Breast Implant Illness: All About Explant 

Repeat the following adage: Breast implant illness is treatable. So many people worldwide are afflicted with illnesses that are not easily eradicated, but this is not one of them: Implant removal can mean an end to symptoms that seem so pervasive, it’s difficult to believe small implants surrounded by silicone can be the culprit. Breast implant safety is a subject of great discussion, but one truism is clear: for those who experience brain fog, chronic fatigue, headaches and more with no other obvious cause, explant can be a panacea.

As the FDA recently admitted, women should be informed of the risks of implants before they undergo augmentation. Unfortunately, the journey from implant to explant is often full of pain and indecision. The Heal is Real aims to change that.

Read below as we explain why some women should consider explant and what happens during and after the operation. This is a great article to use as a resource as you and your medical professional decide if explant is a viable option. Remember: the overall goal of explant is to remove the implant and capsule with as little stress as possible to your body.

Who Needs to Explant?

Those affected by the chronic issues that come with breast implant illness may answer -everyone. Why take the chance of developing chronic fatigue, hardened breasts, tinnitus, and a much longer list of maladies? Still, the choice to explant is a personal one. 

Take for example the women who selected Allergan BIOCELL textured implants (now recalled). These implants have been linked to anaplastic large-cell lymphoma (BIA-ALCL). This type of cancer affects the immune system; as soon as explant that involves the implant and scar tissue removal is completed, symptoms usually vanish. Even with the proven risk apparent, the FDA does not recommend that asymptomatic women who have these implants opt for removal. It’s not necessary, they argue. The risks are still low.

For the thousands of women who suffer from symptoms they cannot explain, explant offers relief. One reason for this may be that women are keeping their implants longer than recommended, giving them more of a chance to rupture and rot. Even gummy bear implants, touted for their ‘realistic’ shape and feel, can slowly leak for years before an MRI reveals the truth.

Once a leak is identified, the implant must be removed. A woman is then faced with the decision of whether to replace it and chance that her good health to return, or gamble with rupture. It’s a decision that seems simple to someone who doesn’t consider the self-esteem or social ramifications of ‘going flat.’ The answer, we have to realize, is not that simple.

Who absolutely should explant?

Mysterious health problems are often a precursor to explant. If health tests continue to come back negative, if the breasts become hardened and dimpled, or if a person develops anaplastic large-cell lymphoma (BIA-ALCL), explant should be scheduled. Those who have had their implants longer than the recommended amount of time as put forth by the manufacturer guidelines should also consider the operation, even if ‘fresh’ implants are inserted to take their place. 

Imagine an implant as a small balloon. That balloon can break. If that occurs, it’s usually obvious, as the implant will shrink the size of the breast. Sometimes, as is the case with slow leaks of gummy bear implants, it’s nearly undetectable. That’s why those with gummy bear breast implants are advised to undergo MRIs every few years to check for leaks.  

Every implant is made of silicone. The difference is what makes up the interior substance. Regardless of that substance, surrounding that implant balloon is a layer – sometimes thick, sometimes thin – of scar tissue. When implants leak, the scar tissue is the first line of defense – but that doesn’t mean the body is safe.

This scar tissue barrier should be removed along with the implant because it can absorb the detritus of that implant and can then spread it throughout the body. The different explant surgeries focus on this capsule and the extent to which it is removed from the body. Take note: just because saline implants may be labeled ‘natural saline,’ that doesn’t mean they can’t cause adverse health effects. A ruptured implant can be a moist harbor for bacteria to grow.

What can I expect explant surgery to entail? 

Explant surgery options include:

• Total capsulectomy – Say ‘sayonara’ to that breast implant and the breast implant capsule with this surgery, which ultimately removes both of them. This surgery usually progresses with the breast implant being removed first, followed by the scar tissue capsule. Total capsulectomy differs from en bloc capsulectomy in that the entirety of the implant and its capsule are not cut from the body at the same time. This results in the scraping of the capsule off any places to which it has adhered.

• En bloc capsulectomy – ‘En bloc’ means ‘as a whole’ in French, and it’s a fitting descriptor for this type of capsulectomy; it did originate in France. In this surgery, the surgeon cuts around the entirety of the capsule and its implant, removing both at the same moment. As you can imagine, this is more of a seamless operation than a total capsulectomy, which involves two parts. The reason this surgery became popular is because it minimizes the possibility of puncturing the implant during surgery. Consider en bloc implant/capsule removal more like tracing around an object and then dislodging it. Have silicone or textured implants in your body? This is the preferred capsulectomy procedure for you. 

• Capsulectomy – Here, you’ll achieve implant removal – but parts of the capsule will stay in the body. This can be a problem. These capsules are not absorbed by the body. Instead, they can leech harmful mold or worse into your system. The medical community has mixed feelings about the effects of silicone. Remember: all implants have a silicone outer shell. Leave shards of that inside the body, and harmful elements could possibly leech their way throughout your system.

Why can’t saline implants just be drained?

Note: A dwindling number of medical professionals will advise you to drain saline implants. Their rationale is that saline should not harm the body. This in itself is true – but it’s misguided. Your saline breast implants may harbor bacteria. Deflating them releases that into the body, and then there is the matter of the empty silicone outer shell that will still exist in the chest cavity. Consider total or en bloc capsulectomy instead.

Doesn’t my surgeon naturally know what type of explant surgery is best for my unique situation?

Perhaps – but why take a chance? Go into the consultation already understanding your options. Surgeons' recommendations can vary, and it’s your ‘job’ to be an informed healthcare consumer. If it’s important to you to have an en bloc capsulectomy, for example, insist upon it. Doing anything ‘the easy way’ is not necessarily ‘the right way.’ Give yourself the best chance to heal.

How do I make sure my surgeon has removed both the implant and the capsule?

Be very clear with the surgeon if you wish to have both the implant and capsule removed. It may sound morbid, but some women even demand to see pictures after the surgery in order to prove that these foreign objects no longer exist inside the body. These can be found throughout the Internet, and they vary: some pictures show obvious bacterial growth, while others seem as pristine as the day they were inserted. 

The reality that the body encapsulates breast implants is evidence that they are not meant to be inserted. The body reacts to a foreign invader (the implant) by surrounding it with scar tissue. If implants were a natural device, if the body accepted them readily and with no apparent detriment, breast implant illness would not be an issue. As it stands, the body does not want the implant. It is not natural. And some women respond very poorly to their existence.

What can I expect in terms of recovery?

Ironically, recovery is often similar to that of the original breast augmentation. Remember when you couldn’t exercise for a few weeks? The same is true now. Some tenderness may persist for a while. Drains may be present to take care of excess fluid buildup. This is all a small price to pay for the realization that breast implants, which may have been slowly poisoning the body, are now gone. Plan for your explant using the tips shared here.  

For more detailed information regarding explant surgery options, consider reading the breast implant removal protocols as detailed by the American Society of Plastic Surgeons. This can be found here.

Good luck on your explant journey! May you too find that the heal is real. For more information about implant, explant, and the latest scientific findings regarding breast implant illness and more, visit thehealisreal.org. Share your implant/explant story in the hopes that others can find comfort and take action. Start here. Together, we can bring global awareness to the dangers of breast implants and share feasible (and possibly life-altering) solutions.