Sydney

Breast Implant Removal

They are related but not the same thing. Your body forms a capsule of scar tissue around any implant. A capsulectomy means removing that capsule, either in full, which is a total capsulectomy, or in part. En bloc removal means taking the implant and the capsule out together as a single sealed unit, without opening the capsule. Simple explantation means removing the implant on its own and leaving the capsule in place. Which approach is appropriate depends on the condition of the capsule, whether the implant has ruptured, and where the implant sits in relation to the chest wall. A/Prof Bish will explain which he recommends for you and why.

Not always. A thin, healthy capsule often does not need to come out and can be left in place. Removing the capsule is generally recommended where it is thickened or calcified, where capsular contracture has developed, where a silicone implant has ruptured, or where there is any concern about BIA-ALCL, in which case tissue is sent for pathology. Capsule removal is a larger operation with a higher chance of bleeding, and the capsule sits close to the chest wall and ribs. There is currently no high quality evidence that removing the capsule improves systemic symptoms compared with removing the implant alone.

Sometimes, depending on whether there is a current medical indication. Item 45548 covers removal of a breast prosthesis on its own as an independent procedure. Item 45551 covers removal together with excision of at least half the fibrous capsule where there is a medical reason such as capsular contracture, a mass within the capsule, or BIA-ALCL, with tissue sent for histopathology. Items 45553 and 45554 cover removal and replacement following complications such as rupture. Implants originally placed for cosmetic reasons can still qualify if a genuine complication has since developed. Removal purely to change size or appearance does not attract a rebate, and health funds will not contribute where no item number applies.

Costs vary with the operation involved, so no single price applies. Removing implants on their own is a shorter procedure than removing them together with a full capsulectomy, and adding a lift or fat transfer increases both the operating time and the cost. Your total is made up of the surgeon’s fee, the anaesthetist’s fee, hospital and theatre fees, and follow-up care. Where a Medicare item number applies, Medicare and your health fund may cover part of the medical and hospital costs, which can make a substantial difference to what you pay. You will receive a written, itemised quote after your consultation.

Breast implant illness is the term used for a group of systemic symptoms that some women with implants report, most commonly fatigue, joint or muscle pain, and difficulty concentrating. It is not currently a formally defined medical diagnosis and there is no test for it. A 2025 systematic review of 48 studies covering more than 7,000 patients found that 49 per cent reported these symptoms, and that around half of those patients had another identifiable medical explanation for them. Among patients who had their implants removed, 57 per cent reported improvement. Improvement is common but it is not universal and it cannot be promised beforehand. A/Prof Bish will take your symptoms seriously, and will also want other possible causes properly investigated.

Often, but not always. Implants stretch the skin over time, so when they are removed the remaining breast tissue may sit lower than you would like. A breast lift, or mastopexy, repositions the nipple and tightens the skin envelope. It can be performed at the same time as removal, or as a second operation later. Combining them means one anaesthetic and one recovery. Staging them allows the breast to settle first, so the lift can be planned more precisely against the final shape. A/Prof Bish will measure where your nipple sits and talk you through which approach suits your situation.

Yes. If you want to keep implants but address a problem, the old implants can be taken out and new ones inserted during the same operation. This is common where an implant has ruptured, where capsular contracture has developed, or where you would prefer a different size or shape. It is worth understanding that replacement restarts the clock rather than resolving the matter permanently, because implants are not lifetime devices and further surgery may be needed again in future. Some patients decide during their consultation to go without implants instead.

Most patients return to their usual routine after one to two weeks and avoid vigorous exercise and heavy lifting for six weeks. Removal on its own is generally an easier recovery than the original augmentation was. Where a full capsulectomy is performed, or a lift is done at the same time, expect the recovery to take longer and to be more uncomfortable. A drain is sometimes left in place for a day or two to collect fluid. You should arrange for someone to drive you home and to help around the house for the first few days.

Allow two to three months for the swelling to settle, and up to a year for the breast to reach its final shape. The early appearance after removal can be confronting, because the tissue is swollen and has not yet redraped over the smaller volume. Most patients notice a marked improvement between six weeks and three months as the skin retracts. If you are considering a lift or fat transfer as a second stage, that is usually planned once the breast has settled, which gives a more predictable result.

Not necessarily. The Therapeutic Goods Administration does not recommend removing implants in women who have no symptoms, including women with textured implants. If you have textured implants and are well, the guidance is to stay aware of changes rather than to have surgery. A ruptured silicone implant is usually recommended for removal even if you feel well, because silicone can migrate into the surrounding tissue over time. Rupture is often silent and may only be picked up on ultrasound or MRI. If you are not sure what type of implants you have, an implant check can establish this.

It depends on why you are having the surgery. Where implants are being removed for a medical reason, such as rupture, capsular contracture or suspected BIA-ALCL, the procedure is medically justified and the cosmetic surgery cooling-off requirements do not apply. Where implants are being removed for appearance alone, the surgery is classified as cosmetic, so the seven day cooling-off period, the two consultation requirement and the other Medical Board of Australia requirements do apply. A referral is required either way. A/Prof Bish will tell you which pathway applies to your situation at your consultation.