QUESTIONS ASKED PRIOR TO EXPLANT SURGERY

The decision to remove breast implants can be a difficult one; however, once you understand and establish realistic expectations, many women still have a few questions prior to having explantation surgery. Below are a few typical questions that are often asked during consultations in my Beverly Hills practice. Feel free to call our office at any time at 310-275-4513 with

questions related to breast augmentation, revision and explantation surgery.

Different PPO policies have different inclusions and exclusions. Some PPO policies will consider explantation of implants, a functional surgery and yes, will cover the operation as a functional procedure.

Implants that are often removed for infections, seroma or associated with a malignancy or cancer to the breast may often be covered by PPO insurance. Ruptured silicone implants are often covered by PPO insurance; however, they do often require evidence of the rupture prior to the operation which can be obtained by MRI radiographic testing. Medically, saline implants can also be determined to be ruptured in preoperative photographs of the patient with a ruptured saline implant may be useful as well. Capsular contracture and removal of scar tissue associated with explantation can often be covered with PPO insurance and once again, inclusion and exclusion must be determined by each specific policy.

Absolutely. General anesthesia is always required in our patients for explantation surgery. Board Certified Anesthesiologists always put our patients under general anesthesia either via laryngeal mask airway or general endotracheal tube intubation if the patient has a history of reflux. This is especially important as to we do not want the patient to have any remembrance or pain in this surgery. Removing scar tissue is often a component of explantation surgery, requires that the patient does not move on the operating room table as the capsule does also affix to the intercostal rib space.

The incision points often on revision and explantation can be made along the inframammary fold. This is an excellent location for removal of implant, implant material and capsulectomy as well as placement of the JP drain through that same incision and securing it with a 3-0 Prolene suture. Inframammary incisions are most often used for complete explantation; however, a periareolar incision can also be performed if the patient desires it.

Rather than do a concurrent full mastopexy or breast lift at the same time as the explantation depends upon the amount of skin laxity the patient has. This can be determined by a Board Certified Plastic Surgeon who has experience performing explantation with or without breast lifts. In some situations the size of the implant may have a determination as to whether a lift is required. Patients who present in my office who have had surgery at a different place with a different surgeon and are not able to identify the implant information prior to surgery with us, may make it difficult to determine if they are on the borderline whether a breast lift is needed. At this stage, the patient may be asked to simply do the explantation with drainage and present for a breast lift if necessary, as a second stage three to six months later.

In general, six weeks is a good period of time to allow your breasts to recovery as well as to allow some of the skin to contract and allow the fluid to be reduced through the JP drain. The drains were removed after one week. Antibiotics are maintained for at least seven years until the JP drains are removed. The sutures are taken out on Day 14 and patients are able to shower on day 7 after the drain tubes have been removed. It takes at least six to eight weeks for the swelling as well as the fluid within the tissue to recover. In terms of tightening of the breast, it can take six to 12 months for the skin to retract. You will be wearing a Dr. Linder Bra as tightly with as much compression as possible will certainly help in the tightening

aspects.