Breast Implant Removal (Explant) / Capsulectomy in Dallas and Fort Worth, TX
Why are some patients choosing to remove their breast implants:
There are a variety of reasons some patients choose to remove their implants:
1.) No longer like the way their implants look: Some patients feel their breasts look very different than they did when they had their original augmentation. The breasts have sagged or changed shape. Sometimes the breasts have sagged while the implants have stayed high causing a double bubble appearance to their breasts. Some patients feel that their breasts have enlarged in size and now they are too big and heavy for their bodies.
2.) No longer want the maintenance of the implants: Implants are not lifetime devices. They do break down over time. Most surgeons would recommend thinking about replacing the implants every 10 years to stay ahead of possible implant ruptures. Many women get to a point in their lives when they no longer want to think about having more surgeries in the future. They feel young and healthy now and they find it hard to imagine doing another surgery in 10 more years.
3.) Have developed a capsular contracture or rupture: Capsular contractures occur when the capsule (or scar tissue) around the implant becomes very thick and hard. It will feel firm and can start distorting the breast or causing pain. Once a capsular contracture has occurred it is a high likelihood of it occurring again with replacement of the implants. In addition, some women experience a rupture in their implants. Many women choose to explant instead of replacing when this occurs.
4.) Concern about breast implant associated anaplastic large cell lymphoma (BIA-ALCL): This is a type of lymphoma associated with textured breast implants. While it is still relatively rare, it is much more common than previously suspected. Most women will present with a fluid collection (seroma) around their implants. This is easily seen on a mammogram or ultrasound. Some patients choose to explant to try to minimize the risk of developing this lymphoma.
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5.) Concern about breast implant illness (BII): This is a concern the implants could be causing or contributing to medial issues for the patient. While research into BII is ongoing many patients who seek out Dr. Surjit Rai for their explant surgery do so out of concern about BII. Dr. Rai has extensive knowledge on breast implant illness and shares his experiences with his patients. Many patients who have breast implant illness concerns elect to have a total en bloc capsulectomy. Dr. Rai will discuss these options with the patients during their consultation.
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How is a breast explant / capsulectomy done?
Dr. Surjit Rai performs most of his procedures at his fully certified (AAASF) in suite operating room. It meets the same safety standards as a hospital or surgical center operating room. However, it is much more convenient and private. Dr. Rai works with a team of MD board certified anesthesiologists who provide excellent care for his patients.
Explant / capsulectomy:
This surgery involves removal of the breast implant with the surrounding scar tissue (capsule) that the body has created around the implant. This is typically done en-bloc, which is removal of the capsule and the implant in one unit (the implant still inside the capsule). The surgery takes 2 hours to perform, and Dr. Rai will leave surgical drains in the breasts to optimize the recovery and safety for his patients. Drains typically will stay in place about 3-5 days depending on how much is draining. The patient will be placed in a surgical ACE wrap for compression. The patient will recover in the office and be released home the same day when they are comfortable.
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Explant / capsulectomy with breast lift (mastopexy):
This surgery involves removal of the breast implant and capsule and removal of excess skin on the breasts. This is called a breast lift or breast mastopexy. It can be done safely at the same time as the explant. Dr. Rai will use an anchor lift incision to remove excess skin. This will tighten the breast around the new smaller size. Dr. Rai utilizes an auto-augmentation technique during his breast lift to use the tissue at the bottom of the breast to try to fill and volumize as much of the breast as possible. The areola will also be made smaller, and the areola and nipple will be lifted to a higher location on the breast. This surgery will take 3 hours to perform but the patient will also leave the same day. Surgical drains and an ACE wrap will be used for this procedure as well.
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Combining breast explant with other cosmetic procedures or fat transfer:
Breast explants with or without breast lifts can be combined very safely with other cosmetic procedures. Typical combination surgeries include abdominoplasties (tummy tuck), face or neck lift, eyelid surgery, and liposuction. Many patients elect to have other procedures done at the same time to minimize the recovery and cost of surgeries. Sometimes fat transfer can be performed for patients as well. This involves liposuction to remove fat from other areas of the body and injecting it into the breasts to add some volume to the breast after the explant.
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What happens to the capsule that is removed and the implants?
The capsule is sent to the pathologist to look for any incidental breast cancer. Additional testing (CD30 stains) can be done as well to look for BIA-ALCL. The implants can be returned to the patient if they desire or are disposed of by the office. Additional testing for microbiology (mold, fungus, bacteria) can be done if warranted.
Recovery after breast explant / capsulectomy:
Patients will recover after their surgery for between 1-2 hours in our office. They will then go home. They will begin recording their drains daily. They can shower on the second day and then replace their ACE compression wrap. Dr. Rai will see patients to remove their drains when the drain outputs are low enough (usually 3-5 days after surgery). Some patients elect to remove their own surgical drains. Dr. Rai will then see the patient 2 weeks after the drains have been removed, 2 weeks after that, and then scheduled depending on how they are healing. Out of town patients can be seen virtually and send photos of their breasts to determine how they are healing.
If the patient is just having an explant done, they should expect to limit their lifting to 10 lbs until 4 weeks and then no restrictions on activities at that time. If a patient is undergoing a lift at the same time, they should limit their lifting to 10 lbs for 4 weeks and then expect full recovery without restrictions between 6-8 weeks from the surgery date. Patients are encouraged to avoid driving for 1 week after the surgery.
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Why Choose Dr. Surjit Rai for your breast explant / capsulectomy?
1.) Dr. Rai has extensive experience in breast explants, capsulectomies, en bloc capsulectomies, and breast implant illness. He is performing his own clinical research on the topic of breast implant illness. He has patients coming from all over the world who seek him out for his breast explant and breast implant illness knowledge.
2.) Dr. Rai has performed over 2500 explant procedures to date.
3.) Dr. Rai prides himself on his personal care for his patients. Patients can expect frequent communication with Dr. Rai. Dr. Rai is always available for his patients and prides himself on personally communicating with his patients to make sure they all feel well cared for at any stage of their explant journey.
4.) All capsule specimens are sent for pathological testing to rule out any unknown cancers.
5.) Your safety is our top priority: Dr. Rai performs his surgeries in his fully accredited (AAASF) facility. This in suite operating room meets the latest safety standards and provides patients with a safe, private, and convenient environment for their surgery. Dr. Rai only uses board certified MD anesthesiologists to take care of his patients.
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6.) Dr. Rai aims to get the best cosmetic result possible using his auto augmentation breast lift technique to try to utilize as much natural breast tissue as possible to reshape and volumize the breast.
7.) Latest medical advancements: Dr. Rai uses Exparel which is an injectable anesthetic that can aid in pain relief for up to 72 hours. Dr. Rai also uses Emend which is a newer anti-nausea medication to help prevent nausea for patients after their surgery.
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