Breast Reconstruction after Implant Removal

Reconstruction after explant

After removal of long-standing breast implants, many patients are left with sagging skin and very little breast tissue. While some patients may wish to have smooth implants replaced in the breast pocket, others may want to enhance the breast shape with their own natural tissues. This may involve a combination of fat grafting and/or breast lift.

There has been a significant rise in breast implant removal (“explant”) recently that is mostly due to concerns involving breast implant associated anaplastic large cell lymphoma (BIA-ALCL) and breast implant illness (BII).

What is BIA-ALCL?

BIA-ALCL is a very rare lymphoma associated with textured implants that presents with breast swelling and a fluid collection around the implant. Left untreated, this disease can be fatal, but most cases of BIA-ALCL can be completely cured by removal of the implant and surrounding capsule. The implant type responsible for most of the reported cases was recently removed from the market. The FDA is not currently recommending implant removal in the absence of symptoms. However, some patients feel more comfortable undergoing explant regardless of symptoms.

What is BII?

The truth is, we know very little about BII, but it is presumed to be an autoimmune disorder that affects a certain subset of women after placement of silicone breast implants. There is a wide range of associated symptoms that patients have reported, including fatigue, chronic pain, headaches, brain fog, depression, and skin/hair changes. Anecdotally, the majority of women who undergo explant subsequently experience some relief in symptoms.