What happens after Breast Implant Removal ? (Explant)

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What You Need to Know Before Making the Decision

Whether you’ve had your implants for decades or just a few years, you may be considering this procedure—known medically as explantation—for various personal or medical reasons.

Breast implants have been a part of modern cosmetic surgery since the 1960s, and in Australia alone, thousands of women undergo breast augmentation each year. However, as life changes, so do our choices about our bodies.

Sydney Specialist Plastic Surgeon Dr Mark Kohout frequently consults with women who, while once happy with their implants, are now contemplating removal for reasons ranging from changing aesthetic preferences to health concerns.

Download Dr Mark Kohout’s Breast Implant Replace Guide

Why Consider Breast Implant Removal?

Whilst breast implants remain a popular choice for many women, and many patients enjoy their results for decades without complications, there are various reasons why you might consider having them removed. Dr Mark Kohout has helped many women through this decision, and their motivations typically fall into these categories:

Personal Comfort and Aesthetic Concerns

Some women find that their relationship with their implants changes over time. You might experience:

Persistent discomfort related to the sensation of having implants
A cold feeling in the breast area
Visible wrinkling of the skin over the implant
General dissatisfaction with the look or feel
A desire to return to your natural breast size

Medical Complications

Through Dr Kohout’s practice, he has encountered several medical reasons that might necessitate implant removal:

Capsular Contracture: When the scar tissue around the implant becomes hard and painful, potentially distorting the breast shape.
Chronic Pain or Discomfort: Some women experience ongoing discomfort that doesn’t resolve with conservative treatment.
Recurring Infections: Though rare, infections can develop within the scar capsule surrounding the implants.
Implant Rupture: Implants may rupture or leak with age or trauma, requiring removal.

Serious Health Concerns

While serious complications are rare, they deserve careful consideration:

BIA-ALCL : A rare type of T-cell lymphoma that can develop in the capsule surrounding breast implants, most commonly associated with textured implants used between 1990 and 2017.
BII (Breast Implant Illness): Though not yet scientifically proven, many women report symptoms they attribute to their implants, such as:

- Muscle and joint pain
- Shortness of breath
- Hair thinning
- Skin rashes
- Sleep disturbances

Autoimmune Concerns: Research suggests potential links between silicone implants and autoimmune conditions, including:

- Sjögren’s syndrome
- Scleroderma
- Rheumatoid arthritis
- Increased risk of melanoma

Aesthetic Outcomes after Breast Explant Surgery

A common concern among breast explant patients is how their breasts will look after implant removal. While it’s true that removing implants will reduce breast fullness and cup size, the outcome often surprises women positively, as many have sufficient natural breast tissue to achieve a soft, natural-looking result.

Sometimes, large implants result in skin looseness or nipple droop, which may be better managed with a tightening or lifting procedure to restore shape.

Breast Implants & Enlargement Before and After Images

Several factors influence how your breasts might look after explant, including:

The size of your original implants
How long you’ve had the implants
Your skin elasticity
Your natural breast tissue volume
Your age and hormonal status
Whether you’ve had children or significant weight changes

Surgical Options after Explant

Simple Explant

A simple explant procedure may be sufficient for women with:

Smaller implants
Good skin elasticity
Adequate natural breast tissue
Minimal ptosis prior to implants

In these cases, the breast tissue often retracts naturally, creating an optimal result without additional intervention.

Breast Lift (Mastopexy) with Explant

This combined procedure is beneficial if you have:

Large implants that have stretched the skin
Significant skin laxity
Nipples that sit below the breast crease
Loss of upper pole fullness

During this procedure, Dr Kohout removes the implants and reshapes your natural breast tissue, removing excess skin and repositioning the nipple-areola complex to a more elevated position.

Fat Transfer with Explant

For women concerned about volume loss, fat transfer can be a natural alternative. This procedure involves:

Removing fat from other areas through liposuction
Processing the fat for transfer
Carefully injecting it into specific areas of the breast

Benefits of fat transfer include natural-feeling results, no foreign objects in the body, adjusted body contours where fat is harvested, and long-lasting results.

What to Expect During Recovery

Recovery after breast implant removal varies depending on the procedure and your healing capacity. Most patients experience initial discomfort and swelling for the first few days, gradually improving over the first week. You’ll need to wear a support bra and follow specific post-operative instructions.

The first 48 hours are typically the most challenging, but pain is usually well-managed with prescribed medication. Most patients can shower after 48 hours, though you’ll need to be gentle around the surgical sites. Sleeping on your back, with your upper body slightly elevated, is recommended for at least the first two weeks.

Light activities usually resume within a week, but heavy lifting or vigorous arm movements should be avoided according to your procedure’s specific timeline.

Recovery Timeline Comparison

Simple Explant
- 1-2 weeks
- 4-6 weeks
- 3-6 months
  Minimal scarring, quickest recovery
Explant with Lift
- 2-3 weeks
- 6-8 weeks
- 6-12 months
  Additional healing for lift incisions
Explant with Fat Transfer
- 2-3 weeks
- 6-8 weeks
- 6-12 months
  Multiple site recovery (breasts and liposuction areas)

Making Your Decision

During your consultation with Dr Mark Kohout, you’ll discuss:

Your aesthetic goals
Your breast tissue quality
The best surgical approach for your situation
Expected recovery time
Potential risks and complications
Realistic outcome expectations

Long-term Considerations after Explant Surgery

Regular Health Monitoring

Regular breast health screenings are essential post-explant surgery. Without implants, your breasts are easier to examine, but it’s important to:

Have annual clinical breast examinations
Resume regular mammogram scheduling
Learn how your “new” breasts feel for effective self-examination
Report any unusual changes promptly

Weight Management

Maintaining a stable weight helps preserve your breasts’ appearance. Consider working with a nutritionist if needed, as weight changes can affect breast shape more noticeably without implants.

Ongoing Support and Care

Proper breast support remains important long after surgery:

Invest in well-fitting, supportive bras
Consider professional bra fitting once your size stabilises
Avoid underwire bras until fully healed (typically 3-6 months)

Natural Ageing Process

Your breasts will continue to change over time due to natural ageing, hormonal changes, gravity, and skin elasticity changes.

Follow-up Care

Long-term monitoring supports optimal outcomes. Attend scheduled follow-up appointments, document healing progress, and address concerns promptly.

FAQs about Medicare Cover for Breast Implant Removal

Will mammograms be easier after implant removal?

Yes, mammograms typically become more straightforward and accurate post-implant removal, as radiologists can better visualise breast tissue.

How soon after breastfeeding can I have my implants removed?

Dr Kohout usually recommends waiting at least 3-6 months after breastfeeding to allow breast tissue to stabilise and hormones to normalise.

What happens to the capsule during explant surgery?

Options for handling the capsule include total capsulectomy (removing all capsule tissue), partial capsulectomy (removing problematic areas), or capsule scoring (releasing tight areas but leaving the capsule). Remember that in taking the capsule, some breast tissue may be sacrificed. Removal of the capsule may not be necessary for every patient.

Can I have another breast augmentation in the future if I’m unhappy with my explant results?

Yes, re-augmentation is possible after explant surgery, usually after a 6-12 month healing period.

How does explant surgery affect exercise and upper body strength?

Generally, light cardio can resume after 2-3 weeks, with chest exercises restarting around 6-8 weeks. Upper body strength typically returns to normal by 3 months.

Will my implant removal be covered by Medicare or private health insurance?

Coverage varies by case; insurance may cover explant surgery for medical reasons like capsular contracture, implant rupture, or BIA-ALCL diagnosis, but aesthetic concerns are typically not covered.

What happens to my breast sensation after explant surgery?

Changes in breast sensation after explant surgery can vary significantly:

Some women report improved sensation within 6-12 months.
Some notice immediate changes as pressure from implants is relieved.
Nerve function that was compressed may take time to recover.
Any new numbness typically improves gradually.

Factors affecting sensation include:

Original implant placement
Length of time with implants
Surgical technique used for removal
Whether a lift is performed simultaneously

What happens after Breast Implant Removal ? (Explant)

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What You Need to Know Before Making the Decision