When it’s time to have your breast implants removed, you need to know your options. As a board-certified plastic surgeon and breast implant removal expert, Dr. Katerina Gallus is passionate about educating her patients on the facts. Below, she answers questions unique to breast implant removal that patients ask.
Does Dr. Gallus perform en bloc or total capsulectomy?
Yes, Dr. Gallus performs en bloc and total capsulectomy to remove saline or silicone implants. She has performed hundreds of breast implant removals using various techniques.
The phrase “en bloc” comes from a cancer surgery technique that involves removing a tumor within surrounding healthy tissues to avoid allowing the cancer to spread; for breast implant removal, it has become shorthand for removing the entire capsule and implant intact. But with patient safety as Dr. Gallus’ first priority, it’s important to understand that there are instances in which the safest thing to do is to perform a total capsulectomy, which removes the implant and capsule separately; doing the procedure in two steps poses less risk to surrounding tissues. Additionally, total capsulectomy allows for somewhat shorter incisions.
Speaking with a board-certified plastic surgeon is a critical first step to a safe explant surgery. Dr. Gallus has been practicing plastic surgery since 2006 and is an expert in all forms of capsulectomy and breast implant removal. She has been certified by the American Board of Plastic Surgery since 2007, maintains leadership roles in the American Society of Plastic Surgeons, and is a Visiting Professor to plastic surgery programs across the nation. Learn more about Dr. Gallus’ credentials and experience here »
“I recently had severe BII, and I needed surgery quicker than usual due to declining health. Restore SD Plastic Surgery with Dr Gallus was one of my best decisions! After going to several doctors in the area, her office was professional, warm, and welcoming; she answered ALL my questions and made me feel good about the procedure under such delicate circumstances. She was able to get me on the books at a reasonable time; my surgery was a success, the recovery excellent, and all the follow-ups after! I cannot thank Dr Gallus and her staff enough for my new chapter in life, and I feel so much better after the surgery!”
—Google Review for Dr. Gallus
How should I prepare for breast implant removal?
You should see your primary care provider and obtain a medical clearance for surgery along with any lab testing and imaging studies, as needed: if you over age 40 or have a strong family history of breast cancer, preoperative imaging studies will be required—at least a current mammogram, and possibly an ultrasound or MRI, if Dr. Gallus says these are indicated.
You will also need to stop certain substances and supplements. If you smoke or vape, or use nicotine in any form, you will need to stop—this is a great opportunity to quit for good. It is also important to avoid taking aspirin, antiinflammatory drugs, and herbal supplements in the two weeks prior to surgery.
Of course, Dr. Gallus will also go over the surgery’s risks, benefits, incision plan, recovery process, and expected outcomes with you beforehand, which is an important part of preparing for surgery.
How long will my breast implant removal surgery take?
On average, breast implant removal with en bloc capsulectomy takes 4 hours in our operating room. The complexity of surgery and the addition of cosmetic procedures like breast lift (mastopexy) or fat transfer will add to the overall surgical time.
Where will my surgery take place?
Breast explant is performed in our on-site Quad-A accredited surgery center, Restore SD Plastic Surgery Center, located within our practice at 8899 University Center Ln #200, San Diego, CA 92122. Dr. Gallus works with an experienced, board-certified anesthesiologist and carefully vetted surgical team.
What are the steps in breast implant removal surgery?
- An incision is made at the base of your breast, around the bottom of the areola, or through a pre-existing breast lift surgery scar.
- Dr. Gallus identifies the capsule and, if you are having en bloc capsulectomy, takes great care to completely dissect around the capsule, leaving the capsule and implant intact.
- The capsule and implant are then removed, and the pocket is washed out with betadine and antibiotic solution.
- Drains may be placed and Dr. Gallus will close the incision, or proceed with a breast lift or fat transfer if planned.
- You will be placed in a postoperative bra with absorbent padding (this will be removed at your first postoperative visit).
Is my capsule or implant sent for lab evaluation or to pathology?
Yes, pathology examination is available at an additional cost, although some insurance policies will cover pathology and laboratory exams.
Prior to committing to a course of action, it is important to review your individual insurance policy benefits to determine exactly what is covered. Then, during your consultation, Dr. Gallus will review specific tests with you and help guide you to the best choice.
Will Dr. Gallus return my implants and capsule tissue to me?
We can clean and return your breast implants to you at one of your early postoperative visits, but the capsule tissue is considered biohazardous waste and federal regulations prevent us from giving this tissue to patients. If you request it, we will provide you with photos of your capsule tissue.
Will breast implant removal with en bloc or total capsulectomy cure my breast implant illness?
The emerging data show that women who identify themselves with breast implant illness (BII) and are not diagnosed with any blood, neuromuscular, endocrine, or rheumatoid disorders frequently improve after explant and may notice a reduction or resolution of their symptoms with either en bloc or total capsulectomy. Women who have a definitive diagnosis of something else may experience relief after explant, but have been shown to have a higher chance of recurrent symptoms 6 months after implant removal.
Because BII represents such a wide constellation of symptoms, there is no single diagnostic test to establish the illness—or its cure. For these reasons, Dr. Gallus cannot guarantee individual results or symptom resolution after breast implant removal. Learn more about current research into breast implant illness »
What should I expect after my breast implant removal?
Your breasts will feel sore after explant surgery, and you will have pain medication. The day immediately following surgery, you will have a postoperative visit and you may shower (but do not soak in a bath, hot tub, or pool for 2 weeks). Your next post operative appointment is at 1 week; if you had a drain placed, it will be removed at that time.
Your incisions will be healed by 4 weeks, but the scars will take up to 12 months to fully mature. Your surgical package includes three scar laser treatments with our CO2 fractionated laser. In addition to your scar laser treatment, we provide you with BioCorneum, a scar gel that is only available in physician offices.
After breast implant removal, you will notice a difference in the shape and profile of your breast; if you were experiencing capsular contracture, the tight, hardened appearance will be gone. The breast shape and any skin changes can take several months to become final as swelling subsides.
When can I return to work after breast implant removal with capsulectomy?
Most women can return to work about 2-3 weeks post-op. That said, returning to work after breast implant removal will depend not only on the complexity and nature of your individual surgical procedures, but also what your job entails. For women that have very active or physically demanding jobs, you may need to take 4 weeks or longer off to allow tissues to heal properly. (Returning to light exercise is generally possible in the 4-6-week range while getting back to more vigorous physical activity may require 8 weeks or longer.)
Don’t forget that having little ones around the house is also a full-time job; getting assistance with childcare the first few weeks after surgery is very important if you have young children.
To ensure a safe healing process, Dr. Gallus will be seeing you frequently the first month after surgery and will provide specific, personal guidance on when you can safely return to any given activity.
What will my breasts look like after breast implant removal?
The postoperative appearance of your breasts will depend on the size of the implant removed, the amount of breast tissue, and the quality of the breast skin. Breasts may sag at first, but it is really important to be patient after surgery and know that you will not see your final results for up to one year after surgery. You can expect to see swelling in the first 3 months after surgery, and for the skin and tissue to retract and smooth out over the next few months.
My implants are out but I am worried about how my breasts look now. What are my options?
Fat transfer to increase breast size and breast lift to refine their shape and tighten excess skin are options to improve breasts’ appearance after removal without implants, but we recommend waiting 12 months after explant for secondary surgery. Dr. Gallus is happy to discuss your options with you beforehand, however.
Will insurance pay for my breast implant removal and en bloc capsulectomy?
In the majority of cases, explant is considered a non-covered benefit because, for most women, their original breast implant surgery was cosmetic surgery. By extension, insurance companies consider any subsequent complications or health concerns related to your breast implants to be related to the original cosmetic surgery and not covered.
We do not perform insurance-based surgery, and in our experience, BII symptoms are not covered. If you have an insurance plan, we can provide you with the appropriate codes and you will need to submit the claim through your insurance company for potential reimbursement.
What if I want my implants removed but am concerned about the cost?
Using a plastic surgery financing service, you may be able to afford your explant procedure with payments as little as $255 per month. At our San Diego Plastic Surgery practice, we offer a variety of financing options including Care Credit and Alphaeon.
I would like to have Dr. Gallus perform my breast implant removal. What’s next?
The first step is to schedule a consultation. At your appointment, female San Diego plastic surgeon Dr. Katerina Gallus will review your medical history, perform an exam, take photos with the 3D Canfield Vectra system, and develop a treatment plan. You will also meet with our patient coordinator, who will provide you with scheduling and financing information. Once you are ready to schedule surgery, our patient coordinator will work with you to find the earliest date that works for you.
At Restore SD Plastic Surgery, Dr. Gallus and her team highly value patient relationships and are committed to being there for you from start to finish. Call 858-224-2281 or contact us online to schedule your appointment today.
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