Introduction
In New York City, the demand for breast implant removal and related procedures has been on the rise in recent years. There are several reasons for this, including concerns about breast implant - associated anaplastic large cell lymphoma (BIA - ALCL), breast implant illness (BII), and dissatisfaction with the aesthetic results of previous breast augmentations. In this article, we will take an in - depth look at some of the popular hospitals and surgeons in New York City for breast implant removal and prosthesis - related procedures.
Top Surgeons and Their Practices
Dr. Darrick E. Antell
Dr. Darrick Antell is widely regarded as one of the most experienced breast surgeons in the New York area and globally. He is a top New York plastic surgeon who specializes in cosmetic and aesthetic surgery. His name frequently appears on the best - doctors lists in well - known magazines such as Town and Country, Vogue, and New York Magazine.
Dr. Antell performs custom breast implant removal (explant) surgery. He can remove existing silicone or saline implants from the body. Women may opt for this surgery for lifestyle, cosmetic, or medical reasons. In some cases, he also conducts an en bloc capsulectomy to remove the tissue that has grown around the breast implant. He also handles the removal of the Allergan textured breast implants, which were recalled by the FDA due to their association with an increased risk of BIA - ALCL.
During the consultation process, Dr. Antell thoroughly evaluates the patient's general health, medical history, and the current condition of the breasts. He discusses the procedure, risks, and recovery in detail. If needed, he may recommend pairing the explant surgery with another procedure, like a breast lift, to achieve a more desirable outcome. Most of his patients prefer to have the procedure in his discreet, private operating room near Lenox Hill Hospital. After the surgery, patients recover in his state - of - the - art recovery suite, and he provides an individualized recovery plan.
Dr. Olivia Hutchinson
Dr. Olivia Hutchinson is recognized as a top breast implant removal surgeon on the Upper East Side in NYC. As a board - certified, Harvard and Columbia - educated female aesthetic plastic surgeon, she has over 20 years of experience in evaluating patients with breast - implant - related concerns and performing breast implant removal.
There are multiple reasons why patients may seek breast implant removal. Aesthetic issues include a palpable or visible implant (folded, rippled, or wrinkled), implant rupture, leakage, or deflation, malposition, capsular contracture, breast asymmetry, unsightly scars, and nipple or areola problems. Medical issues involve severe capsular contracture, chronic pain, BIA - ALCL, breast implant illness (BII), and infection or bleeding.
Regarding BIA - ALCL, it is a rare cancer associated with certain textured breast implants. The recall of Allergan textured implants in 2019 was due to the incidence of this disease. While removal of all textured breast implants in NYC is not currently the standard treatment, patients should make an informed decision after consulting with their plastic surgeon. BII refers to a wide variety of symptoms that patients may experience after breast augmentation or reconstruction. It is believed to be associated with pre - existing autoimmune problems.
Popular Hospitals and Their Plastic Surgery Programs
Columbia University
Columbia University is one of New York's best hospitals and a world - class medical center. Its plastic and reconstructive surgery division has highly experienced surgeons proficient in multiple areas of specialization, ranging from routine non - surgical cosmetic procedures to complex reconstructive operations and body contouring surgery after significant weight loss.
The plastic surgery programs at Columbia include:
- Cosmetic Care: Offers surgical and non - surgical options such as ear and eyelid lifts, breast augmentation, and tummy tucks.
- Reconstructive Care: World - leading in areas like breast reconstruction after breast cancer, skin lesion excision, and reconstructive surgery for the nose and ears.
- Cleft Palate / Cleft Lip Care: Through the craniofacial surgery program, provides specialized care for newborns with cleft lip and cleft palate.
- Orthoplastic Surgery Care: Combines orthopedic and reconstructive plastic surgery for better treatment options, resulting in lower wound complication rates and higher patient satisfaction during recovery.
- Breast Reconstructive Care: Dedicated to helping breast cancer patients reclaim their physical and emotional well - being through post - lumpectomy or post - mastectomy reconstruction, with a team of cancer experts and reconstructive plastic surgeons.
The hospital also has an active research laboratory focused on areas such as stem cells, tissue engineering, bone substitutes, and gene therapy for wound healing. Their plastic surgery team consists of well - known and highly skilled surgeons, each with their own areas of expertise.
Mount Sinai
Mount Sinai offers services related to breast reconstruction. For women who are planning to have a mastectomy, the decision of whether to undergo breast reconstruction is a very personal one, based on medical condition and personal preferences. The expert plastic surgeons at Mount Sinai can guide patients through this decision - making process.
Patients have to consider several aspects when making this decision. First, they need to decide if they want to have reconstruction at all. Some may choose reconstruction to look balanced, feel comfortable with their body shape, or avoid wearing a prosthesis. Second, if they decide to have reconstruction, they need to determine the timing. Immediate reconstruction may have advantages such as fewer surgical procedures and a better - preserved breast skin shape, but some patients may prefer to wait for their body to heal first. Third, patients need to choose between using implants or their body's own tissue for reconstruction, considering factors like overall health, tumor size and location, breast size, and recovery speed.
Reasons for Breast Implant Removal
Medical Reasons
- Breast Implant - Associated Anaplastic Large Cell Lymphoma (BIA - ALCL): This is a type of non - Hodgkin lymphoma that occurs in the scar tissue surrounding the implant. If left untreated, it can spread to nearby lymph nodes. Symptoms include pain or swelling around the breasts and changes in breast size or shape. Treatment usually involves surgically removing the implants and surrounding scar tissue, and in more severe cases, chemotherapy or radiation may be required. The FDA has recalled certain textured breast implants due to their association with a higher rate of BIA - ALCL.
- Breast Implant Illness (BII): BII refers to a collection of symptoms that patients may experience after breast augmentation or reconstruction. These symptoms include fatigue, fever, gastrointestinal complaints, migraines, breathing difficulties, depression, anxiety, rashes, pain, and brain fog. It is thought to be related to pre - existing autoimmune problems and is also known as “autoimmune / inflammatory syndrome induced by adjuvants (ASIA).”
- Severe Capsular Contracture: This occurs when significant scar tissue forms around the implants. It can cause pain and discomfort and also affect the cosmetic appearance of the breasts.
- Infection and Bleeding: These are potential complications of breast implant surgery that may require the removal of the implants.
Aesthetic Reasons
- Unsatisfactory Appearance: The implant may become palpable or visible, folded, rippled, or wrinkled. There may also be issues with breast asymmetry, unsightly scars, nipple or areola problems, or an abnormal implant position such as a “double bubble” appearance or “symmastia.”
- Desire to Return to Natural Breast Size: Some patients may have had a change of heart and prefer to have their natural breast size back after their initial breast augmentation.
The Breast Implant Removal Process
Consultation
During the initial consultation with a surgeon, the patient's general health, medical history, and the current condition of the breasts are evaluated. If the patient has medical reasons for implant removal, it is crucial to discuss all symptoms with the surgeon. It is also helpful to bring any information about the existing implants and previous breast augmentation surgery. The surgeon and the patient will have an open discussion about the desired outcome, and based on this, a surgical plan will be created. In some cases, additional procedures like a breast lift may be recommended.
Pre - operative Preparation
Depending on factors such as age and implant condition, the patient may be sent for imaging tests like an ultrasound, mammogram, or MRI before the surgery. The patient will receive guidelines on eating, drinking, smoking, and taking or avoiding vitamins, iron tablets, and specific medications. Prescriptions may be given, and in some cases, pre - operative clearance from another doctor may be required. Since the procedure is usually performed under “twilight” sedation, the patient needs to arrange for someone to drive them home after the surgery and assist them during the first few days of recovery.
Surgery
Breast implant removal is typically performed with local anesthesia and intravenous sedation or another type of “twilight” anesthesia. In rare cases, only local anesthesia may be used. A board - certified anesthesiologist monitors the patient throughout the procedure. If possible, the surgeon will remove the implant through the existing incisions from the initial breast augmentation surgery. However, in some situations, especially when there are complications like capsular contracture or silicone implant rupture, it may be necessary to remove the hardened scar tissue around the implant (en - bloc resection). Multiple layers of internal, dissolving sutures are usually used to close the incisions, and an external layer of sutures may be added if needed. The surgery usually takes between one to two hours, and en - bloc resection may take longer.
Recovery
After the surgery, the patient recovers in the surgeon's recovery suite under the monitoring of a registered nurse. A specialized local anesthesia is used to reduce discomfort. Since it is an outpatient procedure, the patient can go home on the same day. However, they cannot drive for 24 hours after the anesthesia. The breasts may be covered with a layer of gauze or a bandage. Patients may feel tired or sore, but many can return to most daily activities within days. Vigorous exercise should be avoided for about two weeks. The patient may experience some numbness in the breast area and fluid drainage from the incision site. In most cases, patients do not need a breast lift after surgery as the breasts often return to their pre - operative shape naturally. The patient will usually return to the office the day after surgery for a follow - up, and if external sutures are used, they are typically removed around 7 - 10 days after the procedure. It may take several months for the final results to be visible, and the scars will gradually fade.
Carcinogenicity of Breast Implants and Prostheses
According to research, there is evidence suggesting a lack of carcinogenicity in humans of breast implants made of silicone for female breast carcinoma. However, there is inadequate evidence in humans for the carcinogenicity of implanted prostheses made of silicone for neoplasms other than female breast carcinoma, as well as for non - metallic implants other than those made of silicone, metallic implants, metallic foreign bodies, orthopaedic implants of complex composition, and cardiac pacemakers.
In experimental animals, there is sufficient evidence for the carcinogenicity of implants of metallic cobalt, metallic nickel, and a nickel alloy powder containing approximately 66 - 67% nickel, 13 - 16% chromium, and 7% iron. There is limited evidence for the carcinogenicity of implants of some other alloys containing cobalt and nickel. And there is inadequate evidence for the carcinogenicity of implants of chromium metal, stainless steel, titanium metal, titanium - based alloys, and depleted uranium.
Case Studies and Patient Experiences
Many patients have shared their experiences of breast implant removal. For example, some patients who had issues with capsular contracture and were experiencing pain and discomfort reported significant relief after the removal of their implants. One patient who had concerns about BIA - ALCL after the recall of her Allergan textured implants was very satisfied with the personalized care she received from Dr. Antell. He carefully explained the procedure, risks, and recovery process, and the patient felt confident throughout the entire process. Another patient who was dissatisfied with the aesthetic results of her previous breast augmentation chose to have the implants removed by Dr. Hutchinson. She underwent a combined explant and breast lift procedure and was very happy with the new shape and size of her breasts.
Conclusion
In New York City, there are several highly qualified surgeons and excellent hospitals for breast implant removal and related prosthesis procedures. Surgeons like Dr. Darrick Antell and Dr. Olivia Hutchinson have the experience and expertise to handle a variety of cases, whether they are for medical or aesthetic reasons. Hospitals such as Columbia University and Mount Sinai offer comprehensive plastic surgery programs that cover a wide range of procedures related to breast health and aesthetics.
It is essential for patients to thoroughly research their options, have in - depth consultations with their surgeons, and make informed decisions. If you are considering breast implant removal or getting a prosthesis in New York City, we encourage you to reach out to one of the top surgeons or hospitals mentioned in this article. You can schedule a consultation to discuss your specific needs and concerns and take the first step towards achieving your desired results.
