Breast Implant Removal (Explant)

Written by: Dr. Akash Chandawarkar, Board Certified Plastic Surgeon, Mirror Plastic Surgery | Last updated: September 28, 2026

Key Takeaways

• Breast implant removal (explant) is a recognized, valid surgical endpoint and a complete destination on its own.

• Common reasons for explant include implant rupture, capsular contracture, aging implants, BII symptoms, and BIA-ALCL concerns.

• Three main surgical approaches exist: simple removal, total capsulectomy, and en bloc capsulectomy. The appropriate technique depends on clinical indication.

• Breasts typically appear smaller and lower after explant. A lift is sometimes helpful, and going flat or smaller is a legitimate outcome.

• Mirror Plastic Surgery provides unhurried, anatomy-first consultations with a strict no-upsell philosophy that respects removal-only decisions.

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Why Women Choose Breast Implant Removal

Women seek explant for many reasons, and each reason deserves respect. A 2023 retrospective study of more than 500 women found that the most common subjective complaint among women seeking removal was dissatisfaction with breast appearance. Physical discomfort, pain, and safety concerns followed closely. The most common objective medical drivers are capsular contracture and implant rupture or leakage.

Common clinical reasons for explant include:

• Implant rupture: Silicone implant rupture rates reach 7.8% at 10 years for primary augmentation, and many ruptures are silent, detectable only on imaging. Saline ruptures usually present as visible deflation.

• Capsular contracture: Capsular contracture is the most common long-term complication of breast implant surgery. The scar tissue capsule tightens, hardens, and compresses the implant, which produces pain and visible distortion.

• Implant malposition or aging implants: Implants placed 10 or more years ago carry increasing complication risk. A 28-year longitudinal study found that 43.5% of implants worn for more than 10 years were removed for objective clinical reasons.

• Breast implant illness (BII) symptoms: The FDA uses the term "systemic symptoms associated with breast implants" and has collected over 10,000 adverse event reports from women describing symptoms beyond the surgical site, including fatigue, joint pain, brain fog, anxiety, and hair loss. The FDA has not established a definitive causal relationship between breast implants and these systemic symptoms, but the agency takes the reports seriously, and so does Mirror Plastic Surgery. Feelings of "I just want them out" and "I do not want to be talked into bigger again" are heard and respected here.

• BIA-ALCL warning signs: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare immune system cancer most associated with textured implants. Symptoms include persistent swelling, fluid collection around one implant, a palpable mass, or pain. Any such symptom warrants prompt evaluation. Do not wait for a scheduled appointment.

The FDA notes that breast implants are not lifetime devices and that the risk of complications may increase over time. Many patients eventually need additional surgery.

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What Sets Mirror Plastic Surgery Apart

Mirror Plastic Surgery follows a concierge medicine model that differs from high-volume practices. Consultations run up to an hour and include a top-to-bottom anatomical assessment. Dr. Akash reviews the patient's motivations, tissue quality, implant history, and goals in detail.

The practice performs only one to two surgeries per day. This schedule keeps the entire clinical team focused on one patient at a time before, during, and after the procedure.

The guiding philosophy is safety first, function second, aesthetics third. Applied to explant, this means the safety of the removal is non-negotiable. Restoring comfort and function comes next. Natural aesthetic outcomes follow from those foundations.

Mirror Plastic Surgery is a supplier-neutral, no-upsell practice. A patient who arrives wanting removal only will leave with a plan for removal only when her anatomy and goals support that choice. That philosophy extends to the clinical details. Pre-operative assessment includes in-office ultrasound for precise evaluation of implant integrity and surrounding tissue. All procedures take place in accredited facilities with board-certified physician anesthesiologists.

Meet Dr. Akash Chandawarkar

Dr. Akash Chandawarkar graduated from Harvard Medical School (cum laude, with Honors) and completed a seven-year integrated plastic and reconstructive surgery residency at Johns Hopkins University. He then completed an aesthetic surgery fellowship at the Manhattan Eye, Ear and Throat Hospital (MEETH), with advanced training in breast surgery and body contouring. He is board certified by the American Board of Plastic Surgery.

Dr. Akash was selected to testify before the U.S. Food and Drug Administration on breast implant safety, which directly benefits patients navigating explant decisions in a landscape of conflicting information. He serves on advisory boards for companies developing breast technologies, including Motiva, and has authored peer-reviewed articles and textbook chapters in plastic surgery. His approach to explant consultations centers on honest, evidence-based communication and unconditional respect for the decision to remove rather than replace.

Types Of Breast Implant Removal Explained

The surgical approach to explant depends on the patient's anatomy, implant history, capsule condition, and clinical indication. There is no single default protocol. The 2024 Breast Surgery Collaborative Community (BSCC) consensus statement, endorsed by the American Society of Plastic Surgeons (ASPS), The Aesthetic Society, and the International Society of Aesthetic Plastic Surgery (ISAPS), defines four types of capsulectomy and emphasizes that the type and extent of capsule removal should be determined by clinical indication, not patient demand alone. The three primary removal approaches are:

1. Simple implant removal (implant only): The implant is removed through the existing incision and the capsule is left in place to dissolve naturally over time. This option fits situations where the capsule is thin, soft, and non-problematic. It is the least invasive approach and usually carries the shortest recovery.

2. Total capsulectomy (implant plus capsule removed in pieces): The implant and the entire surrounding scar tissue capsule are removed, though not necessarily as one intact unit. Relative indications include capsular contracture, ruptured silicone gel implants, calcified or heavily thickened capsules, and removal of textured implants. This approach is appropriate for most patients seeking removal for BII symptoms.

3. En bloc capsulectomy (implant and capsule removed intact as one specimen): The implant and the entire capsule are removed together as a single unit with a margin of surrounding healthy tissue. The 2024 BSCC consensus statement states that en bloc capsulectomy is exclusively indicated for suspected or established breast implant-associated cancers such as BIA-ALCL and BIA-SCC, and is "absolutely not necessary in the treatment of breast implant illness." En bloc is the most technically demanding approach and carries the highest surgical risk, including the possibility of pneumothorax (lung puncture) during dissection near the chest wall.

The social media narrative that en bloc is required for BII symptom relief is not supported by peer-reviewed evidence. Research by Khong et al. (2023) and McGuire and Glicksman (2024) found that symptom improvement after explant occurred regardless of whether the capsule was removed. Patients who underwent simple explantation experienced similar rates of relief compared to those who underwent total or en bloc capsulectomies. Recommending en bloc for BII without a malignancy indication adds surgical risk but no proven benefit.

The following table summarizes the three approaches across key clinical dimensions:

What Breasts Typically Look Like After Implant Removal

After breast implant removal, breasts usually appear smaller, softer, and lower than they did with implants in place. The degree of change depends on implant size, how long they were in place, the patient's natural breast tissue volume, and skin elasticity. The remaining breast envelope often appears deflated, flat, or ptotic, especially in patients who had larger implants or significant skin stretch over time. Volume loss, laxity, skin wrinkling, asymmetry, and changes in nipple position relative to the inframammary fold are all documented outcomes*.

Immediately after surgery, breasts often look oddly flat or "deflated." Compressed native breast tissue gradually "fluffs" back out and finds its natural shape. Most of this settling occurs between three and six months after surgery.

Some patients benefit from a breast lift, and others do not need one. The surgeon assesses the patient's skin elasticity and breast tissue to determine whether a lift is appropriate. Younger patients with smaller implants and firmer skin sometimes achieve a near-normal result after removal alone, while patients with long-standing augmentation and lax tissue are much more likely to need reshaping. Fat grafting is an option for patients who want modest volume restoration without a prosthetic. Going flat or significantly smaller is a valid and often deeply satisfying outcome*, and Mirror Plastic Surgery fully supports that choice when it matches the patient's goals.

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Preparing For Explant Surgery At Mirror Plastic Surgery

The consultation at Mirror Plastic Surgery is unhurried and comprehensive. Dr. Akash conducts an in-depth assessment that includes in-office ultrasound evaluation of the implants and surrounding tissue, a full review of the patient's implant history, and a thorough discussion of motivations, anatomy, and goals. Patients move at their own pace and are not rushed toward a procedure they did not come in for.

Pre-operative preparation typically includes:

• Cessation of blood-thinning medications and supplements as directed

• Avoidance of caffeine in the days leading up to surgery

• Cessation of all nicotine products for a mandatory period before and after surgery, as smoking significantly increases the risk of skin necrosis and poor scar formation

• Arrangement of home support for the first several days of recovery

• Pre-operative assessment and lab work as indicated

• A clear timeline and written instructions covering the days leading up to the procedure

Recovery After Breast Implant Removal

What Explant Recovery Usually Feels Like

Post-operative pain from breast implant removal is typically described as deep muscle soreness and a burning sensation. Prescribed anti-inflammatory medications usually manage this discomfort. Recovery is generally less painful than the original augmentation, particularly for simple removal.

When capsulectomy is performed, especially if the capsule is dissected from the chest wall, soreness is more pronounced in the first week*. Most patients still find the discomfort manageable with oral medication and describe the first week as the most uncomfortable phase.

Timeline For Healing And Breast Settling

Full recovery, meaning the point at which results are fully visible, typically takes three to six months as swelling resolves and scars continue to mature. The general recovery roadmap looks like this*:

• Days 1–5: Soreness, swelling, bruising, and possible surgical drains in place

• Weeks 1–2: Drain removal (if applicable), light activity resumes, most patients can return to desk work

• Weeks 3–6: Gradual tissue "fluffing" as compressed breast tissue begins to expand, swelling continues to improve

• Months 3–6: Final breast shape settles, scars mature and fade

A compression bra or surgical bra is worn continuously for up to six weeks to limit swelling and support healing tissue. Heavy lifting (greater than 10–15 pounds) and strenuous upper-body exercise should be avoided for at least four weeks so the breast tissue can adhere back to the chest wall. Light walking can typically resume within the first two weeks.

Cost And Insurance For Explant Surgery

Mirror Plastic Surgery does not publish procedure pricing, because costs vary based on the surgical approach, facility, anesthesia, and any concurrent procedures. A personalized consultation with Dr. Akash provides an individualized assessment and a clear breakdown of what is involved in the patient's specific case.

Insurance coverage depends on the documented medical reason for removal. Most major insurers cover explant for confirmed silicone gel implant rupture documented by MRI or ultrasound, and for severe capsular contracture graded Baker Class III or IV. Insurance rarely covers removal driven by personal preference or self-reported BII symptoms alone, because coverage policies are structured around objective, measurable clinical findings. Over 60% of initial insurance denials for explant surgery are reversed after a structured appeal with surgeon documentation, and the Mirror Plastic Surgery team can help navigate that process. Patients are encouraged to verify benefits with their insurer and to bring any relevant imaging or physician documentation to the consultation.

How To Choose An Explant Surgeon

The surgeon a patient chooses for explant matters as much as the decision to remove. Questions worth asking any prospective surgeon include:

• Are you board certified by the American Board of Plastic Surgery?

• How many explant procedures do you perform, and do you perform removal-only cases?

• Will you honor a decision to remove without replacement or lift if that is what I want?

• Is the surgical facility accredited?

• Who administers anesthesia, a board-certified physician anesthesiologist or a CRNA?

• How much time will I have with you in consultation?

Red flags include pressure to replace rather than remove, dismissal of reported symptoms, rushed consultations that do not allow time for questions, and surgeons who promote en bloc capsulectomy as a universal cure for BII without discussing its risks. ABPS certification requires at least six years of surgical training, specialized training in plastic and reconstructive surgery, and ongoing continuing education. This credential is the baseline to verify.

Mirror Plastic Surgery meets these standards on every criterion. Patients receive up to an hour-long consultation, anatomy-first planning, accredited facilities, board-certified physician anesthesiologists, and a strict no-upsell philosophy that honors a removal-only decision.

Emotional And Psychological Considerations Of Explant

The decision to remove breast implants carries real emotional weight. Women who have had implants for 10, 15, or 20 years are not just changing their bodies. They are navigating a shift in identity, self-image, and sometimes a long-standing health concern. A 2026 qualitative study found that while many women experienced symptom improvement after explant, some remained dissatisfied with the appearance of their breasts following surgery. Honest pre-operative expectation-setting helps reduce this risk.

The psychological adjustment after explant can be significant: even when surgery is wanted, patients may experience relief, uncertainty, grief, or mixed feelings as the reflection looks unfamiliar after volume and projection change. These responses are normal. Many women also report profound relief from physical symptoms, from anxiety about their implants, and from finally feeling heard and having their decision respected.

Explant is a legitimate destination and a complete choice. The goal of the consultation at Mirror Plastic Surgery is to give every patient an honest, individualized picture of what removal will involve and what outcomes are realistic for her specific anatomy. That clarity supports a fully informed decision.

Frequently Asked Questions About Explant

Below are answers to questions patients often ask during explant consultations.

Can You Combine Explant With Other Procedures?

Many patients combine explant with other procedures, such as a breast lift, fat grafting, or body contouring. The decision depends on anatomy, health status, and goals. Some women prefer a staged approach so they can see how their breasts look after explant alone before deciding on additional surgery. Others choose a single combined operation to reduce total recovery time. Dr. Akash reviews both options and helps patients weigh tradeoffs during consultation.

What If You Change Your Mind After Removal?

Some women feel completely at peace after explant and never consider implants again. Others later decide they want more volume or reshaping. Re-augmentation or fat grafting remain options in the future for many patients, assuming overall health and breast tissue allow. Mirror Plastic Surgery focuses on the current decision and does not push replacement, while still explaining what future choices may look like.

Will Insurance Cover Explant Surgery?

Insurance coverage for explant depends on the documented medical reason for removal. Confirmed silicone implant rupture documented by MRI or ultrasound, severe capsular contracture (Baker Grade III or IV), confirmed BIA-ALCL, and certain other medically documented complications are the most commonly covered indications. Removal for personal preference, aesthetic dissatisfaction, or self-reported BII symptoms alone is generally considered elective and usually not covered. Documentation matters. Imaging reports, physician notes documenting symptoms, and a clear clinical rationale all strengthen a coverage request. Initial denials are frequently reversed on appeal with adequate surgeon documentation.

How Long Do Systemic Symptoms Take To Improve?

Systemic symptoms, when present, often follow a different timeline than visible healing. Musculoskeletal complaints tend to improve most rapidly by three months, neurocognitive symptoms by six months, and fatigue stabilizes around twelve months, with some symptoms taking up to two years to fully resolve. Individual experiences vary, and no surgeon can guarantee symptom resolution, but many women report meaningful improvement over time.

Book A Consultation With Dr. Akash Chandawarkar

Mirror Plastic Surgery is located in St. Petersburg, Florida, and serves the entire Tampa Bay area. Patients who have decided, or are close to deciding, that they want their implants removed can expect an anatomy-first, no-upsell consultation with Dr. Akash Chandawarkar. The visit includes up to an hour of dedicated time, honest evidence-based answers, and a plan built around the patient's anatomy and goals.

To schedule a consultation, contact Mirror Plastic Surgery at 780 4th Ave S, St. Petersburg, FL 33701, by phone at 727-361-6515, or by email at [email protected]. Follow the practice on Instagram at @mirrorplasticsurgery and @dr.akashplasticsurgery.

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Disclaimer: Results may vary from person to person. Editorial content, before and after images, and patient testimonials do not constitute a guarantee of specific results.