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.
What the capsule is
Your body forms a layer of scar tissue around any implant — that layer is the capsule. It is not part of the device and it is not an abnormality; it is the normal response to a foreign object. What differs between operations is how much of it comes out.
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 by the word they use.
These are schematic drawings made to explain the difference between the operations. They are simplified, they are not to scale, and they do not depict a real patient or a surgical result.
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, and the capsulectomy sectioncovers the terminology in full — including capsulectomy versus capsulotomy, which is the distinction most often blurred in consultation.
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.
Schematic again — the dashed outline shows the starting shape for comparison. Scar patterns differ by technique and are not drawn here; ask your surgeon to show you the specific pattern they are proposing.
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 admin@explanthealth.com. Contributions are anonymous and we publish only aggregates.