreast implants and illness: a model of psychological factors. Ann Rheum Dis. 2001;60:653–657
5 Magnusson MR, Cooter RD, Rakhorst H, McGuire PA, Adams WP, Deva AK. Breast Implant Illness: A Way Forward. Plastic and Reconstructive Surgery: March 2019 – Volume 143 – Issue 3S – p 74S-81S
doi: 10.1097/PRS.0000000000005573 Available:
6 U.S. Food and Drug Administration. Risks and Complications of Breast Implants. Available: Accessed November 6, 2019.
7The American Society for Aesthetic Plastic Surgery. Breast Implant Illness – Frequently Asked Questions/Talking Points. Available: Accessed November 6, 2019.

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