Breast Implant Removal & Replacement (Capsular Contracture)

By Elena Prousskaia MD, FRCS (Plast), FEBOPRAS

Implant removal and replacement surgery, also known as capsulectomy is a procedure which is undertaken when a breast implant is being replaced and is intended to alleviate discomfort while offering the potential of improving both the feel and appearance of the breasts.

Implants can be replaced for many reasons, including wanting to change the shape or size of the implants, breasts change due to weight loss or gain, age or having children, or if implants rupture.

Breast implants do not have an expiration date. They only need to be replaced in the very rare case whereby they break or rupture, which is usually a result of sub-standard implants or sub-standard surgery. This is not serious or a health risk, but may cause a change in shape or feel of the implant necessitating its removal.

What is breast implant removal and replacement surgery?

Implant removal and replacement surgery, also known as capsulectomy, refers to the removal of the scar tissue or capsule which typically forms around an implant.

It is a procedure which is undertaken when a breast implant is being replaced and is intended to alleviate discomfort while offering the potential of improving both the feel and appearance of the breasts.

The capsule (scar tissue) which forms around the implant is a completely normal reaction to the insertion of a foreign body (the implant) into the breast. There are cases in which the capsule thickens and contracts. This is known as capsular contracture and can make the breasts feel a lot harder. As well as being uncomfortable or painful for an individual, capsular contracture which gets progressively worse can distort the shape of the breasts. A capsulectomy can address issues with the look and feel of the breast, and serve to alleviate the pain.

The procedure can be done for the purpose of reversing a previous breast augmentation procedure.

Is implant removal and replacement surgery for me?

One of the primary reasons to undergo implant removal and replacement surgery is to address complications which have been experienced with breast implants.

These problems can include capsular contracture or infection, which lead a plastic surgeon to recommend the removal of the breast implant.

Implant rupture, deflation or folding are other causes of complications which can lead to the need for implant and removal surgery. The procedure can also be necessary when women experience necrosis or dead tissues developing around the implant, bleeding, or a build-up of calcium.

In some cases, the decision to opt for implant removal and replacement surgery can be a personal choice. Some women might feel that breast implants they received as part of a breast augmentation procedure have given their breasts the wrong size or shape, or the implants have moved into the wrong position due to factors such as pregnancy, weight gain, or weight loss.

How is Implant removal and replacement surgery performed?

Implant removal and replacement surgery is typically performed using the same incisions which were made during the breast augmentation procedure.

During surgery, the capsule which surrounds the implant is taken out, and a new implant is then inserted into this vacant area known as ‘the pocket’. In cases of capsular contracture, patients are typically recommended polyurethane implants as a replacement. That is because, compared to a standard silicone implant, polyurethane implants are accepted as having less risk of capsular contracture. Once the new implants have been inserted, the skin incision can be closed.

Usually implant removal and replacement surgery takes an hour and is performed under a general anaesthetic, which means that the patient is asleep during the procedure. Implant removal and replacement surgery usually requires a one night stay in hospital, although on some occasions the patient is permitted to go home on the same day.

Advice On Breast Implants

Since December 2018, many regulatory bodies around the World have issued statements regarding their own position and some have limited the distribution of other textured devices. The advice does vary from country to country because the research data available is limited and not conclusive. None have called for the precautionary removal or replacement of textured devices that are already inside patients’ breasts.

Breast implants however are not lifelong devices and in general will need removal or replacement at some point. In an effort to have more robust data about both conditions, the Breast and Cosmetic Implant register (BCIR) collects breast implant data for patients in England and Scotland. The MHRA continues to collect and analyse UK information through a reporting system. It also has links with up to date information from international public health organisations. The most recent advice from MHRA on BIA-ALCL was updated on the 4th April 2019.

View the MHRA statement on Allergan

Download the BAAPS statement on ALCL

Frequently Asked Questions

How Do I Prepare For Implant Removal And Replacement Surgery?

At your first consultation Elena will answer any questions you have about the surgery itself. You will then have a second consultation to go through the consent forms prior to your surgery. You will also have a Pre-Assessment with the nurses at your chosen hospital for any blood tests and investigations to check on your general health. On the day of surgery an implant removal and replacement surgery, you will not eat for a six-hour window prior to the procedure. Before entering the operating room, you will discuss the agreed form of anaesthesia with the anaesthetist, you will also see Ms Prousskaia for surgical marking, signing hospital consent, and for any additional questions you may have. If you feel anxious, we can provide you with medication that can make you feel more relaxed prior to going down to theatre.

What Is An Implant Removal And Replacement Surgery Recovery Time?

It is entirely normal to feel sore and stiff for a few days following implant removal and replacement surgery. During the first 72 hours, when the most discomfort is expected to be felt, painkillers can be administered in order to address the discomfort. Rest is normally recommended for a period of one week following implant removal and replacement surgery. A support bra is usually worn for six weeks after the procedure. Patients can benefit from taking four weeks off work, and after you have seen Ms Prousskaia for your four weeks follow up you can discuss beginning a gym routine focused on lower body strength.

What Is The Aftercare?

The Elena Prousskaia Clinic prides itself on the quality of its aftercare so we’ll make absolutely sure you know what to expect, and how much rest is needed. We’ll give you specific instructions that may include how to care for your breasts following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow-up with Elena.

How Much Does It Cost To Remove And Replace My Implants?

Please scroll down for more information on pricing.

What Are The Risks Of Implant Removal And Replacement Surgery?

While complications with implant removal and replacement surgery are infrequent, no surgical procedure is without risks. Among the possible complications are scars, infection, haematoma, implant displacement, breast asymmetry and implant rupture. Elena will provide you with further information with the risks and provide you with a detailed consent form during your consultations. This will help you to minimise the risks.

How Long Does Surgery Take?

Generally speaking, this surgery takes around 2.5-3 hours, although this varies depending on the nature of the procedure.

Is This Surgery Painful?

After surgery it is normal to experience some discomfort, the level of which varies widely amongst patients. There is rarely prolonged pain unless there is a complication and in all cases you will be prescribed pain medication.

Should I Get My Implants Removed and Replaced?

It is recommended you change implants about every 10 years. Breast implant removal and replacement surgery can be undertaken for a number of reasons, typically:

• Lifespan of implants
• Ruptured implants
• Capsular contracture
• Wish to change shape or size of the breasts.
• Body has changed due to weight loss or gain, age or childbirth resulting in the breasts changing.

What Would My Expected Results Be?

Elena prides herself on taking the time to truly understand a patient’s aims and discussing what result will work best given the patient’s body shape and size. Although good results are expected, the body is not symmetric and almost everyone has some degree of unevenness, which may not be recognized in advance. The more realistic your expectations as to results, the better your results will be in your eye. You will have at least two consultations with Elena where she ensures that she meets your expectations and she will always try to achieve your expected results.

What Type Of Implants Are Used?

The shape of implants can be round or anatomical (teardrop). Both can provide an excellent result. The outer shell and the filling may vary depending on the manufacturer. Miss Prousskaia has never used PIP implants in her practice and she will offer you high quality implants from the best manufacturers. You will discuss with Miss Prousskaia which specific shape and size of implant would give you the optimal result. You should know that in the European Union (EU) 95% of implants used for breast augmentation are made of silicone gel and only 5% contains other type of fillings such as saline. Mentor Silicone Gel-Filled Breast Implants are devices with shells constructed from silicone elastomer. The shell is filled with MemoryGel®, Mentor’s proprietary formulation of silicone gel.

Why Choose Elena Prousskaia?

Ms Elena Prousskaia has been carrying out plastic and aesthetic surgery procedures for more than 20 years. Elena trained for eight years in Plastic and Reconstructive Surgery and since then has held leading Fellowships around the world and specialised in breast surgery procedures, whether a patient is having the procedure for purely aesthetic reasons or as part of breast reconstruction. As an NHS Consultant Plastic and Reconstructive Surgeon at Southmead Hospital, she dedicated several years to complex microsurgical reconstruction and general plastic surgery. During this time at North Bristol Trust, she particularly enjoyed rebuilding patients who suffered from breast cancer giving them their body and confidence back. At present, Ms Prousskaia runs her own successful private practice performing full range of plastic and aesthetic surgery for face, body and breast. Elena Prousskaia consults in several clinics around the South West. Please see the ‘Our Locations’ tab in the menu for exact addresses or call us to discuss your closest location.

Can This Procedure Be Performed With Other Procedures?

This procedure can be performed on its own or in combination with breast uplift approaches or body remodelling surgery, such as a tummy tuck, liposuction, intimate surgery or facial surgery. This would depend on the result you are looking for. Elena prides herself on taking the time to truly understand the patient’s aims and discussing what result will work best given the patient’s body shape and size.

Can I smoke or vape before my surgery?

Elena does not operate on patients that regularly smoke or vape. To be considered for this procedure you must refrain from smoking or vaping for 3 months before and after your surgery.

Treatment Cost

The total cost of the surgery will be confirmed after the first consultation.

The cost includes the hospital, surgeon and anaesthetic fees. It also covers all post-operative visits. The initial consultation fee will be invoiced separately. The prices apply only at the time of publication and are subject to changes without notification.

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Treatment At A Glance

Surgical Time 2.5 - 3.5 hours
Hospital Stay Over night hospital stay
Initial Recovery Time 4 - 8 weeks
Anaesthetic General anaesthetic
Final Result 3 - 12 months
Follow Up 1, 4, 12 weeks & 1 year

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Joint Statement between ABS, BAAPS, BAPRAS & MHRA on BIA-ALCL

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Elena was recommended to me and as soon as I met her I felt entirely comfortable. Her explanations made sense in terms of expectations. Having made the big decision I did feel nervous but had absolute trust and confidence in Elena. I knew I was in the best hands. Elena's team is so supportive, my questions were answered with patience and understanding. My care at the McIndoe Centre was excellent. I am five weeks post op for abdominoplasty and liposuction and last week. Quite amazing to see the before and after pictures! I am so pleased that I was fortunate enough to meet Elena and have no hesitation in recommending her.

SM – Abdominoplasty & Liposuction

I have been both physically and mentally uncomfortable in my body since I was 12. I was born with ‘breast mutation’ and I first had surgery to correct this through the NHS at 16 years old. The surgery I have had with Elena, 17 years later, has removed the NHS implants, one of which had ruptured, and completely altered the shape of my chest. By doing this she has made me look and feel like a woman for the first time in my life. She is at all times quietly kind and fiercely adept. A true artist. She has surrounded herself with the most wonderful team and I cannot thank them all enough for the new lease of life that I have been given.

EG – Removal & Replacement of Implants

I have been self conscious for the whole of my adult life and I cannot express how much this surgery  has changed things for me. Both mentally and physically. I highly recommend Elena. She supported me throughout my journey from start to finish. Elena is very particular which for me is really important. Elena really took care of me from initial consultation right through to surgery and aftercare.My scaring is minimal and I am absolutely over the moon with my results. Thank you Elena!

JB – Breast Reduction

Elena is an OUTSTANDING surgeon. I had PIP implants and was looking to have them changed. I knew Elena was the surgeon to help, she put me at ease and explained my options. The lovely ladies in her office were helpful, I wanted to get sorted asap, when an alternative date was available contacted me straight away. I received outstanding care from start to finish from Elena, her team and the hospital. The aftercare is amazing, nothing is too much trouble, can call any time. I was so relaxed, I knew I was in great hands. The final results are fantastic. Elena has worked magic and I couldn’t be happier. I’m so glad I found her. I can’t thank her and her team enough.

LMS – implant Removal & Replacement

Had surgery with Elena in September, I was extremely anxious about the whole thing, but Elena and her whole team, from admin to the hospital staff were amazing with me and reassured me throughout my journey. I can not recommend Elena enough, and she has changed my life for the better! Already saving for my next operation with her!

SM – Abdominoplasty & Arm Lift

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