July 5, 2022
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By Dr. Andrew Campbell-Lloyd

Breast Implant Removal (“Explant Surgery”) With Total Capsulectomy

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Information

COSTS:
Plastic surgeon’s fee: from $5,950 - $12,520

Total approximate cost (uninsured patient, day surgery only): $TBC

Total approximate cost (insured patient, optional hospital stay covered by insurance): from $5,950 - $17,140

Associated item number: 45551

May be performed with: FAT TRANSFER
May be performed with: MASTOPEXY

LENGTH OF PROCEDURE/HOSPITAL STAY:
3-5 hours

Day surgery for most patients

Key Features

Total capsulectomy
Dr Campbell-Lloyd will not leave any capsule behind.

En-bloc capsulectomy
More correctly referred to as “total-intact capsulectomy”, which involves the complete removal of the capsules, intact, with the contained breast implant within. This is always an option, however a longer incision is required.

  • Dr Campbell-Lloyd has previously written about capsulectomy procedures. Please click here to read more.

Pectoralis major muscle repair
Dr Campbell-Lloyd will always repair the Pectoralis major muscle following capsulectomy. This is absolutely vital as it will prevent persistent "animation" deformity. Unfortunately we are now seeing patients who have had explant surgery elsewhere presenting with troublesome animation and distortion/deformity of the breast due to the unrepaired muscle.

Drainless
Unlike most surgeons, Dr Campbell-Lloyd does not use drains for capsulectomy procedures. This allows for patients to go home on the day of surgery, and is associated with less pain.

Associated procedures
Fat transfer & mastopexy are commonly performed in the same procedure.

Reasons To Consider This Procedure

Capsular contracture - tightening, hardening and distortion of the breast.

Painful implants - often associated with capsular contracture, and with previous “under the muscle” or dual-plane implant placement.

Change in breast shape – most commonly a result of capsular contracture, or incorrect positioning of the implant at the time of the original breast augmentation.

“Botched” breast augmentation procedures – unqualified or inexperienced surgeons may be responsible for implants which are incorrectly placed, incorrectly positioned & the wrong size. There may be progressive problems leading to pain and cosmetic deformity.

Breast implant rupture – more common for long standing breast implants, and when contracture is present.

“Animation deformity” – the movement of the implant (typically upwards, and outwards) due the effect of the Pectoralis major muscle on the implant.

Concern regarding possible “breast implant illness (BII)” symptoms – the symptoms attributed to BII are extensive and the experience of every patient is different.

What To Expect

Dr Campbell-Lloyd believes strongly that in the vast majority of cases, removal of breast implants should be performed in conjunction with a total capsulectomy.

Because most breast augmentation procedures in Australia involve cutting the Pectoralis major muscle and placing the breast implant “under the muscle”, Dr Campbell-Lloyd has developed a technique that involves removal of the breast implants, total capsulectomy and repair of the muscle. This technique has many functional and cosmetic benefits, and it also allows the surgery to be performed as a day-case procedure, without drains.

The appearance of the breast after explant surgery can be hard to predict. There will always be a loss of volume after the implants have been removed. Even with breast lift procedures and fat transfer, the breast will always appear smaller, and more natural after explant surgery.

Body image can be variably impact by breast implant removal. Dr Campbell-Lloyd has written about this previously, and body image is a very important component of the pre-operative discussion. We encourage our patients to consider this aspect of their recovery very carefully before surgery.

All sutures are dissolving sutures, under the skin. A layer of glue is then applied to any incisions. There are no “sticky” dressings applied which can cause irritation and prevent showering.

After breast implant removal and total capsulectomy, patients are discharged home with a surgical compression bra which must be worn at all times for the first 4-6 weeks.

Patients are discharged with antibiotic tablets, and pain-relief medications.

Patients are discharged home with detailed instructions. The instructions include emergency contact details for Dr Campbell-Lloyd.

Routine follow-up appointments are made for:

  • 3-4 days post op
  • 4-6 weeks post op
  • and 3-4 months post op.

There will be some pain. Most patients will experience pain at the incision site in the crease under the breast for the first 7-10 days. Some patients will experience occasional discomforts relating to movement after that time as the healing process continues.

The nature of this surgery is such that patients should expect to require pain relief medication for at least the first 2-3 weeks. Some patients will require simple pain relief (such as Nurofen) on occasion for up to 6 weeks as they increase activity. The need for pain relief will be dependent on the original surgery performed, the size of the implant to be removed, the presence of capsular contracture, and level of activity after surgery.

It is vital to maintain a decreased level of activity for 6 weeks after surgery to ensure that the muscle repair is not inflamed or aggravated.

It will take at least 3-4 months for full recovery. Final results can only be appreciated after that time, once scars have softened and relaxed. Scars may only fade after 6-12 months on the breast.

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https://acl-seo.webflow.io/articles/breast-implant-removal-explant-surgery-with-total-capsulectomy

https://acl-seo.webflow.io/articles/breast-implant-removal-explant-surgery-with-total-capsulectomy