Kare Plastic Surgery · Los Angeles and Santa Monica
Ruptured and Infected Breast Implants
Los Angeles
804 7th Street Santa Monica CA 90403 · (310) 998-5533
Ruptured implant removal, infected implant explantation, capsular contracture repair, total capsulectomy, and breast implant revision by board-certified plastic surgeon Dr. Raffy Karamanoukian at Kare Plastic Surgery
Call (310) 998-5533 Schedule a Consultation
BoardCertified Plastic Surgeon
ImplantRemoval Specialist
Breast Implant Removal and Revision Los Angeles
A Ruptured or Infected Breast Implant Requires Prompt Surgical Evaluation. Do Not Wait.
Dr. Raffy Karamanoukian MD FACS Board-Certified Plastic Surgeon Breast Implant Removal · Capsulectomy · Capsular Contracture · Implant Revision · BIA-ALCL · Kare Plastic Surgery Los Angeles
Breast implants are not lifetime devices. They age, they can rupture, they can develop complications years after placement, and they can become infected at any time after surgery. When a complication occurs, prompt surgical evaluation by an experienced board-certified plastic surgeon is essential. The longer a ruptured silicone implant remains in place after rupture, the more silicone can migrate beyond the implant capsule into the surrounding breast tissue, making removal more complex and complete extraction more difficult to achieve. An infected breast implant pocket that is not addressed urgently can escalate to serious soft tissue infection requiring extended hospitalization.
At Kare Plastic Surgery, Dr. Raffy Karamanoukian MD FACS provides expert breast implant removal and revision for patients throughout Los Angeles. His deep experience in breast surgery includes ruptured implant explantation, infected implant removal with pocket irrigation and antibiotic management, total capsulectomy, and full breast implant revision for patients who want to change their implant size, type, or position at the time of removal.
Seek prompt evaluation if you have: sudden breast deflation, unexplained new breast firmness, breast pain or swelling around an implant, redness or warmth over the breast pocket, fever associated with a breast implant, or any new unexplained fluid accumulation around a textured implant. Call Dr. Karamanoukian at Kare Plastic Surgery in Los Angeles: (310) 998-5533.
Kare Plastic Surgery · Los Angeles · (310) 998-5533
Ruptured, infected, or problematic breast implant? Schedule your evaluation with Dr. Karamanoukian today.
Clinical Documentation · Kare Plastic Surgery · Dr. Raffy Karamanoukian
Problematic Breast Implant Removal · Intraoperative at Kare Plastic Surgery Los Angeles
Actual patient at Kare Plastic Surgery · Problematic breast implant with capsular contracture and surface biofilm removed by Dr. Raffy Karamanoukian · Los Angeles
Breast Implant Removal Intraoperative · Kare Plastic Surgery · Dr. Karamanoukian Los Angeles Explanted silicone breast implant with surface inflammatory material and biofilm consistent with capsular contracture and implant pocket infection · Total capsulectomy performed
What You Are Seeing
This explanted silicone breast implant shows adherent inflammatory material on its surface consistent with biofilm formation and capsular contracture. Biofilm is a thin layer of bacteria that can colonize an implant surface without causing overt infection. Over time biofilm drives the chronic inflammatory response that leads to capsule hardening and capsular contracture. In this patient the capsular contracture had progressed to Baker Grade III with firmness and breast distortion requiring surgical removal.
What Dr. Karamanoukian Did
Dr. Karamanoukian performed a total capsulectomy, removing the entire scar capsule en bloc around the implant without entering or disturbing it. The implant pocket was then irrigated with antibiotic solution, and the decision to exchange versus remove the implant was made based on intraoperative findings and the patient's preoperative preferences. Total capsulectomy is the gold standard for capsular contracture and is essential for BIA-ALCL cases.
Revision or Explantation
Not every patient who undergoes breast implant removal wants new implants placed. Dr. Karamanoukian counsels patients individually on their options before surgery. Some patients choose explantation with a breast lift to restore natural breast shape. Others choose implant exchange with a new implant in a different position or of a different size. Both options are available at Kare Plastic Surgery. The decision is made collaboratively based on each patient's goals and intraoperative findings.
Breast Implant Complications
Breast Implant Problems Treated byDr. Karamanoukian
Silicone Implant Rupture
Silicone implant rupture is often silent because the cohesive gel stays within the implant capsule initially. Over time a ruptured silicone implant causes breast shape changes, asymmetry, and firmness. MRI is the most sensitive imaging modality to confirm silicone rupture. The FDA recommends MRI screening for silicone implants at 5 to 6 years after placement and every 2 to 3 years thereafter. Prompt removal and total capsulectomy is recommended once rupture is confirmed.
Saline Implant Deflation
A deflated saline implant is immediately obvious as a sudden size reduction in the affected breast. Saline deflation can occur from valve failure, shell fatigue, or trauma. The saline solution is safely absorbed by the body. However the deflated shell and capsule remain and require removal. Dr. Karamanoukian removes the deflated implant and capsule and offers implant exchange at the same surgery for patients who want reconstruction.
Capsular Contracture
Capsular contracture is the most common complication of breast augmentation. When the natural capsule hardens and tightens around the implant it causes breast firmness, pain, and distortion. Baker Grade III and IV capsular contracture requires surgical treatment. Dr. Karamanoukian performs total capsulectomy to remove the hardened capsule completely and implant exchange to restore a soft, natural breast appearance and feel.
Breast Implant Infection
Breast implant infection can occur shortly after surgery or years later following a bacteremic event. Acute infection presents with redness, warmth, swelling, and fever. A periprosthetic infection typically requires implant removal and pocket irrigation for resolution. Attempting to treat a breast implant infection with antibiotics alone without removing the implant almost never succeeds because bacteria colonize the implant surface in a biofilm that is impenetrable to systemic antibiotics.
Implant Malposition
Implant malposition occurs when the breast implant shifts out of its intended position. A bottoming out implant drops below the natural breast fold. A lateral malposition moves the implant toward the armpit. Symmastia occurs when both implants migrate toward the midline. Each type of malposition requires specific surgical correction including pocket revision, capsulorrhaphy to close and reshape the pocket, and implant replacement.
BIA-ALCL
Breast Implant Associated Anaplastic Large Cell Lymphoma is a rare lymphoma associated with textured breast implants. It presents as late-onset breast swelling, fluid around the implant, or a new mass, typically 3 to 14 years after implant placement. When detected early and confined to the capsule, BIA-ALCL is typically cured with total capsulectomy and complete implant removal. Dr. Karamanoukian evaluates and manages BIA-ALCL concerns including urgent total capsulectomy when indicated. Call (310) 998-5533.
Treatment Options at Kare Plastic Surgery Los Angeles
Total Capsulectomy
Total capsulectomy removes the entire implant capsule intact around the implant without opening it. This is the most complete form of capsule removal and is the recommended approach for confirmed or suspected BIA-ALCL, for silicone rupture with extracapsular silicone migration, and for severe capsular contracture where the hardened capsule is too thick to leave in place. Dr. Karamanoukian performs total en bloc capsulectomy as the standard approach for complex implant revision cases where complete capsule removal is clinically indicated.
Implant Exchange and Revision
Many patients who present with a breast implant complication also want to change their implant size, implant type, or implant position at the time of revision. Dr. Karamanoukian performs comprehensive breast implant revision at Kare Plastic Surgery including switching from saline to silicone, switching from textured to smooth implants, changing implant size, moving the implant from subglandular to submuscular position, correcting malposition with pocket revision and capsulorrhaphy, and adding a breast lift when implant removal leaves excess skin requiring reshaping.
Explantation without Replacement
Some patients want their implants removed permanently without replacement. Dr. Karamanoukian performs complete explantation with total capsulectomy for patients who want their implants out. For patients with breast skin laxity following explantation, a concurrent breast lift is available to remove the excess skin and reshape the native breast tissue into a natural and supported breast contour. Dr. Karamanoukian discusses all explantation options thoroughly at the preoperative consultation so patients understand exactly what to expect from their result.
Infected Implant Removal
Acute breast implant infection requires prompt implant removal, complete pocket irrigation with antibiotic solution, drain placement, and systemic antibiotic therapy. Dr. Karamanoukian performs urgent infected implant explantation at Kare Plastic Surgery in Los Angeles. Replacement implants are not placed at the time of infection removal as the contaminated tissue bed cannot reliably support a new implant. Replacement is offered after a minimum of 3 to 6 months once the infection has fully resolved and the tissue is healthy. Call (310) 998-5533 immediately if you suspect breast implant infection.
Textured to smooth implant exchange: The FDA and the American Society of Plastic Surgeons have identified textured surface breast implants as the implant type most strongly associated with BIA-ALCL. Many patients with textured implants are seeking proactive exchange to smooth implants for peace of mind. Dr. Karamanoukian performs elective textured to smooth implant exchange at Kare Plastic Surgery in Los Angeles for patients who want to reduce their BIA-ALCL risk. This is an elective decision that does not require symptoms. Call (310) 998-5533 to discuss your options.
"The most important thing I tell every breast implant patient is this: your implants are not permanent. They need to be monitored and eventually addressed. When a problem develops, come in early. A ruptured implant addressed promptly is a straightforward surgery. The same rupture left for years becomes a complex reconstruction."
— Dr. Raffy Karamanoukian MD FACS · Board-Certified Plastic Surgeon · Kare Plastic Surgery Los Angeles
Frequently Asked Questions
What are the signs of a ruptured breast implant?
Silicone implant rupture is often silent. Over time it may cause breast shape changes, asymmetry, or firmness. Saline deflation causes immediate visible size reduction. Any suspected rupture should be evaluated by Dr. Karamanoukian at Kare Plastic Surgery in Los Angeles. MRI is the most accurate imaging test for silicone rupture. Call (310) 998-5533.
What is capsular contracture and how is it treated?
Capsular contracture is the abnormal hardening of the scar capsule around a breast implant. It causes firmness, pain, and breast distortion. Baker Grade III and IV capsular contracture requires surgical treatment with total capsulectomy and implant exchange. Dr. Karamanoukian performs capsular contracture repair at Kare Plastic Surgery in Los Angeles. Call (310) 998-5533.
What is BIA-ALCL and should I be concerned about my breast implants?
BIA-ALCL is a rare lymphoma associated with textured breast implants that presents as late-onset breast swelling or fluid. When caught early it is cured with total capsulectomy. Any patient with textured implants and new unexplained breast swelling should be evaluated promptly. Call Dr. Karamanoukian at (310) 998-5533.
Schedule Your Breast Implant Consultation
Kare Plastic Surgery · Los Angeles and Santa Monica · 804 7th Street
Treat Your Breast Implant Problem with Dr. Karamanoukian
Dr. Raffy Karamanoukian is a board-certified plastic surgeon at Kare Plastic Surgery who provides expert breast implant removal and revision throughout Los Angeles. He treats ruptured implants, infected implants, capsular contracture, implant malposition, BIA-ALCL concerns, and elective implant exchange. Same-week appointments are available.