Miami Breast Implant Removal (Breast Explant) Specialist Dr. Nathan
Breast implant removal surgery (aka breast explant surgery) is a plastic surgery procedure that Dr. Nirmal Nathan performs for women who want to remove their breast implants. There are numerous reasons that women choose to remove their implants, some reasons are aesthetic, while others occur due to a complication. Dr. Nathan is a highly experienced, board-certified plastic surgeon who regularly performs a variety of plastic surgery procedures, including breast implant removals.
Surgical Options for Breast Implant Removal Surgery in Miami
A woman may choose to have Dr. Nirmal Nathan remove and then replace her breast implants, or remove her implants without replacing them. Dr. Nathan may recommend that a woman who chooses not to replace her breast implants have a breast lift (aka a mastopexy). During a breast lift, Dr. Nirmal Nathan removes excess skin and moves the patient’s breasts to a more youthful position on her chest.
Why Would Dr. Nirmal Nathan Recommend a Mastopexy?
After having breast implants for a substantial amount of time, or having relatively large implants, the breasts’ tissue and skin stretches. With age, skin and tissue elasticity, which is the ability to stretch and then bounce back to its original state, declines. Therefore, upon removal of the breast implants, the skin may not contract.
Reasons a Woman May Choose to Have Breast Implant Removal Surgery in Miami
The patient had her breast augmentation more than 10 years ago:
Although many people believe that once they have breast implants placed, the implants will last a lifetime, this is not necessarily the case. According to the American Society of Plastic Surgeons (ASPS), the breast implants that surgeons use today typically last about a decade. However, after 10 years have passed, the likelihood of the implant rupturing, or some other complication arising, increases by one percent, annually.
Breast implants offer longevity, but do not necessarily last a lifetime:
Breast implants do offer longevity, but, on average, saline and silicone breast implants usually have a lifespan of about 10 to 15 years. Form-Stable breast implants (i.e., gummy bear breast implants) last a little longer, with a lifespan of about 20 years. Nonetheless, most implant manufacturers’ offer a 10-year warranty on their products. Needless to say, the specifics of each manufacturer’s warranty vary.
What Affects an Implant’s Longevity?
The lifespan of an individual’s breast implants can be affected by the way the patient cares for them (e.g., biannual MRIs, wearing support garments during recovery). The way a patient’s immune system reacts to her breast implants also affect their longevity.
A Woman May Have Breast Implant Removal Surgery in Miami for Aesthetic Reasons
She may just want to make a change:
There are times when a woman grows tired of her current breast implants and decides to have Dr. Nathan remove and then replace them. The patient may want one of the newer, more advanced breast implants.
She may want to exchange her implants for a set that consists of a different material.
A woman may want to go larger:
A woman may decide that she would like her breasts to be larger.
She may want smaller breast implants:
When a woman has large breast implants, later in life she may want her breasts to be smaller.
A patient may not like the way the implants look and feel:
A woman may eventually decide that she is no longer happy with how her current implants make her breasts look or feel.
A Woman May Have Breast Implant Removal Surgery in Miami to Resolve an Issue with Her Implant or Its Capsule
Potential Breast Implant Issues
Some complications are more likely to occur based on the type of implant a patient has. For example, a saline breast implant has a higher incidence of rippling than a silicone implant does.
A saline breast implant may begin to leak:
When a saline breast implant develops a hole or a tear, it begins to leak. These implants deflate quickly, which causes the patient’s breast to shrink. The saline solution in the implant’s shell is just salt water; therefore, it is harmless. The body just absorbs it; however, the patient needs to contact Dr. Nathan, so he can resolve the issue with breast implant removal and replacement surgery in Miami.
The implant may become displaced:
Displacement can affect one or both breast implants. Implant shifting can result due to the patient choosing an implant that is too large and the surgeon being unaware of this risk or neglecting to discuss this possibility with the patient.
Other issues include the incorrect placement of the breast implant during surgery, as well as problems associated with the skin on the patient’s breast and the effects of gravity.
This shifting can occur even when the implant is within its pocket.
A rippling implant:
There may be a ripple in the breast implant. Sometimes, these ripples are visible and can be felt beneath the skin. This complication is seen more frequently with saline breast implants.
A visible, palpable breast implant:
If a surgeon places a breast implant above the pectoral muscle, and the patient does not have an adequate amount of breast tissue available to cover it, the implant becomes visible and palpable. When this issue arises, the implants need to be relocated. The surgeon moves them from above the pectoral muscle, to beneath it. Patients can help prevent this type of complication by choosing an experienced, board-certified plastic surgeon to perform their breast augmentation procedure.
Changing the location of an implant:
During implant insertion, the surgeon can place the breast implant submuscularly (i.e., beneath the pectoral muscle) or subglandularly (i.e., above the pectoral muscle, but beneath the breast tissue). Sometimes, an implant issue only requires a change in its placement. For example, a visible, palpable implant that is placed subglandularly may be relocated to a pocket beneath the pectoral muscle.
A silicone breast implant may rupture:
Due to the thickness of the silicone gel that is encased within the shell of the implant, even if the shell becomes compromised in some way (e.g., developing a tear or a hole) the silicone remains within the implant’s pocket.
Symmastia (aka Uniboob)
This complication occurs when the muscle and skin between the implants, which is located just above the sternum, detaches, causing the implants’ pockets to come together, essentially forming a single pocket.
To resolve this problem, Dr. Nathan needs to remove the breast implants and their capsules, contour the breast tissue and create new pockets for the replacement implants.
The patient may experience a complication related to the implant’s capsule.
What Causes Capsular Contracture to Develop?
Since the body considers a medical implant a foreign object, it needs to isolate it. To accomplish this, the body’s immune system creates a barrier of scar tissue around it.
Scar tissue development around the breast implant is normal. This scar tissue creates the implant’s capsule, which helps keep the breast implant from shifting. However, there are times when a patient’s immune system overreacts, creating too much scar tissue around the breast implant.
As the scar tissue accumulates, it thickens. The thickened scar tissue begins squeezing the implant. This tightening around the implant causes the patient’s breast to look misshapen, become firm and move higher up on her chest. When a case is extreme, the patient experiences breast pain as well.
There are four grades of capsular contracture:
At this point, the scar tissue is accumulating around the implant, but it is not affecting the size, shape or firmness of the breast. Most women with grade one capsular contracture are unaware there is a problem.
Although minor aesthetic issues are present, the shape of the breasts remains the same. Nonetheless, the breast may feel slightly firmer.
It is obvious that breast changes are occurring. At this stage, the breast begins to look and feel different. The breast is now noticeably firmer to the touch, it appears exaggeratedly rounded, and the nipples may look distorted. At this point, most women do not experience very much pain, if any.
The breasts remain hard, misshapen and once the patient’s capsular contracture progresses to stage four, the breasts are usually tender and the patient experiences pain when they are touched.
A buildup of calcium deposits around the breast implant. These deposits feel like hard lumps beneath the skin.
A Medical Complication
Infection, which may occur because a surgeon introduces bacteria into the breast during implant insertion.
Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)
BIA-ALCL is a highly treatable cancer that tends to develop near breast implants. Although the development of this cancer is uncommon, many believe that this disease typically develops in women who receive textured implants, because of bacterial contamination that is introduced during surgery, due to the age of an implant or because the patient has a genetic predisposition for BIA-ALCL.
Breast Implant Associated Anaplastic Large Cell Lymphoma seems to occur more frequently in those who choose to have their plastic surgery while they were overseas. Nonetheless, the likelihood of a woman developing this cancer is minimal. For this reason, unless a patient is symptomatic (e.g., experiencing inflammation, a lump near the armpit, itchiness, rashes warmth or discomfort), most surgeons prefer that a patient’s implants remain in place.
Breast Implant Removal Surgery in Miami, with a Replacement: The Procedures
Dr. Nathan performs each of his breast implant removal surgeries in Miami as outpatient procedures.
The implant removal process is very similar for all breast explant procedures.
Breast implant removal takes from one to three hours. Patients who are having additional procedures (e.g., a breast lift) should expect to remain in surgery longer.
After the patient arrives for surgery:
- A member of Dr. Nathan’s medical staff takes the patient to the surgery preparation area. While there, the nurse takes the patient’s vitals (e.g., blood pressure, oxygen level).
- Dr. Nirmal Nathan visits the patient while she is in pre-op. He may make several markings on her breasts with a medical marker. These markings serve as a guide for Dr. Nathan during surgery.
- Dr. Nirmal Nathan discusses the patient’s unique surgical plan with her again. This ensures that he and the patient are on the same page. Patients who have questions for Dr. Nathan should ask them at this time.
The patient receives medication to help her fall asleep (e.g., IV sedation or general anesthesia). Dr. Nirmal Nathan determines which medication is best for each of his patients. He discusses his anesthesia recommendation with the patient prior to her surgery.
IV Sedation or General Anesthesia: What is the Difference?
IV sedation (aka twilight sedation) places the patient in a relatively light state of sleep. Although the patient is only in a light sleep state, she will not remember her surgery. The benefit of IV sedation is that the patient is easy to arouse after surgery, and the side effects frequently associated with general anesthesia are not an issue (e.g., nausea).
General anesthesia places the patient into a deep sleep. While this type of anesthesia is necessary for some procedures, it does have side effects (e.g., continuing to feel tired after surgery). Patients receiving general anesthesia who know they experience nausea after surgery should inform Dr. Nathan or the nurse. Dr. Nirmal Nathan may have a medication available to help prevent this side effect.
Creating the Incision
After preparing the patient for surgery, and she is comfortably asleep, Dr. Nathan creates an incision. This incision may extend around the entire border, or along the lower border of the nipple-areolar complex. Another incision option is within the inframammary fold, which is located at the base of the breast. Whenever possible, Dr. Nirmal Nathan creates the patient’s implant removal incision within the scar resulting from her breast implant placement surgery.
Removing the Original Implant and Addressing Excessive Scar Tissue
Dr. Nathan carefully removes the current implant. If there is excessive scar tissue present, he removes that part of the implant’s capsule.
The next step Dr. Nirmal Nathan takes depends on the reason for the breast implant removal or breast implant removal and replacement surgery.
If the patient:
- Desires a larger implant, Dr. Nirmal Nathan may need to increase the size of each implant’s capsule before placing the patient’s new breast implant inside.
- Wants a smaller implant, Dr. Nathan may need to reduce the size of each implant’s capsule before he places her smaller breast implant inside.
- Has a leaking or ruptured saline implant. This complication requires implant replacement or complete removal of the implants. Patients requesting complete removal may need to have a breast lift to address sagging tissue and skin.
- Is experiencing capsular contracture, has uneven breasts, excessive sagging or has developed symmastia (aka Uniboob), Dr. Nathan may need to remove the breast capsule, reshape the breast tissue and then reconstruct the pockets for the patient’s new breast implants.
- Has a ruptured silicone breast implant. When this issue arises, Dr. Nirmal Nathan removes the ruptured implant, as well as any residual gel within the capsule. The patient may decide to replace the ruptured implant with one that is comparable. By choosing this option, if the patient’s other implant is healthy, she may be able to avoid replacing it.
She may also choose to remove both of her implants without replacing them, or replace both implants with new implants that have the characteristics she desires (e.g., larger, smaller, silicone, saline, a newer model). If she chooses to remove both implants, but does not replace them, the patient may need to have a breast lift to address sagging breast tissue and loose skin.
Addressing a Rippling, Visible or Palpable Breast Implant During Breast Implant Removal Surgery
Depending on the unique characteristics of the patient, there are several options available for addressing a rippling, visible or palpable breast implant.
When a patient has a subglandularly placed breast implant that is visible or palpable. Dr. Nathan may create a pocket for the implant beneath the pectoralis muscle and then move the implant there. To ensure symmetry, both implants need to be moved beneath the muscle.
If the size of the patient’s implant is causing the problem, Dr. Nirmal Nathan can exchange both of the patient’s current implants for those of a smaller size.
When a surgeon overfills or under fills a saline breast implant, it may ripple. If this is the case, Dr. Nirmal Nathan may only need to add or remove saline from the implant. He can perform this procedure in-office, however, having this in-office procedure could void the manufacturer’s warranty.
If a saline breast implant is rippling, Dr. Nathan may recommend that the patient replace her saline breast implants with one of the silicone options available. Silicone implants are much less likely to ripple than their saline counterparts.
Using sutures, skin adhesives or clips, Dr. Nathan closes the incisions.
A Combination Procedure: Breast Lift with Breast Implant Removal in Miami
Once Dr. Nathan removes the patient’s breast implants and their capsules, he may need to perform a breast lift. Dr. Nirmal Nathan uses the same incision sites, therefore, as long as he performs these procedures during the same surgical session, there is no need for him to create additional incisions.
During the breast lift, Dr. Nathan reshapes the breast tissue, removes excess skin and tightens the tissue and skin that remains.
After a mastopexy, the patient’s breasts appear perkier and, due to their new location, more youthful.
What Patients Can Expect While Recovering from Their Breast Implant Removal Surgery
Although the healing process spans several months, patients state that there is very little discomfort. Even so, patients must discontinue participating in physical activities and heavy lifting for about eight weeks.
Breast Implant Removal with Implant Replacement Recovery
Patients who receive drains may have them in place for up to 10 days. These drains help excess fluid drain, thus reducing swelling. In addition, compression garments may be present after surgery. Patients will wear these compression garments for some time. By placing pressure on the surgical areas, the patient experiences less inflammation.
To help prevent the development of an infection, surgical wounds must be kept clean. Patients should follow the directions for cleaning their incisions that they receive from Dr. Nathan or his nurse before leaving recovery.
Full recovery takes about eight weeks.
Scars resulting from implant removal surgery fade with time.
A General Recovery Timeline
Since each patient is unique, she needs to follow the personalized recovery information she receives from Dr. Nirmal Nathan. Nonetheless, a general outline can be helpful when preparing for a breast implant removal surgery.
Inflammation, discomfort and pain are possible. Patients need to rest and refrain from all forms of exercise.
Inflammation and pain decreases, patients should still avoid exercising and lifting objects weighing more than 20 pounds.
Patients who have a low intensity job that does not require them to perform strenuous activities may return to work.
Weeks Two and Three
As long as patients remember to take things slow, they can begin performing daily tasks again. It is important that patients avoid placing pressure on their incisions.
Weeks Four and Five
At this point, most patients can change their compression garment out for a soft sports bra.
Light exercises may be acceptable at this time. For safety’s sake, patients need to ask Dr. Nathan for his permission before starting to exercise again.
Most patients can perform nearly every daily activity, including their typical exercise routine. Again, each patient is unique and should okay any exercise routines or strenuous activities with Dr. Nathan.
Although, barring no complications, the patient’s breasts completely heal within this timeframe, full results do not become evident for about a year.
A Consultation at The Nathan Clinic for Breast Implant Removal
Women in the Miami area who are considering breast implant removal surgery, with or without implant replacement, should make an appointment with Dr. Nathan. During this consultation, patients provide information about their medical history, including medications, previous surgical procedures and chronic health issues (e.g., cardiac disease).
Dr. Nathan wants to know what the patient would like to accomplish with breast implant removal surgery. Patients need to be candid, letting him know whether implant replacement is something that she desires.
Dr. Nirmal Nathan will examine the patient’s breasts. It is likely that he will take measurements and photographs of the patient’s breasts. Each of these provides Dr. Nathan with valuable information as he creates the patient’s custom-designed surgical plan for her breast implant removal procedure.
Preparing for Breast Implant Removal with Dr. Nathan in Miami
Patients receive anesthesia; therefore, they need to bring a driver with them on the day of their surgery. For-hire transportation is not available to patients following any procedure that requires the use of sedation or anesthesia. Dr. Nathan follows this policy to ensure that his patients are not taken advantage of while they are in a vulnerable position. As such, patients who do not arrive with a driver will need to reschedule their procedure.
If a patient smokes or uses other products that contain nicotine, she needs to discontinue smoking or using these items for at least four weeks before and after her surgery. Nicotine inhibits the body’s ability to heal itself, therefore, patients who continue to use these products or smoke place themselves at a higher risk of open wounds, infection and even skin necrosis.
For their own safety during surgery, patients who participate in recreational drug use need to let Dr. Nathan know ahead of time. This helps him determine if the medications she receives during and after her surgery need to be adjusted.
Any medication (e.g., NSAIDs, aspirin, Coumadin), vitamin (e.g., vitamins E and D) or herb (e.g., Kava Kava, Ginkgo Biloba) that thins the blood must be discontinued for at least 10 days before and 10 days after surgery. Patients taking prescription medications must speak with their prescribing physician before decreasing the dose or discontinuing the medication.
If a patient drinks alcoholic beverages, since alcohol tends to increase inflammation, the patient needs to avoid consuming these for at least two days before and after her breast implant removal surgery.
Patients require assistance around the house for several days following their surgery. Dr. Nathan recommends that patients ask someone that they trust and feel completely comfortable with to serve as their caregiver.
Dr. Nirmal Nathan may request that the patient have presurgical testing or receive a medical release from her physician. These patients must complete all their testing and have their release no later than a week before their surgery. If any of this information is missing on the day of surgery, chances are, the patient will need to reschedule.
Potential Risks and Complications of Breast Implant Removal Surgery
As with every procedure, patients need to consider their risks when making the decision to move forward with breast implant removal surgery in Miami. Although complications are rare, they can occur. However, one of the best ways a patient can reduce her likelihood of experiencing a complication is choosing an experienced, board-certified plastic surgeon to perform her procedure.
Potential complications and risks include:
- Excess bleeding.
- Visible scarring.
- An undesirable result.
- Uneven breasts.
- Inadequate drainage of fluid.
- Persistent inflammation.
- Skin loss.
- Skin discoloration.
How Much Does Breast Explant Surgery Cost?
The cost of a patient’s breast implant removal procedure depends on her specific needs. Women who want to learn more about breast implant removal can schedule an initial consultation with Dr. Nathan Nirmal at The Nathan Clinic in Miami.
Health Insurance May Cover Breast Implant Removal Surgery
Although insurance does not cover cosmetic surgery procedures, if a woman is having her breast implants removed due to a complication, her procedure may be covered. Dr. Nirmal Nathan recommends that his patients contact their health insurance company in advance to find out if there is a chance that insurance will cover a portion of their breast implant removal surgery in Miami. During this communication, if the insurance may cover the procedure, patients need to ask the representative what information the insurance needs to consider coverage(e.g., a letter of medical necessity).
Women in and around the Miami area who are considering breast implant removal surgery should schedule an initial consultation with an experienced, board-certified plastic surgeon like Dr. Nirmal Nathan. With nearly 15 years of experience, Dr. Nathan has the skills and artistic vision necessary to provide his patients with the beautifully contoured, youthful-looking breasts they desire. To make an appointment, please call 305-530-8880.
Dr. Nathan dedicates himself to providing each patient with the highest quality of care available in and around South Florida. To ensure he could provide this care, he founded The Nathan Clinic Plastic Surgery and Aesthetics in Miami. Dr. Nathan’s clinic is located at 4770 Biscayne Boulevard, Suite 830.