Removal of breast prosthesis with or without capsule (Explant)
After breast implant placement, some women may experience asymmetry due to incorrect placement of the implant, or the formation of a hard membrane around the implant, known as capsular contracture. Capsular contracture is not dangerous, but the breasts may become hard, tender, and painful.
If you are removing breast implants after capsular contracture has formed, the surgeon will want to remove both the implants and the surrounding scar tissue. Other reasons for removing implants may be that the patient feels that “the implants have done their job, or I am done with them.” Other increasing reasons for removing implants are ALCL (a rare type of non-Hodgkin lymphoma) and breast implant illness – so-called BII; breast implant illness, with symptoms such as headaches, muscle and joint pain and autoimmune diseases.
In this case, the prosthesis can be removed with or without the entire capsule (depending on the thickness of the capsule), and at the same time replace it with fat from your own body. This is advantageously done at the same time, as the skin is already expanded. But it can also be done secondarily after the removal of the implant. The result is better if this is done at the same time.
We use the PAL Micro Air vibration machine which evens out the pressure and the donor site of fat. At the same time, we correct unwanted fat accumulation in certain body parts and leave very small scars of 1-2mm.
See our article about this treatment: Excerpt from our KK interview
The degree of capsular contracture varies from 1 to 4, and the most severe form (3 and 4) occurs in 5-8% of women who have implants. The reason for this has to do with how the body reacts to silicone as a foreign body. This can also be both cosmetically and physically troublesome, such as tenderness and pain. Capsular contracture is not dangerous, but the breasts can become hard, tender and in some cases painful. If the breast implants are to be removed due to severe capsular contracture,
The surgeon may remove both the implants and the scar tissue (capsule) around the prosthesis. Some people may experience silicone leakage in the form of nodules or reduced volume, which can be examined with ultrasound or MRI.
See link ( Breast implant conversion and ALCL/Bll )
Some people want to fill their breasts with their own fat – read our separate article about breast augmentation with fat grafting. ( Breast augmentation with own fat and Breast implant conversion )
The procedure itself under deep sedation takes about 1-1 ½ hours, depending on the type/degree of the capsule that has formed. It is considered whether to remove the entire capsule or only parts of the capsule - which is easier. The incision is usually made where the old scar is, this is to avoid creating new scars.
After removing the old prosthesis, the same cavity will be used for the new prosthesis, possibly also filled with the patient's own fat. In some cases where only the prosthesis is removed or replaced with a new one, it may be sufficient to only split the capsule from the inside, thus creating more space for the new prosthesis. During surgery, thorough homeostasis is performed to stop bleeding, as capsule removal can cause minor bleeding.) Replacement of the prosthesis can easily be combined with fat transplantation with fat or breast lift.
Pick-up and accommodation
You must arrange in advance with someone to pick you up from the clinic approximately 1 hour after the surgery, as you cannot drive, take public transport or taxis alone. You must also have someone with you on the same day and the first night.
If you live far from the clinic, we recommend that you stay overnight in Oslo, either with family/friends or in a hotel.
Hotels near Oslo Plastic Surgery;
Hotel Gabels Hus in Gabelsgate 16.
Frogner House Apartments, Bygdøy Allé 53.
(We have an agreement with Frogner House Apartments. Please inform us when booking a room)
Before the operation
You must be healthy on the day of the operation. If you are in doubt whether you have a cold or similar, you must contact us. The operation is not performed when you have the flu with fever, cough or other infection in the body. Before the operation you will receive a prescription for antibiotics, possibly painkillers and Hibiscrub solution 40 mg/ml which you can buy at the pharmacy.
The day before surgery and on the day of surgery, you should wash your entire body with Hibiscrub solution in the shower. This is a disinfectant soap that should be rinsed off with water, and the skin should be dried with a clean towel. Put on clean clothes when you leave home. Do not use perfume or cream. All jewelry, piercings and nail polish/false nails must be removed at the latest the day before surgery and may be put back on 7 to 10 days after surgery.
To get the best possible result and to avoid complications, it is recommended that you have a normal weight, and not an excessively high BMI. If you smoke, or use nicotine such as snus or electronic cigarettes, you must quit at least 2 weeks before the surgery and 2 weeks after the surgery.
You should arrive at the surgery fasting. This means that you should not eat food including fruit or drink juice with pulp or dairy products 6 hours before the surgery. You can drink water, juice, juice without pulp or coffee/tea without dairy products or chew gum / drops / throat lozenges up to 4 hours before the surgery. Medications that you may need to take on the day of surgery can be swallowed with 1 glass of water max. 100 ml up to 1 hour before the start of anesthesia.
It is important that you stop taking blood-thinning medications about 14 days before the operation, preferably after consulting your GP or us. For other medications, consult the clinic before the operation. A lot of garlic and health food preparations should also not be consumed.
You must arrange in advance with someone to pick you up from the clinic approximately 1 hour after the surgery, as you cannot drive, take public transport or a taxi alone.
If you are going to have breast implants inserted, are over 40 years old and it has been a long time since you have had your breasts examined, it may be appropriate to have a mammogram before the surgery.
On the day of surgery
You will be received by our staff who will prepare you for the operation before the surgeon sees you.
Before the actual procedure, the surgeon will go over the procedure, draw up the plan, and answer any questions you may have. Anesthesiologists will also come to greet you and answer your questions. When the surgery is about to begin, the operating room nurse will pick you up and clean the surgical area while the anesthesiologists give you a sedative in your arm so that
you sleep during surgery. In addition, the surgeon puts local anesthesia in the surgical area for a long-lasting pain relief effect in the surgical area after the surgery, which in addition
reduces bleeding in the area. After the operation, you will be moved to the recovery room where you will have your own bed.
You will then rest for 1-2 hours and will be served food and plenty of drinks in the form of bread, yogurt and juice (remember to inform about allergies). Painkillers may be given if necessary. The surgeon will see you before your return home/hotel stay and you will be assessed by anesthesiologists before you travel home with an adult companion. The PVK attached to your hand will be removed before you leave. You must use a car or taxi as a means of transport immediately after surgery; we do not recommend public transport or walking.
After the operation
All patients will come for a post-operative check-up the day after surgery. We recommend that you do not travel by air for the first 48 hours after surgery. During this time, a check-up appointment will be arranged at the clinic and you will come for a check-up at the clinic the day after surgery.
The first few hours after the operation you may feel a little tired, and sometimes a little nauseous. It is important that you take painkillers as prescribed and when needed, and make sure to drink plenty of fluids during the first 24 hours. Some people may feel a little dizzy, so it is a good idea to take a few minutes when you get up. For the first two days you should rest and lie as still as possible, with your upper body elevated. For the next five days you can move carefully. If you have an active job, it is a good idea to stay home. After the operation you will be given a special bandage that will be removed after 3 days, the tape will be left on for 2 weeks.
You should wear a sports bra for 6 weeks after the bandage is removed. After the tape is removed (after 2 weeks), you can shower the area and reapply tape. It is recommended that you tape the scars with skin-friendly tape for at least 2 months. Surgical tape such as Micropore or Steri-Strip can be purchased at the pharmacy, or silicone tape.
We close the wound with stitches that dissolve on their own. A drain is often placed in the pocket to remove blood and fluid from the wound area under the breast, which is usually removed 1-2 days after
operation.
The final result can only be assessed after 3-6 months. Follow-up checks are arranged with the clinic; the day after surgery, after 1-2 weeks and 3-6 months, as well as a final check-up after a year. You must call to arrange the check-ups yourself, or make an appointment with the clinic on the day of surgery.
Bleeding and infection are uncommon and in very rare cases require reoperation and/or antibiotic treatment. Complications of anesthesia, such as allergic reaction to
anesthetics, are extremely rare.
Breast augmentation does not in principle provide grounds for sick leave, but if you have a physical job, we recommend that you take this into account in the first few days after surgery.
Physical exercise and hard physical work should be avoided for about 4 weeks.
The scars are often red, itchy and hard at first, but over time they will fade and soften. The scars are, however, hidden by a bra and will not be visible in low-cut dresses. In rare cases, the scars can become wide and clearly visible, this depends on the woman's own inherited skin characteristics. We therefore recommend that you tape the scars for a couple of months after a breast augmentation. Plaster tape is available at pharmacies.
If correction is necessary due to complications or unsatisfactory results, this will be done free of charge within one year, provided there is a medical indication and a clear improvement potential. This is our guarantee period.
Ask for guidance and advice
The best advice we can give face to face. We will guide you to the best solution for you.
The responsible physician is Dr. Amin Kalaaji , MD, specialist in plastic surgery and clinic manager at Oslo Plastic Surgery, and head of the Norwegian Society for Aesthetic Plastic Surgery (NFEP) 2018-2020.
Dr. Kalaaji holds many positions and gives lectures and trainings around the world. This benefits all our patients as he is always up to date on the latest and most advanced treatments and surgical techniques.
Patient safety, high quality and individual treatment always have the highest priority at Oslo Plastic Surgery.
FAQ - Frequently Asked Questions
Oslo Plastic Surgery answers frequently asked questions here, and we hope that this will provide you with good information. We want to be helpful in the process before an operation. If you have any more questions, just write or call us.
When you have breasts with older prostheses.
When you have a hard and painful capsule formation and a negative change in breast shape.
When you feel that "the prostheses have done their job, or I'm done with them."
By entering the scar from the insertion of the prosthesis. The old prosthesis is removed together with the capsule in cases of capsular contracture.
Yes, you can combine breast implant replacement with, for example, breast augmentation and/or fat grafting. This is agreed with the surgeon prior to the operation.
For the first 6 weeks, you should only wear a sports bra, and for the first 3 weeks, both day and night, together with a chest strap. Avoid underwire bras for the first 6 months.
You can shower your body after the surgery, but avoid the bandage that will be on for 3 days, we recommend that you wait until after this. After 2 weeks, you should shower the chest area and apply new surgical tape Micropore or Steri-Strips that can be purchased at the pharmacy.
Normally, you can exercise carefully after 2 weeks, and you should use your arms carefully during the same time. That is, do not lift your arms high or carry heavy things.
You can return to work two to three days after the procedure, as long as you do not have hard physical work. Normally, sick leave is not required for breast surgery, but we will issue a certificate of medical examination and treatment upon request.
All patients must undergo a consultation before surgery. The consultation is conducted by our experienced plastic surgeon who will ask you questions about your medical status; past or current illnesses, previous surgeries, use of medications, etc. An examination is then performed, and the surgeon considers a possible operation.
If you are suitable for surgery, you will receive information about the surgery itself, precautions to take before and after the procedure, and you will get answers to your questions.
For patients with long distances to travel, we offer consultations via telephone and/or video consultation. We will then send you a health information form in advance, which you must fill out and return to us before the consultation. You will also send us some photos.
Should surgery be necessary, the surgeon will conduct a thorough assessment the day before the planned surgery.
You must be healthy on the day of the operation. If you are in doubt whether you have a cold or similar, you must contact us. The operation is not performed when you have the flu and/or fever or cough or other infection. Before the operation, you will receive a prescription for antibiotics, possibly painkillers and Hibiscrub solution 40 mg/ml, which you can buy at the pharmacy.
In Norway, it is not allowed to show before and after pictures of silicone from cosmetic procedures in marketing or on the clinic's website. However, we can show you beautiful pictures from previous patients when you come for a consultation with the surgeon. This can be very helpful when we discuss the size of the implant, and it can make it easier for you to imagine an expected result.
We can also offer a preliminary examination with a 3D imaging system. We take pictures of your body and can use image simulation to show you what an expected result will look like with different sizes and implant types.
If correction is necessary due to complications or unsatisfactory results, this will be done free of charge within one year, provided there is a medical indication and a clear improvement potential. This is our one-year warranty agreement.