Explant surgery
Removal is one operation with several decisions inside it: how much capsule comes out, whether anything is done to reshape afterwards, and when. This section covers each decision on its own terms.
What explant surgery is
Explantation is the surgical removal of breast implants. It is usually performed under general anaesthetic as a day procedure, often through the original scar. What varies, and what most of the disagreement is about, is how the capsule — the layer of scar tissue the body forms around any implant — is handled, and whether anything is done to the remaining breast tissue at the same time.
The capsule decision
Three approaches are described in the literature and in consultation rooms. They are not interchangeable, and the language around them is used loosely enough that it is worth confirming what your surgeon means.
- Capsulotomy— the capsule is cut into to remove the implant, and most of the capsule is left behind.
- Total capsulectomy— the whole capsule is removed, though not necessarily in one piece.
- En bloc capsulectomy— implant and capsule are removed together as a single sealed unit.
The 2024 Breast Surgery Collaborative Community consensus, endorsed by the American Society of Plastic Surgeons, The Aesthetic Society and ISAPS, reserves en bloc capsulectomy for established or suspected breast implant-associated cancer. For breast implant illness, total capsulectomy is the approach it supports.
This matters practically: en bloc requires a wider dissection and carries a higher reported risk of complications. Our full page on whether you need en bloc goes through the evidence and what to ask instead.
What happens to the breast afterwards
Removing an implant leaves a space, and how the breast settles depends on how much natural tissue you have, how long the implant was in, and your skin’s elasticity. Some people are happy with the result without further surgery. Others choose a lift, or fat grafting, to reshape.
Breast tissue commonly continues to change for several months to a year after removal as swelling settles and tissue redistributes. Surgeons generally advise waiting before judging the aesthetic result or deciding on revision, though the timeline varies between people.
Whether to combine removal with a lift in one operation, or stage them, is a genuine trade-off between fewer anaesthetics and a more predictable aesthetic result. It is worth asking your surgeon which they recommend for you specifically, and why.
Cost
Costs vary widely by geography, by whether a capsulectomy is included, and by whether reshaping is done at the same time. Where removal is medically indicated — for example for rupture, or for confirmed implant-associated cancer — insurance may cover part of it, though coverage for removal on the basis of systemic symptoms alone is inconsistent.
A cost survey is in progress. Rather than quote a range from marketing pages, we are collecting what people actually paid, by region and procedure type. If you have had explant surgery and are willing to share what you were charged, write to hello@explanthealth.com. Contributions are anonymous and we publish only aggregates.