Implant Removal + Breast Lift
Breast Lift After Silicone Implant Removal (Explant + Mastopexy)
One of the most significant trends in breast surgery over the past decade has been the increasing demand for breast implant removal — driven by Breast Implant Illness (BII) concerns, capsular contracture, implant rupture, aesthetic dissatisfaction, and a broader cultural shift toward a more natural appearance. When implants are removed, particularly after many years of implant-related tissue changes, the breast is left with stretched, excess skin, reduced glandular tissue, and a significantly deflated, ptotic appearance that almost always requires mastopexy to address.
At Kare Plastic Surgery, Dr. Karamanoukian is a recognized specialist in breast implant removal — including en bloc capsulectomy, total capsulectomy, and partial capsulectomy — and routinely performs simultaneous mastopexy at the time of explantation. His combined surgical and aesthetic expertise allows him to plan the explant and lift as a single, integrated operation: managing the capsule removal, preserving viable breast tissue for reshaping, and executing the mastopexy with the understanding that the breast mound will be significantly smaller and differently positioned after the implant and capsule are removed.
En Bloc Capsulectomy with Simultaneous Mastopexy
En bloc capsulectomy — the removal of the breast implant and surrounding scar capsule as a single intact unit — is indicated for silicone implant rupture, suspected BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma), or when maintaining the integrity of the capsule boundary is clinically important. En bloc removal is technically more demanding than standard explantation, as the surgeon must maintain the capsule intact while navigating the surrounding anatomy — including the pectoralis muscle, intercostal vessels, and chest wall.
When mastopexy is performed simultaneously with en bloc capsulectomy, Dr. Karamanoukian plans the skin excision pattern to complement the explant access incision — typically using an anchor or lollipop pattern — maximizing tissue efficiency and minimizing the total number of incisions on the breast. His reconstructive surgery background is particularly valuable in this context: managing the complex three-dimensional changes in breast shape following en bloc removal requires the same tissue planning skills used in reconstructive breast surgery.
What to Expect from Breast Shape After Implant Removal
Patients considering explantation should understand that the appearance of the breast after implant removal is significantly influenced by the size of the implants that were in place, the duration of implantation, the degree of capsular involvement, the amount of native breast tissue present, and the degree of skin stretching that occurred over time. In patients who carried large implants for many years, the native breast tissue may be significantly compressed, atrophied, or distorted — requiring careful planning of what mastopexy technique will produce the most natural and aesthetically pleasing result given the tissue available.
Fat Grafting as an Adjunct: In patients who undergo explantation with mastopexy and desire modest additional volume without new implants, autologous fat transfer (fat grafting) to the breast can be performed simultaneously. Fat is harvested from the abdomen, flanks, or thighs by liposuction, processed, and injected into the breast to restore gentle fullness. Dr. Karamanoukian incorporates fat grafting into his explant/mastopexy planning when the patient’s body composition supports it and the volume goals are appropriate for this technique.
2–3 hrsTypical duration for en bloc capsulectomy + mastopexy
GeneralAnesthesia used for all explant + lift procedures
1–2 wksReturn to desk work post-explant mastopexy
6 monthsTimeline to fully settled final result