Breast Implant Removal

There are many reasons a patient may decide to have breast implants removed. Some have lived with their implants for years and no longer wish to have them. Others are responding to a specific problem — a capsular contracture that has made the breast firm or distorted, a known or suspected implant rupture, or a constellation of systemic symptoms they associate with their implants. Whatever the reason, the decision to explant is a valid one, and it deserves a thorough, unhurried, and non-judgemental assessment.

Breast implant removal is more than simply taking the implant out. The capsule — the layer of scar tissue the body forms around every implant — and the shape of the breast that will remain are central considerations. Dr Sparks’ approach incorporates a total capsulectomy wherever it can be performed safely, and a clear plan, agreed in advance, for the appearance of the breast after the implant is gone.

Dr Sparks brings to this surgery the same careful, considered approach he applies to facial plastic surgery — meticulous attention to proportion, symmetry, scar quality, and the subtleties of shape. Explantation is both a removal and a reshaping, and is planned with the same care as any aesthetic procedure.

Implant removal is a considered plan — for the capsule, and for the shape of the breast that remains.

Understanding Explantation & The Capsule

Every breast implant is enclosed by a capsule — a layer of scar tissue the body forms naturally around it. Understanding the capsule explains why capsulectomy is central to Dr Sparks’ approach.

The implant — saline or silicone, positioned above or below the chest muscle, which is removed at explantation.
The capsule — the scar-tissue envelope the body forms around the implant; it may be thin and supple, or thick, calcified, and contracted.
Capsular contracture — tightening and thickening of the capsule, which can make the breast firm, distorted, high-riding, or uncomfortable.
Implant rupture — failure of the implant shell; silicone may remain within the capsule or extend beyond it, and rupture is sometimes ‘silent’ (without symptoms).
Breast implant illness (BII) — the term patients use for a range of systemic symptoms they attribute to their implants; the symptoms are genuine, and many patients report improvement after removal.
The remaining breast — after years with an implant, the breast tissue and skin envelope have adapted; their shape after removal is a key part of planning.

Dr Sparks’ standard is to remove the capsule, not only the implant, wherever this can be done safely — for capsular contracture, for rupture, and for patients explanting because of breast implant illness. Where total removal cannot be performed safely, the reasons and the alternative are explained clearly.

Dr Sparks’ Philosophy & Approach

Dr Sparks approaches explantation with respect for the patient’s decision and thoroughness in its execution. His standard is to remove the capsule, not only the implant, wherever this can be done safely — and to be honest where it cannot. Equally important is the plan for the breast that remains: explantation is a reshaping as much as a removal.

The careful, considered approach he applies to facial plastic surgery — attention to proportion, symmetry, and scar quality — is carried into this surgery. The goal is a considered, complete result: implant and capsule addressed thoroughly, and a breast shape the patient has understood and agreed to in advance.

Remove thoroughly, reshape thoughtfully, and be honest about how the breast will look afterward.

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Who May Be a Suitable Candidate?

Explantation is appropriate for any patient who has made an informed decision to have their implants removed, and who is in good enough health to undergo surgery.

You may be a suitable candidate if:

Capsular contracture causing firmness, distortion, discomfort, or an unnatural appearance.
Known or suspected implant rupture.
A constellation of systemic symptoms the patient associates with their implants (breast implant illness).
A wish to no longer have implants, for any personal reason.
Stable general health, non-smoker (or willing to cease well before and after surgery), and a realistic understanding of how the breast will look afterward.

This procedure may not be appropriate if:

Significant unmanaged medical conditions that increase surgical or anaesthetic risk.
Current smokers unable to cease — smoking materially increases the risk of wound-healing problems.
An expectation that explantation will return the breast precisely to its pre-implant appearance, which is not achievable.
An expectation of guaranteed resolution of systemic symptoms.

Surgical Techniques

The explantation plan addresses both the implant and the capsule, and the shape of the breast afterward. The components below are assembled into a plan specific to the indication, the state of the capsule, and the patient’s goals.

Total Capsulectomy

Dr Sparks’ standard — removal of the implant together with the entire capsule.

A total capsulectomy is the removal of the implant together with the whole of the surrounding capsule. It is Dr Sparks’ standard approach to explantation wherever it can be performed safely, and is appropriate across a range of indications — capsular contracture, implant rupture, and explantation for breast implant illness.

Removing the capsule, rather than leaving it in place, removes calcified or contracted scar tissue, removes the capsule that may contain silicone in cases of rupture, and addresses the request of patients who wish to have all implant-related tissue removed.

Partial Capsulectomy or Capsulotomy

Used where total removal would carry unacceptable risk.

In some patients, the capsule is densely adherent to the chest wall, the ribs, or the lung lining, and removing it in its entirety would risk injury to those structures. In these circumstances a partial capsulectomy — removing as much capsule as can be removed safely — is the responsible choice.

Dr Sparks discusses this possibility before surgery so that, if the findings during the operation make total removal unsafe, the plan is already understood and agreed.

Mastopexy (Breast Lift) at Explantation

Reshaping the breast that remains after the implant is removed.

After an implant is removed, the breast tissue and skin envelope — which have adapted to the implant over years — frequently need reshaping to produce a result the patient is happy with. A mastopexy (breast lift) performed at the same time, or as a planned second stage, repositions the nipple and tightens and reshapes the breast.

Whether to lift at the same time as explantation or as a separate stage depends on the individual breast, and is discussed in detail at consultation.

Fat Grafting for Volume Restoration

Restoring natural fullness using the patient’s own tissue.

For patients who wish to retain some breast volume after explantation without another implant, autologous fat grafting can restore natural fullness using the patient’s own tissue. It can be performed at the time of explantation or as a planned later stage, and is frequently combined with a lift.

Some patients choose explantation alone, accepting the natural shape of the breast afterward; others combine it with a lift, with fat grafting, or with both. There is no single correct choice — the plan is built around what each patient wants for the breast that remains.

What Surgery Involves & What Dr Sparks Assesses

Explantation is assessed thoroughly and without judgement. The consultation establishes the reason for removal, the state of the implants and capsules, and the patient’s wishes for the breast afterward.

A full history — when and where the implants were placed, the implant type and position, and the reason removal is being considered.
For patients reporting systemic symptoms — a careful, respectful discussion of those symptoms and of what explantation can and cannot be expected to do.
Examination for capsular contracture, implant position, and signs of rupture; imaging (ultrasound or MRI) where rupture is suspected.
Assessment of the breast tissue and skin envelope, to plan the shape of the breast after removal.
Discussion of the options for the remaining breast — explantation alone, with a lift, with fat grafting, or with both.
Discussion of whether a total or en bloc capsulectomy is likely to be feasible, and the plan if it is not.
A clear, honest account of the expected change in breast appearance after the implants are gone.

Breast implant illness is not a formally defined medical diagnosis, but the symptoms patients describe are real, and Dr Sparks takes them seriously. Many patients report improvement in their symptoms after explantation; others do not, and improvement cannot be guaranteed. An honest discussion of this uncertainty is an essential part of the consultation.

Recovery & Aftercare

Recovery from explantation depends on the extent of the surgery — implant removal alone is generally a quicker recovery than removal combined with capsulectomy and a lift. A supportive surgical bra and detailed aftercare instructions are provided. Surgical drains are commonly used and removed in the early post-operative period.

First 2 Weeks

Swelling, drains, supportive bra, and restricted activity.

A supportive surgical bra is worn continuously; drains, where used, are removed once output is low.
Swelling and bruising are most pronounced in the first one to two weeks.
Lifting, reaching overhead, and strenuous activity are restricted; light walking is encouraged.
Most patients return to non-strenuous work within one to two weeks, depending on the extent of the surgery.

Weeks 2 to 6

Progressive return to activity and settling of breast shape

Gentle activity is gradually resumed; strenuous exercise and heavy lifting are deferred until around six weeks.
The breast shape begins to settle as swelling resolves; the settled shape becomes clearer.
Scar management begins once the wounds have healed, where a lift or other incisions were used.

Months 3 to 12

Final shape and, where reported, symptom change.

The settled shape of the breast is apparent by three to six months.
Where fat grafting was performed, the graft establishes its final volume by around three months.
Patients who explanted for systemic symptoms often report changes over the weeks and months following surgery; long-term review allows this to be discussed.

Risks and Important Information

All surgery carries inherent risk. The specific complications and considerations relevant to breast implant removal surgery are discussed in detail at consultation, and include — but are not limited to:

A breast that is smaller, softer, and lower than before the implants were placed — explantation cannot recreate the pre-implant breast.
Where capsulectomy is performed near the chest wall — injury to the lung lining and pneumothorax (a recognised, uncommon risk).
Bleeding, haematoma, or fluid collection (seroma) requiring drainage.
Wound-healing problems and visible scarring.
Asymmetry of breast size, shape, or nipple position.
Altered or reduced nipple and breast skin sensation.
For explantation undertaken for systemic symptoms — symptoms may not fully resolve, and improvement cannot be guaranteed.
The possibility that total or en bloc capsulectomy cannot be completed safely, and a partial capsulectomy is performed instead.
Bleeding, infection, delayed wound healing, or visible scarring.
Adverse reaction to anaesthesia or post-operative thromboembolic events.
Asymmetry, under-correction, or over-correction requiring revision surgery.
Outcomes that fall short of expectations despite a technically appropriate procedure.

In line with the requirements for cosmetic surgical procedures in Australia:

A referral from your GP is required prior to undergoing surgery.
A minimum seven-day cooling-off period applies between your initial consultation and the date of surgery.
You are encouraged to seek a second opinion from another appropriately qualified health practitioner before proceeding.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

All surgical information provided on this website is intended as general educational content only. Individual anatomy, health status, and circumstances vary. This material does not constitute medical advice and does not replace a formal consultation with Dr Sparks. Results depicted or described are not guaranteed and will differ between individuals. Dr Sparks’ practice operates in accordance with AHPRA guidelines and the Medical Board of Australia’s Code of Conduct.

Breast Explant FAQs

What is a total capsulectomy, and why does Dr Sparks favour it?

A total capsulectomy removes the implant together with the entire capsule — the scar-tissue envelope the body forms around it. It is Dr Sparks’ standard approach wherever it can be performed safely, because it removes calcified or contracted scar tissue, removes the capsule that may contain silicone in cases of rupture, and meets the wishes of patients who want all implant-related tissue removed.

What is the difference between total and en bloc capsulectomy?

A total capsulectomy removes the whole capsule along with the implant. An en bloc capsulectomy removes the implant and capsule together as a single, unopened unit, so the implant is never exposed within the wound — particularly valuable where an implant has ruptured. Whether en bloc removal is feasible depends on the thickness and position of the capsule; where it cannot be done safely, a carefully performed total capsulectomy is the appropriate alternative.

What happens if the capsule cannot be fully removed?

In some patients the capsule is densely adherent to the chest wall, ribs, or lung lining, and removing it entirely would risk injuring those structures. In that situation a partial capsulectomy — removing as much as can be removed safely — is the responsible choice. Dr Sparks discusses this possibility before surgery, so that if it arises the plan is already understood and agreed.

I think I have breast implant illness — will removal help?

Breast implant illness is the term patients use for a range of systemic symptoms they attribute to their implants. It is not a formally defined medical diagnosis, but the symptoms described are real, and Dr Sparks takes them seriously. Many patients report improvement in their symptoms after explantation; others do not, and improvement cannot be guaranteed. An honest discussion of this uncertainty is an essential part of the consultation.

Do I need a reason to have my implants removed?

No. The decision to no longer have implants is a valid one for any personal reason, and it is assessed thoroughly and without judgement. Whatever the reason, the focus of planning is the same: a thorough removal and a clear, agreed plan for the shape of the breast that remains.

What will my breasts look like after the implants are removed?

After years with an implant, the breast tissue and skin envelope have adapted, so the remaining breast is typically smaller, softer, and lower than patients expect — it will not look as it did before the implants were placed. A breast lift, fat grafting, or both can improve the shape considerably, but they cannot recreate the pre-implant breast. Dr Sparks discusses this openly so the decision is fully informed.

Can I have a lift or fat grafting at the same time as removal?

Yes. A breast lift can be performed at the same time as explantation, or as a planned second stage, to reposition the nipple and reshape the breast. Fat grafting can restore natural fullness using your own tissue. Whether to combine these with the explantation or stage them depends on the individual breast and is discussed in detail at consultation.

Are surgical drains used?

Surgical drains are commonly used after explantation — particularly when a capsulectomy has been performed — to remove fluid and reduce the risk of a fluid collection (seroma). They are removed in the early post-operative period once output is low.

Next Steps

Implant removal is highly individualised, and each plan is built around the specific patient and their circumstances, not from a template. During your consultation, Dr Sparks will conduct a full history of when the implants were placed and the reason removal is being considered, an examination for capsular contracture, implant position, and signs of rupture, an assessment of the breast tissue and skin envelope to plan the shape afterward, a discussion of whether explantation alone or in combination with a lift or fat grafting will suit your goals, and an honest account of the expected change in breast appearance, and develop a personalised surgical plan that combines your anatomy and your goals.

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Breast Implant Removal