Plastic Surgery Guide for Hospitals for Prosthetic Breast Augmentation Removal in New York City 2025

Introduction

Reasons for Prosthetic Breast Augmentation Removal

Medical Complications

1. Implant Rupture or Leakage: Silicone and saline implants can rupture or leak over time. A ruptured silicone implant may not be immediately noticeable, while a saline implant will typically deflate quickly. Rupture can be caused by factors such as trauma, aging of the implant, or manufacturing defects. When an implant ruptures or leaks, it may lead to pain, swelling, or changes in breast appearance, prompting removal.
2. Capsular Contracture: This occurs when the scar tissue (capsule) that forms around the implant tightens and hardens. It can cause pain, distortion of the breast shape, and a firm or lumpy feel to the breast. Severe cases of capsular contracture often require implant removal and sometimes the removal of the capsule itself.
3. Breast Implant Illness (BII): BII is a controversial condition in which some women with breast implants report experiencing a range of symptoms such as fatigue, joint pain, brain fog, and autoimmune - like symptoms. While the exact cause is unknown, many women who suspect they have BII choose to have their implants removed in hopes of alleviating these symptoms.
4. Anaplastic Large Cell Lymphoma (BIA - ALCL): This is a rare type of non - Hodgkin lymphoma that can occur in the scar tissue surrounding textured breast implants. Symptoms may include pain, swelling, or a mass in the breast. If diagnosed, the treatment usually involves removing the implant and the surrounding scar tissue.

Personal Preferences

1. Desire for a Natural Look: Some women may initially have chosen breast augmentation but later decide they prefer the look and feel of their natural breasts. They may find that the implants no longer align with their aesthetic preferences.
2. Lifestyle Changes: Changes in lifestyle, such as increased physical activity or a more conservative dress code, may make the presence of breast implants less practical or desirable. For example, women who take up high - impact sports may find that the implants cause discomfort during exercise.
3. Dissatisfaction with the Initial Result: Some patients may be unhappy with the size, shape, or position of their implants after breast augmentation. They may wish to have the implants removed to either try a different approach or return to their pre - augmentation state.

Types of Breast Implant Removal Surgeries

En Bloc Removal

1. Procedure: In en bloc removal, the entire implant, along with the surrounding capsule, is removed in one piece. This technique is often recommended for patients with capsular contracture or those who are concerned about potential silicone leakage or implant - related illness. It involves making an incision around the perimeter of the capsule and carefully dissecting it away from the surrounding tissues until it can be removed intact.
2. Benefits: This method minimizes the risk of contaminating the surrounding tissues with silicone or other implant materials during removal. It also reduces postoperative pain and discomfort by minimizing trauma to the surrounding tissues. Additionally, it ensures complete removal of all silicone gel or saline solution from inside the capsule.
3. Limitations: En bloc removal is a more complex and invasive procedure than other types of implant removal. It requires a skilled surgeon and may not be suitable for all patients, especially those with large or adhesed capsules. The incisions may be larger, and the recovery time may be longer compared to other methods.

Capsulectomy

1. Procedure: Capsulectomy involves removing only the capsule that forms around the implant while leaving the implant itself in place (in some cases, the implant may also be removed during the procedure). An incision is made around the perimeter of the capsule, and it is carefully dissected away from the surrounding tissues until it can be removed intact.
2. Benefits: It is a less invasive procedure than en bloc removal and may be associated with fewer risks and complications. It can be a suitable option for patients who want to address capsular contracture or other capsule - related issues without undergoing a more extensive surgery.
3. Limitations: This method may not be suitable for patients with severe capsular contracture or those who wish to remove their implants due to health concerns. It also does not address issues with the implant itself if the implant is the main cause of the problem.

Explantation with Mastopexy

1. Procedure: This surgical procedure involves removing the breast implant, excess skin, and lifting the breast tissue to create a more youthful appearance. It is recommended for patients who have experienced sagging or drooping of their breasts after having implants. An incision is made around the perimeter of the areola or underneath the breast fold. The implant is removed along with any surrounding scar tissue, and the remaining breast tissue is lifted before closing the incisions.
2. Benefits: It addresses both cosmetic concerns related to sagging breasts and health concerns related to implant removal. It avoids leaving behind excess skin that can lead to further sagging after surgery.
3. Limitations: It is a more invasive procedure compared to simple implant removal and may require a longer recovery time. There is also a higher risk of complications associated with the additional lifting procedure.

Explantation with Fat Transfer

1. Procedure: In this procedure, the implant is removed, and the patient's own fat from another area of their body, such as the thighs, hips, or abdomen, is used to reshape and enhance the breasts. An incision is made around the perimeter of the areola or underneath the breast fold. The surgeon removes the implant along with any surrounding scar tissue and then harvests fat from another area of the body through liposuction techniques. The fat is purified before being injected into the breast tissue.
2. Benefits: It avoids the need for additional implants or foreign materials in the body. Using the patient's own fat cells reduces the risk of rejection or allergic reactions and can provide a more natural - looking and fuller appearance.
3. Limitations: Not all of the transferred fat may survive, and multiple sessions of fat transfer may be required to achieve the desired results. The amount of fat that can be transferred is limited by the patient's body fat distribution.

Preparing for Breast Implant Removal Surgery

Consultation with a Surgeon

1. Medical History Assessment: The surgeon will review your complete medical history, including any previous surgeries, medical conditions, allergies, and medications you are currently taking. This information is crucial for determining your suitability for the surgery and for planning the appropriate anesthesia and surgical approach.
2. Breast Examination: A physical examination of your breasts will be conducted to assess the condition of the implants, the surrounding tissues, and the overall breast health. The surgeon may also use imaging studies such as ultrasound, mammogram, or MRI to get a better understanding of the implant and any associated issues.
3. Discussion of Goals and Expectations: You should have an open and honest conversation with the surgeon about your reasons for wanting the implant removal and your expectations for the outcome. The surgeon can then discuss the different surgical options available and recommend the most appropriate one based on your individual situation.
4. Review of Risks and Complications: The surgeon will explain the potential risks and complications associated with the surgery, such as bleeding, infection, scarring, changes in breast sensation, and the need for additional procedures. You should ask any questions you may have about these risks to ensure you have a clear understanding.

Lifestyle Changes

1. Smoking Cessation: Smoking can increase the risk of complications during surgery and slow down the healing process. It is recommended to stop smoking at least two weeks before the surgery. If you are having trouble quitting, talk to your doctor about options for smoking cessation.
2. Medication Adjustment: Certain medications, such as aspirin, ibuprofen, and other anti - inflammatory drugs, can increase the risk of bleeding during surgery. You may need to stop taking these medications for a period of time before the surgery as advised by your surgeon. Blood - thinning medications, such as coumadin and heparin, may also need to be adjusted or stopped, under the guidance of your prescribing physician.
3. Arranging for Post - operative Care: Since breast implant removal is an outpatient procedure, you will need someone to drive you home after the surgery. It is also advisable to arrange for someone to stay with you for at least 24 hours after the surgery to help with daily activities. Make sure you have comfortable clothing that is easy to put on and take off after the surgery.

What to Expect During the Surgery

Anesthesia

1. Types of Anesthesia: The type of anesthesia used for breast implant removal depends on various factors, including the patient's health, the complexity of the procedure, and the surgeon's preference. Options may include local anesthesia with sedation or general anesthesia.
2. Local Anesthesia with Sedation: This involves numbing only a specific area of the body while the patient remains conscious but relaxed. It is often used for less complex procedures or when removing smaller implants.
3. General Anesthesia: This puts the patient into a deep sleep so that they do not feel anything during the surgery. It is typically used for more invasive procedures, such as en bloc removal or when combined with other procedures like mastopexy.

Surgical Steps

1. Skin Preparation: Once the patient is under the effects of anesthesia, the surgical area around the breasts will be cleaned with antibacterial soap to prevent infection.
2. Incision Placement: The incisions for breast implant removal can be made in one of three locations: the crease under the breast, around the areola, or vertically in the armpit. The surgeon will typically try to use the original incision from the breast augmentation surgery to minimize scarring.
3. Implant and Capsule Removal: The surgeon will remove the breast implant from the breast capsule. In some cases, the capsule itself may also be removed, depending on the surgical technique chosen (such as en bloc removal or capsulectomy). If there is any scar tissue or silicone leakage, the surgeon will also address these issues during the procedure.
4. Closure of Incisions: After the implant and capsule are removed, the incisions will be closed using sutures. In some cases, dissolvable sutures may be used, while in others, external sutures will need to be removed after a certain period of time. Dressings will be applied to the incisions to protect them during the healing process.

Recovery Process

Immediate Post - operative Period

1. Monitoring in the Recovery Room: After the surgery, you will be taken to a recovery room where your vital signs will be closely monitored. You may experience some discomfort, and pain medication will be provided to manage the pain.
2. Time in the Recovery Room: You will typically spend about an hour in the recovery room before being allowed to return home. The medical staff will ensure that you are stable and that the anesthesia has worn off sufficiently before discharging you.

Post - operative Instructions

1. Pain Management: Your surgeon may prescribe pain medication to help manage any pain or discomfort after the surgery. It is important to take the medication as directed and not exceed the recommended dosage.
2. Compression Garment: You may be instructed to wear a compression garment around your chest area for several weeks following the procedure. This can help reduce swelling and promote healing.
3. Activity Restrictions: You should avoid strenuous activities and heavy lifting for at least two weeks after the surgery. It is important to give your body time to heal and to follow your surgeon's instructions regarding when you can resume normal activities.
4. Incision Care: Keep the incision sites clean and dry. Follow your surgeon's instructions on how to care for the incisions, including changing the dressings and applying any prescribed ointments.
5. Follow - up Appointments: It is crucial to attend all follow - up appointments with your surgeon. During these appointments, your surgeon will monitor your healing progress, check for any complications, and remove the sutures if necessary.

Expected Recovery Timeline

1. First Week: The first week after surgery is usually the most uncomfortable. You may experience pain, swelling, and bruising in the breast area. It is important to rest and take the prescribed pain medication as needed.
2. One to Two Weeks: Most patients can return to work and light activities within one to two weeks after the surgery. However, you should still avoid strenuous exercise and heavy lifting.
3. Two to Six Weeks: As the swelling and bruising gradually subside, you can start to increase your activity level. By six weeks, most patients can resume normal activities, including exercise, but it is important to listen to your body and not overdo it.
4. Final Results: It may take several months for the final results of the surgery to become apparent. The breasts will continue to heal and settle, and the scarring will gradually fade over time.

Risks and Complications

General Surgical Risks

1. Bleeding: There is a risk of bleeding during or after the surgery. In most cases, minor bleeding can be managed, but in rare cases, additional surgery may be required to control severe bleeding.
2. Infection: Infection can occur at the incision site or in the breast tissue. Symptoms of infection may include redness, swelling, pain, and fever. Prompt treatment with antibiotics is usually required to treat the infection.
3. Adverse Reaction to Anesthesia: Some patients may have an adverse reaction to the anesthesia used during the surgery. This can range from mild nausea and vomiting to more serious allergic reactions. The anesthesia team will closely monitor you during the surgery to minimize these risks.

Breast - specific Risks

1. Changes in Breast Sensation: You may experience temporary or permanent changes in breast sensation after the surgery. This can include numbness, tingling, or hypersensitivity in the breast area.
2. Scarring: All surgeries result in some degree of scarring. While surgeons take steps to minimize scarring, the appearance of the scars can vary depending on factors such as your skin type, the location of the incisions, and how well the wounds heal.
3. Asymmetry: There is a risk of breast asymmetry after implant removal. This can be due to factors such as uneven healing, differences in the amount of scar tissue removed, or pre - existing breast differences. In some cases, additional surgery may be required to correct the asymmetry.

Choosing the Right Surgeon and Hospital

Surgeon Qualifications

1. Board Certification: Look for a surgeon who is board - certified by the American Board of Plastic Surgery. This certification ensures that the surgeon has undergone rigorous training and has met the high standards set by the board in the field of plastic surgery.
2. Experience: Choose a surgeon who has extensive experience in performing breast implant removal surgeries. Ask about the number of procedures they have performed and their success rates. A surgeon with more experience is more likely to be familiar with the potential complications and how to manage them.
3. Patient Reviews: Read patient reviews and testimonials to get an idea of the surgeon's bedside manner, communication skills, and the quality of the results they have achieved. You can also ask for before - and - after photos of previous patients to see the outcomes of their surgeries.

Hospital or Surgical Facility

1. Accreditation: Ensure that the hospital or surgical facility where the surgery will be performed is accredited by a recognized organization. Accreditation indicates that the facility meets certain standards of safety and quality.
2. State - of - the - art Equipment: A facility with up - to - date equipment and technology can provide better surgical outcomes and a higher level of patient care.
3. Staff Expertise: The surgical team, including the anesthesiologist and nursing staff, should be experienced and well - trained. They should be able to provide comprehensive care before, during, and after the surgery.

Cost of Breast Implant Removal

Factors Affecting the Cost

1. Type of Surgery: The