A Word From Dr. Merriman Breast Implant Removal
There are several reasons you may want to remove your implants rather than have them replaced. If they were placed when you were younger and then you gained a significant amount of weight, your natural breasts can become larger, and the implants can make you too large and give you a matronly appearance. In this case, the implants can be removed as a single procedure, or a lift can be done as well to improve the shape of the breasts at the same time. Some women with older implants may have a ruptured implant and/or hardening of the scar tissue (capsule) around the implant. If this is the case, the implants can be removed and replaced with new implants, or just removed. Some women feel that their implants are ruining their health. There are no studies that demonstrate a connection between either type of breast implant and systemic (body-wide) disease. There are several that demonstrate no connection.
There are, however, women who have what they consider autoimmune symptoms that improve with implant removal. It is possible that a small percentage of women are sensitive to the solid silicone implant shell. It would have to be the solid silicone shell, as both saline and silicone gel implants have been used when Breast Implant Illness is considered to be an issue. Or women could get better after removal because of a placebo effect, which is a very powerful effect in many areas of medicine. When implants have been in place for a while, it is a good idea to remove the capsule, or as much of it as possible, without damaging surrounding structures.
Some capsules are thickened and even calcified, and if left, can cause problems with mammograms or even be felt. If left behind, they can also fill with fluid (seroma). If the implant is an old, ruptured gel implant, I try to remove it “en bloc” (capsule and implant together) to avoid spilling the gel into the operative site. It is just neater that way. If a patient wants implants out because they feel they are harming their health, and they request an en bloc removal, I will try to do that. It is not possible in all cases, so it is safe. Some capsules are thin and filmy and almost impossible to separate from the surrounding tissue.
These are also unlikely to be causing problems. In these cases, the remaining capsule can be curetted or cauterized to reduce the chance of forming a seroma. So, if your implants are old, or they make you look too matronly, or you are concerned that they are affecting your health, implants can be removed or replaced. And both of these can usually be safely combined with a breast lift if needed. Fat grafting can also be used to improve the size and shape after implant removal if you want more volume, but want to avoid an implant. Fat grafting cannot provide as much volume as implants, but it is a powerful technique for mild volume increase and shaping.
