Breast Implant Removal: Your Complete Guide to Explant Surgery in Beverly Hills

Breast implant removal—often called explant surgery—is a procedure in which previously placed breast implants are removed, sometimes along with the surrounding scar capsule. Women choose breast implant removal for a variety of reasons including capsular contracture, implant rupture, breast implant illness symptoms, changes in breast shape over time, or simply a desire for a more natural appearance.

At The Sayah Institute in Beverly Hills, Dr. David N. Sayah brings more than 26 years of specialized experience in breast surgery to patients considering explant procedures. As a board-certified plastic surgeon and Fellow of the American College of Surgeons who completed his training at UCLA Medical Center, Dr. Sayah provides the expertise and individualized care this important decision requires.

Although breast implants are durable medical devices, they are not lifetime devices. Many implants remain intact for years, but eventually some patients choose to replace or remove them as their bodies, preferences, or medical circumstances evolve.

Why Women Choose Breast Implant Removal

Breast augmentation remains one of the most commonly performed cosmetic procedures in the United States, second only to liposuction. For most women, it is a safe procedure with relatively small incisions and rapid recovery. Women choose implants for many reasons—some naturally have smaller breasts and desire more fullness, others experience volume loss after pregnancy and breastfeeding, and some simply prefer the confidence that comes with fuller breasts.

With millions of women having breast implants, it is not surprising that many eventually choose removal or replacement. Several primary reasons bring patients to this decision.

Capsular Contracture: The Most Common Reason for Removal

The most common reason women undergo breast implant removal or revision surgery is capsular contracture. Whenever a breast implant is placed, the body forms a thin layer of scar tissue around it called a capsule. This is a normal biological response—the body recognizes the implant as foreign material and creates a protective barrier around it.

For most women, this capsule remains soft and undetectable. In some patients, however, the capsule gradually tightens around the implant. This tightening—capsular contracture—can cause firmness, distortion of the breast shape, or discomfort. Studies indicate capsular contracture occurs in roughly 10–20% of women within the first ten years after augmentation, although only about 5–10% develop symptoms severe enough to require surgery.

Dr. Sayah’s research background in wound healing and scar formation, published in the Journal of Surgical Research and Plastic and Reconstructive Surgery, directly informs his approach to capsular contracture cases. Understanding the cellular mechanisms behind abnormal scar tissue helps determine the most appropriate surgical approach for each patient.

Breast Changes Over Time

The second most common reason women consider implant removal is simply the natural evolution of the breast. Breasts change throughout life as a result of pregnancy, breastfeeding, weight fluctuations, hormonal changes, and aging—all of which influence breast tissue and skin elasticity.

During breastfeeding, breasts enlarge and shrink repeatedly, stretching the skin and supporting ligaments. Meanwhile, the implant maintains its round shape. Over time, natural breast tissue may droop while the implant remains in place, sometimes producing what surgeons call a “double bubble” appearance—where the implant sits high while the natural breast tissue hangs below.

Breast Implant Rupture

Although breast implants are durable medical devices, they can eventually wear out. Clinical studies suggest rupture occurs in approximately 1–5% of implants within the first decade, with the likelihood increasing as implants age.

• Saline Implant Rupture: The sterile saltwater inside the implant is absorbed harmlessly by the body and the breast deflates quickly, making the rupture immediately obvious.
• Silicone Implant Rupture: Often more subtle and may go unnoticed for some time, sometimes called “silent ruptures.” Imaging studies such as ultrasound or MRI confirm the diagnosis.

Dr. Sayah recommends periodic imaging for patients with silicone implants, particularly as implants age beyond 10 years.

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

Researchers have identified a rare lymphoma associated primarily with textured breast implants called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). This condition is not breast cancer—it is a lymphoma that develops in the scar tissue around the implant.

The estimated risk ranges from approximately 1 in 3,000 to 1 in 30,000 patients with textured implants. Most cases present years after surgery with swelling of one breast caused by fluid accumulation around the implant. When detected early, treatment typically involves removing the implant and surrounding capsule.

Breast Implant Illness: What Current Evidence Shows

Increasing attention has been given to symptoms that some women attribute to their breast implants, commonly referred to as breast implant illness. Patients who believe they may have this condition often describe fatigue, brain fog, joint pain, headaches, muscle aches, or a general feeling of inflammation that developed after their implants were placed.

At present, there is no single diagnostic test for breast implant illness. Physicians typically evaluate patients for other medical explanations first. For women who continue to experience symptoms without another identifiable cause, implant removal becomes part of the discussion. Many patients report improvement in symptoms after their implants are removed, although research in this area continues to evolve.

What Breasts Look Like After Implant Removal

The outcome after explant surgery depends on several factors including implant size, how long the implants have been present, the amount of natural breast tissue, and the elasticity of the skin.

Many women are pleasantly surprised by how natural their breasts look after explant surgery. Women who had reasonable breast volume before augmentation typically have good tissue remaining. Those who started with very little breast tissue may notice more deflation after removal.

When additional improvement is desired, procedures can significantly enhance breast shape:

• Breast Lift (Mastopexy): Removes excess skin and raises the nipple position, restoring a more youthful contour
• Fat Grafting: Transfers fat from another area of the body to restore subtle, natural volume to the breasts

These modern techniques allow surgeons to reshape the breast and restore natural volume in ways that produce beautiful, natural-looking results.

How Long Do Breast Implants Last?

Many patients believe implants must automatically be replaced every ten years. In reality, implants do not have a strict expiration date. Many remain intact and problem-free for fifteen to twenty years or longer.

That said, implants are medical devices and they do not last forever. Over time, the shell can weaken, scar tissue can tighten, or the natural breast tissue can change. This is why regular follow-up examinations with a board-certified plastic surgeon remain important for all breast augmentation patients.

Warning Signs That Warrant Evaluation

Patients should consider scheduling an evaluation if they notice:

• Swelling of one breast
• Persistent firmness or hardening
• Pain around the implant
• Changes in breast shape
• New asymmetry between the breasts
• Sudden deflation (particularly with saline implants)
• Any symptoms believed to be related to the implants

Early evaluation allows potential problems to be identified and treated before they become more significant. Dr. Sayah maintains hospital privileges at Cedars-Sinai Medical Center, Saint John’s Hospital, and UCLA Medical Center—affiliations that require demonstrated surgical excellence and ongoing peer recognition.

Common Myths About Breast Implant Removal

Myth: Breasts will look terrible after removal. Many patients are pleasantly surprised by their natural appearance. When additional improvement is desired, breast lift or fat grafting can restore attractive contours.

Myth: Implants must always be replaced every ten years. Implants are replaced only when a problem develops or when a patient wishes to change size or style—not according to an arbitrary timeline.

Myth: Explant surgery is more difficult than the original augmentation. Most patients find implant removal easier to recover from than their original augmentation. The procedure is typically shorter, and discomfort is usually manageable with standard postoperative medications.

Frequently Asked Questions

Will my breasts look terrible after implant removal?

Most patients are pleasantly surprised by how natural their breasts appear after explant surgery. When additional improvement is desired, a breast lift or fat grafting can further enhance breast contour.

Is breast implant removal painful?

Most patients find implant removal easier to recover from than the original augmentation surgery. Discomfort is typically manageable with standard postoperative medications.

Do breast implants have to be replaced every 10 years?

No. Implants do not automatically need replacement after a set number of years. They are addressed only if a complication develops or if a patient desires a different size or type.

Can implants be removed and replaced during the same surgery?

Yes. Implant exchange is commonly performed when patients want to change implant size or type.

What is en bloc capsulectomy?

En bloc removal involves removing the implant and its surrounding capsule as a single intact unit. This technique is often preferred by patients concerned about breast implant illness or those who want the most thorough removal possible.

Schedule Your Consultation at The Sayah Institute

Every patient’s situation is unique. Some women pursue implant removal because of medical concerns, while others simply prefer a more natural appearance as their bodies and preferences change. The best decisions are always made through thoughtful conversation between patient and surgeon.

Dr. David N. Sayah graduated at the top of his class from UCLA David Geffen School of Medicine and completed his plastic surgery residency at UCLA Medical Center. His specialized training includes an Advanced Endoscopic Plastic Surgery Fellowship, and his published research on wound healing and breast reconstruction appears in peer-reviewed journals. As clinical faculty at Cedars-Sinai Medical Center and the University of Southern California, Dr. Sayah remains actively involved in advancing surgical techniques and training the next generation of plastic surgeons.

Contact The Sayah Institute in Beverly Hills at (310) 385-0000 to schedule a consultation. Patients throughout Los Angeles and Beverly Hills trust Dr. Sayah for breast implant removal that respects individual decisions, provides expert surgical care, and delivers results that restore confidence and peace of mind.