Removal of breast prosthesis with or without capsule (Explant)
After insertion of breast prostheses, some women may experience asymmetry due to misplacement of the prosthesis, or that a hard membrane has formed around the prosthesis, so-called capsule formation/capsule contracture. Capsular contracture is not dangerous, but the breasts can become hard, tender and painful.
If you need to remove your breast implants after a capsular contracture has occurred, your surgeon may remove both the implants and the surrounding scar tissue. Other reasons for removing prostheses may be that the patient feels that "the prostheses have done their job, or I'm done with them". Other increasing reasons for implant removal are ALCL (a rare type of non-Hodgkin lymphoma) and breast implant illness (BII), with symptoms such as headaches, muscle and joint pain and autoimmune diseases.
In this case, the prostheses 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 immediately after implant removal. The result is better if you do this at the same time.
We use the PAL Micro Air vibration machine, which evens out the pressure and the donor site for fat. At the same time, unwanted fat accumulation in certain parts of the body is corrected, leaving very small scars of 1-2mm.
See our article about this treatment: Extract from our KK interview
The degree of capsule formation varies from 1 to 4, with the most severe form (3 and 4) occurring in 5-8% of women with prostheses. 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 soreness and pain. Capsule formation is not dangerous, but the breasts can become hard, tender and in some cases cause pain. If the breast implants are to be removed in the event of a severe capsular contracture, the
surgeon will often 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 by ultrasound or MRI.
See link(Breast implant conversion and ALCL/Bll)
Some people want to fill their breasts with their own fat - read a separate article about breast augmentation with fat grafting(Breast augmentation with own fat and Breast implant conversion).
The actual procedure under deep sedation takes approximately 1-1 ½ hours, depending on the type/degree of capsule formed, it is decided whether to remove the entire capsule or just parts of the capsule - which is easier. The incision is usually made where the old scar is, to avoid creating new scars.
After removing the old prosthesis, the same cavity will be used for the new prosthesis, which may also be 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 to create more space for the new prosthesis. See surgery for thorough homeostasis to stop bleeding, as capsule removal can cause minor bleeding). Replacement of the prosthesis can easily be combined with fat grafting with fat or a breast lift.
Pick-up and accommodation
You must arrange in advance for someone to pick you up at the clinic about 1 hour after the operation, as you cannot drive, take public transport or a taxi on your own. You must also have someone with you 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 at 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 any doubt about whether you have a cold or similar, please contact us. The operation is not performed if you have flu with fever, cough or other infection in the body. Before the operation, you will receive a prescription for antibiotics, painkillers if necessary and Hibiscrub solution 40 mg/ml, which you can buy at the pharmacy.
The day before surgery and on the day of the operation, 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 dried with a clean towel. Put on clean clothes when you leave home. Do not use perfume and lotion. All jewelry, piercings and nail polish/fake nails must be removed no later than the day before the operation and replaced 7 to 10 days after the operation.
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 snuff or electronic cigarettes, you must quit at least 2 weeks before surgery and 2 weeks after surgery.
You should come to the surgery fasting. This means that you should not eat any food including fruit or drink juice with pulp or dairy products 6 hours before the operation. 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 operation. 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 medication about 14 days before the operation, preferably in consultation with your GP or us. For other medications, consult the clinic before the operation. You should also avoid eating a lot of garlic and health food preparations.
You must arrange in advance with a person to pick you up at the clinic about 1 hour after the end of the operation, as you cannot drive yourself, take public transport or taxi alone.
If you are going to have breast prostheses inserted, are over 40 years old and have not had a breast examination for a long time, it may be appropriate to have a mammogram before the operation.
On the day of surgery
You will be received by our staff who will prepare you for surgery before the surgeon sees you.
Before the actual procedure, the surgeon will go through the procedure, draw up the plan and answer any questions you may have. Anesthesia staff will also come and greet you and answer your questions. When the operation is about to begin, the surgical nurse will pick you up and clean the operating area while the anesthesia staff give you a sedative in your arm so
you sleep under surgery. In addition, the surgeon will place a local anesthetic in the operating area for a long-lasting analgesic effect in the operating area after the operation, which also
reduces bleeding in the area. After the operation, you will be moved to the recovery room where you will have your own bed.
You then rest for 1-2 hours and are served food and plenty of drink in the form of sandwiches, yogurt and juice (remember to inform about allergies). Painkillers are given if necessary. The surgeon will check on you before your return home/hotel stay and you will be cleared by anesthesia staff before you go home with an adult companion. The PVK attached to your hand will be removed before you leave. A car or taxi must be used as a means of transportation immediately after surgery, we do not recommend public transport or walking.
After the operation
All patients come for a postoperative 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 follow-up appointment will be arranged at the clinic and you should come to the clinic the day after the surgery.
In the first few hours after the operation, you may feel a little tired and sometimes a little nauseous. It's important that you take painkillers as prescribed and as needed, and make sure you drink plenty of fluids for the first 24 hours. Some people may feel a little dizzy, so it's a good idea to take a few minutes to stand 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 gently. If you have an active job, it's a good idea to stay at home. After the operation, you will be given a special bandage that will be removed after 3 days, and the tape will remain on for 2 weeks.
You should wear a sports bra for 6 weeks after the bandage has been removed. After the tape is removed (after 2 weeks), you can shower the area and apply new 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, alternatively silicone tape.
We close the wound with stitches that dissolve on their own. Drains are often placed in the pocket to remove blood and fluid from the wound area under the breast, which is usually removed 1-2 days later
surgery .
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 after a year. You must call to arrange the check-ups yourself, or alternatively make an appointment with the clinic on the day of the operation.
Bleeding and infection are uncommon and in very few cases require reoperation and/or antibiotic treatment. Anesthetic complications, such as an allergic reaction to
anesthetics, are extremely rare.
In principle, breast augmentation does not provide a basis 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 postponed for about 4 weeks.
The scars are often red, itchy and hard at first, but over time they will fade and soften. However, the scars are concealed by the bra and will not be visible in low-cut dresses. In rare cases, the scars can become wide and clearly visible, depending 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 from 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 potential for improvement. This is our guarantee period.
Ask for guidance and advice
We can give you the best advice face to face. We will guide you to the best solution for you.
The doctor in charge is Dr. Amin Kalaaji, senior consultant dr.med, specialist in plastic surgery and head of the clinic at Oslo Plastikkirurgi, and head of the Norwegian Society for Aesthetic Plastic Surgery (NFEP) 2018-2020.
Dr. Kalaaji holds many positions and gives lectures and training 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.Â
Patient safety, high quality and individual treatment are always our top priorities at Oslo Plastikkirurgi.Â
FAQ - Frequently asked questions
Oslo Plastic Surgery answers frequently asked questions here, and we hope this provides you with good information. We want to be helpful in the process before a surgery. If you have any further questions, just write or call us.
When you have breasts with older prostheses.
When you have experienced 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, it is possible to combine the replacement of breast implants with, for example, breast augmentation and/or fat grafting. This is agreed with the surgeon in advance of the operation.
Only wear a sports bra for the first 6 weeks, and both night and day for the first 3 weeks, together with a chest band. Avoid sports bras for the first 6 months
You can shower your body after the operation, but avoid the bandage, which will be on for 3 days, we recommend that you wait until after this. After 2 weeks, shower the breast area and apply new surgical tape Micropore or Steri-Strips, which can be purchased at the pharmacy.
Normally, you can exercise gently after 2 weeks, and you should use your arms gently during the same time. I.e. do not lift your arms high or carry heavy loads.
You can return to work at your leisure two to three days after the procedure, as long as you are not engaged in strenuous physical work. Breast surgery does not normally result in sick leave, but we will issue a certificate of medical examination and treatment on 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; previous or current illnesses, previous surgeries, use of medication and the like. An examination will then be carried out, and the surgeon will consider a possible surgery.
If you are suitable for surgery, you will receive information about the operation itself, precautions for the time before and after the procedure, and you will get answers to your questions.
For patients with long travel distances, we offer consultations via telephone and/or video consultation. We will then send you a health information form in advance, which must be completed and returned to us before the consultation. You also send us some photos.
If a surgery is required, the surgeon will carry out a thorough assessment the day before the planned operation.
You must be healthy on the day of the operation. If you have any doubts about whether you have a cold or similar, please contact us. The operation will not be performed if you have flu and/or fever or a cough or other infection. Before the operation, you will receive a prescription for antibiotics, painkillers and Hibiscrub solution 40 mg/ml, which you can buy at the pharmacy.
In Norway, it is not permitted to show before and after pictures of silicone from cosmetic procedures in marketing or on the clinic's website. However, we can show great pictures from previous patients when you come for a consultation with the surgeon. This can be a great help 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 types of implants.
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 potential for improvement. This is our one-year guarantee agreement.