Explant surgery is removal of breast implants without putting new ones in. More women in Australia are choosing it, and it is a legitimate decision that does not require you to prove a diagnosis first.
The part worth understanding before you book is what the breast looks like afterwards, because that is where expectations most often come unstuck.
What the breast does after removal
The tissue has been stretched around an implant, sometimes for decades, and it does not spring back. After removal the breast is usually smaller than it was before you ever had implants, flatter at the top, and sitting lower. How much depends on how long the implants were in, how large they were, your skin quality and any weight change since.
Some women are content with that and want nothing further. Others want the shape addressed. The options are:
| Option | What it involves |
|---|---|
| Removal alone | Implants out, skin left to retract as it will |
| Removal with a lift | A mastopexy at the same operation, repositioning the nipple and removing skin |
| Removal with fat grafting | Fat taken by liposuction elsewhere grafted to restore some fullness |
| Removal now, shape later | Implants out first, the breast allowed to settle for several months, decisions made then |
Doing everything in one operation is not always the better choice. Where the skin is very stretched, waiting lets the breast declare its final shape before the lift is planned.
What happens to the capsule
The capsule is the layer of scar tissue your body forms around the implant. What is done with it depends on what is found — a thin, healthy capsule may be left; a thickened or contracted one is usually removed; a capsule containing a mass or fluid is removed and sent for testing.
Removing the capsule is a bigger operation than removing the implant alone: more dissection, more bleeding risk, and in thin patients the capsule may sit against the chest wall and ribs. It is done where there is a reason, not as a routine. See en bloc capsulectomy for the term you may have read online.
Cost and Medicare
Two items are relevant and they are not interchangeable.
Item 45548 — removal of a breast prosthesis as an independent procedure.
Item 45551 — removal with excision of at least half of the fibrous capsule, not with insertion of any prosthesis. This item is intended for capsular contracture, a mass within the capsule, or evidence of BIA-ALCL or other malignancy, and where it is claimed the capsule must be sent for histopathology.
So a capsulectomy requested on the basis of symptoms alone, with no contracture or mass, does not meet the indications set out for 45551. Which item applies to you is determined by what is found clinically. and cover the surgeon’s fee only — not the hospital, the anaesthetist or the assistant. Your quote sets each out separately. More about costs.
Recovery
Removal alone is a smaller operation than the augmentation was, and most patients are comfortable within a few days. Where a capsulectomy or a lift is added, recovery follows the breast lift timeline: Prineo and Micropore for six weeks, a pressure garment for six weeks, desk work at around two weeks and full exercise at six. Drains are used where the dissection warrants it.
If your reason is how you feel
Many women considering explant are doing so because of symptoms they attribute to their implants. Dr Kumar will not dismiss that, and will not promise it will resolve either. Improvement is commonly reported; the published evidence is largely observational, so the size of the effect is uncertain. Having other causes investigated with your GP first is part of doing this properly. Breast implant illness: what we know.
Common questions
Will my breasts look like they did before implants? Usually not. Expect smaller and lower.
Should I have a lift at the same time? Sometimes yes, sometimes better delayed. It is decided on examination.
Do I have to have the capsule removed? No, and it is not automatically better. It depends on what is found.
Can I change my mind and have implants again? Yes, though it is a further operation.
Will my health fund help? Funds contribute to hospital costs where there is a recognised clinical indication and your cover allows. The hospital checks and quotes.
Next step
Bring a GP referral — it is required to see Dr Kumar — and your implant cards if you have them. If you are travelling a distance, you can send photos first. Call 1300 267 726. More about implant removal and revision.
The initial consultation with Dr Kumar is $400, with a Medicare rebate of approximately $88 where you have a GP referral. Surgical fees are quoted individually after your consultation, in a written itemised quote.
All surgery carries risks, and individual results will vary. Read more about the risks of surgery here. A GP referral is required to see Dr Kumar.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
