Breast Expansion: A Complete Guide for Patients Who Want to Remove Their Implants

Breast explantation is a plastic surgery procedure that consists in the removal of previously placed breast implants. In recent years, the demand for this type of intervention has grown steadily in Spain and around the world, driven by different reasons: medical complications, changes in aesthetic preferences or personal desire to return to the natural anatomy. Knowing what breast implant removal surgery consists of, when it is indicated and what results can be expected is essential to make an informed decision. This guide offers a complete clinical perspective, elaborated by Mallorca Medical Group, to guide those who are considering this option.

What is breast implant removal and when is it indicated?

Breast implant removal, or explantation, is the surgical procedure used to remove silicone or saline implants that were placed during a previous breast augmentation. The procedure can be performed on its own or combined with other techniques such as a mastopexy (breast lift) or, in some cases, with the replacement of the implants with new ones.

The most frequent indications to request an explantation are:

• Grade III or IV capsular contracture: progressive hardening of the fibrous capsule surrounding the implant, which can cause pain, deformity, and discomfort.
• Implant rupture or deflation: either intracapsular (silicone contained within the capsule) or extracapsular (silicone leaking into the surrounding tissue).
• ASIA syndrome or implant-associated systemic illness (BII, Breast Implant Illness): a set of nonspecific symptoms that some patients attribute to the presence of implants, which remains the subject of ongoing scientific study.
• Change in aesthetic preferences: a personal decision to restore a natural appearance or reduce breast volume.
• Implant aging: although modern implants do not have an established expiration date, periodic monitoring can detect changes that may require intervention.

The individualized preoperative assessment makes it possible to determine the most appropriate option for each patient, taking into account their anatomy, the condition of the implant and their realistic expectations.

Surgical techniques for breast implant removal

There is no single way to perform explantation. The technique is tailored to each case depending on the implant’s location (subglandular or submuscular), the condition of the capsule, and the state of the surrounding tissue.

The main options are:

• Simple implant removal: when the capsule is thin and shows no significant alterations, it may be sufficient to remove the implant through the original incision.
• Partial capsulectomy: removal of part of the fibrous capsule, particularly when it shows calcification or thickening.
• Total en bloc capsulectomy: removal of the implant together with the capsule surrounding it, without opening it. This is the technique of choice in cases of severe contracture, intracapsular rupture, or suspected implant-related illness.

“The decision on which technique to apply in each explantation is made after a thorough preoperative study that includes clinical history, physical examination and, when indicated, imaging tests such as magnetic resonance imaging. The objective is to guarantee patient safety and to obtain the best possible anatomical and functional result for each case.”

Explantation with or without simultaneous mastopexy

One of the most important considerations for patients is how the breast will look after implant removal. The answer depends on several factors: the size of the implant being removed, how long it has been in place, the elasticity and quality of the skin, and each woman’s individual anatomy.

When there is breast ptosis (drooping of the breast) secondary to the prolonged presence of large implants, a mastopexy may be indicated. This technique elevates and reshapes the breast, improving its position and contour. Mastopexy can be performed simultaneously with explantation or deferred, depending on tissue conditions and surgical planning. In some cases, the combination of explantation with lipofilling (autologous fat grafting) allows to compensate part of the lost volume in a natural way.

The need for mastopexy cannot be determined without a direct medical examination. There is no universal rule: each case is different and individualized planning is essential.

Preoperative preparation and required tests

Before the procedure, the patient must undergo a complete preoperative assessment, which includes:

• General blood tests and coagulation studies.
• Electrocardiogram and cardiology assessment, if required.
• Imaging tests: breast ultrasound and/or MRI, particularly to assess the condition of silicone implants.
• A detailed medical history, including the type and model of implant, the date it was placed, and any previous procedures performed.

Patients with textured implants from certain manufacturers should communicate this during the assessment, since some models have been subject to additional monitoring by the European health authorities. The medical team of Mallorca Medical Group provides full information on the risks and alternatives applicable to each particular situation.

In the days prior to surgery, the usual surgical preparation guidelines are recommended: suspension of anticoagulants if necessary, preoperative fasting, and avoidance of smoking to promote healing. Each patient receives specific instructions adapted to his or her case.

Recovery after breast implant removal

Recovery after breast implant removal surgery is, in general, well tolerated. The first few days may involve some discomfort, a feeling of tightness in the area, and mild swelling, which are managed with prescribed pain medication.

The usual recovery process is as follows:

• First 48-72 hours: relative rest, use of a bra or compression garment as indicated by the surgeon, and adherence to prescribed pain management and wound care guidelines.
• First week: gradual return to low-intensity daily activities. Exertion involving the arms and torso should be avoided.
• Second to fourth week: gradual return to work and social activities. Restrictions on intense physical exercise remain in place.
• Fourth to sixth week: in most cases, moderate physical activity can be resumed, always with the surgeon’s approval.
• Final result: the final breast contour is progressively appreciated between 3 and 6 months later, when the swelling has completely subsided and the tissues have adapted to the new situation.

The scars, located in the mammary folds or in the areola depending on the technique used, evolve favorably with time and appropriate care.

Safety and postoperative follow-up in plastic surgery in Mallorca

Patient safety is the primary consideration in any plastic surgery procedure. Breast implant removal, performed by a plastic surgeon specialized in the field at an accredited facility, has a well-established safety profile. However, like any surgical procedure, it carries risks that should be understood before the intervention: bleeding, infection, changes in sensitivity, asymmetry, or the need for revision surgery.

The postoperative follow-up at Mallorca Medical Group is structured with scheduled check-ups that allow us to monitor the patient’s evolution, detect any incident early and guarantee an adequate result according to the realistic expectations of each case.

Dr. Garcia Ceballos FCCP, with more than 34 years of clinical practice in plastic, aesthetic and reconstructive surgery, and specialized training in hospitals of the Université Libre de Bruxelles (UZ VUB, Brussels), offers an individualized medical assessment to each patient considering breast implant removal in Mallorca. His experience in primary and revisional breast surgery provides a complete clinical approach adapted to the particularities of each case.

Mallorca Medical Group works in collaboration with Hospital Quirónsalud Palmaplanas and Hospital Quirónsalud Son Verí, guaranteeing the highest surgical safety conditions. The clinic is located in Palma de Mallorca, being a reference in aesthetic surgery in Mallorca and in plastic surgery in Spain.

Conclusion

Breast implant removal is a safe, well-planned procedure that addresses a wide range of medical, aesthetic, or personal needs. Understanding the available options, the applicable surgical techniques, and the recovery process allows patients to make this decision with complete information and expectations aligned with the clinical reality of their specific case.

An individualized indication, the appropriate surgical technique, and proper postoperative follow-up are the three pillars that determine the outcome of this procedure. If you are considering breast implant removal, the first step is a personalized medical assessment with an accredited plastic surgeon.