Breast Implant Removal

Breast Implant Removal is requested by women who have previously had breast augmentation or enlargement (‘Boob job’) and no longer desire the implants.

Women seek breast implant removal for a variety of reasons:

  • The breast implants are uncomfortable or painful
  • The breast implants are mal-positioned – too high, too low, too far to the left or right
  • The breast implants have become hard (capsular contracture)
  • The breast implants are suspected to be ruptured, or rotated
  • Some women report systemic symptoms that they attribute to having the breast implants
  • They no longer desire the breast implants because their native breast size has changed since they were first placed
  • Previous unsatisfactory result from Breast Augmentation
  • There is a concern regarding ALCL

The operation is a reasonable request for the above reasons, and is ideal for women who:

  • Have reasonable expectations
  • Are medically healthy
  • Have had time to think about their decision to remove their existing implants

It may not be suitable for women who have breast implants who:

  • Have an excellent cosmetic result
  • There is no evidence of rupture, rotation, malposition, capsular contracture or ALCL.

Dr Aggarwal is one of the only Sydney Plastic Surgeons who has completed further fellowship training in dedicated Breast Cosmetic and Reconstructive Surgery. He is an expert in the field of breast cosmetic surgery.

It is important to remember that implant removal will result in a decrease in breast size, with possible ptosis (drooping). There may also be a return of asymmetry that may have been present before the operation. Women need to therefore consult with Dr Aggarwal as to whether a breast lift or fat grafting may be needed at the time of implant removal.

Procedure Snapshot
  • Anaesthetic: GA by accredited anaesthetist
  • Time: 2-3+ hours (depends on level of complexity, and if additional procedures are needed)
  • Duration of stay: Day Surgery or Overnight stay (may need to stay longer if drains)
  • Hospital: Offered at any of the private hospitals where Dr Aggarwal works
  • Medicare/Health Fund Rebate: Usually yes.
  • Recovery: Most people can do most things at the end of the first week. Upper body exercise is disallowed for 6 weeks and strenuous exercise for 3 months. Avoid swimming in a pool or beach for 2 weeks.
  • Results: This depends on individual cases and what the reason was for removal of the implants, and if a simultaneous breast lift has been performed. In general, our patients who have decided to remove unsatisfactory implants, never regret their decision. It is important to remember the results vary from patient to patient, and depends on previous surgery and scarring, and degree of complexity of surgery.

Cosmetic Concerns

  • Older generation implants had more liquid silicone which could leak and form cysts in the breasts.
  • Dr Aggarwal will generally advise you to obtain imaging to see if this is the case
  • In general you will require removal of the implant and its capsule.
  • It may then be possible to insert new implants if you desire, or alternatively undergo a breast lift, and avoid the need for implants.
  • This is called capsular contracture
  • The treatment involves removal of the implants and the surrounding capsule
  • New implants are then inserted if you desire. It is thought that capsular contracture occurs due to a low grade contamination of the implant during insertion and we undertake several steps to prevent contamination of implants we insert (read our 14 point plan).
  • However in some patients recurrent capsules form despite best efforts and if you have had several revisions before without success it may be best to remove the implants altogether.
  • If implants are too close together there can be a loss of gap between the two breasts – this is called symmastia.
  • This is due to over dissection in a previous implant insertion in an effort to give a patient cleavage
  • It can be a very difficult problem to fix – it may be reasonable to remove the implants and allow tissues to heal.
  • It can be possible to re-insert implants at a later date.
  • If implants are painful this could be because they have gone hard, or because scarring or previous dissection near sensory nerves.
  • Removal of implants is often requested for this reason.
  • It is important to remember that removing the implants may not settle the pain although we find that many of these symptoms improve after removal.
  • Some patients report systemic symptoms that are non specific such as general fatigue, flu-like symptoms, and other ailments.
  • In the 1990s implants were banned for this reason in the USA although no evidence existed that there was an association between implants and systemic illnesses. The ban was then lifted in the early 2000.
  • There is still no evidence that there is an association between these illnesses and implants.
  • However in patients who report these, often choose to remove foreign objects from their bodies – we suggest that you think long and hard before making decisions to remove existing implants for this reason.

Procedure Information

The procedure is always performed under general anaesthesia given by an accredited anaesthetist in a fully accredited and licensed facility (usually one of the North Shore’s premier private hospitals). The procedure takes can take two to three hours and sometimes longer depending on the degree of complexity of surgery. Most patients will be tend to stay overnight, and some longer depending on the use of drains.

  • Before any surgery on your breast Dr Aggarwal will refer you for a mammogram and ultrasound to ensure the breast is clear of any pathology, and to check the integrity of the existing implant.
  • Generally it is possible to use the previous incision made for surgery
  • If however a transaxillary (arm-pit), periareolar (around the nipple) or transumbilical (belly button) incision was made to insert your implant, we will generally suggest that surgery is performed via a new small inconspicuous incision in the fold of the breast.

  • This inframammary incision allows the best access to remove the old implant, and to perform a capsulectomy (removal of the capsule)
  • The breast implant and capsule is removed en bloc
  • If the implant is placed in a subglandular (just below the breast and above the muscle), removal of the entire capsule is generally possible
  • If the implant is in a submuscular plane (below the muscle) it may not be possible to remove the capsule behind the implant as this is attached to the ribs and intercostal muscles (muscles between the ribs). Attempts at removal of this posterior layer of capsule can be painful and risk entering inside the chest and causing a pneumothorax.
  • It is common for patients to have additional procedures such as a breast lift or fat grafting or both at the time of implant removal
  • This is because the removal of implants will reduce the breast size and possible result in ptosis (drooping). This can be quite dramatic as the breast implants can thin out the normal breast tissue over time.
  • Dr Aggarwal will place waterproof dressings over the incisions.
  • You will usually have drains in place as the empty space created by the removal of implants will fill with fluid, further exacerbated by removal of capsule.
  • You will also be placed in a surgical bra that you must wear for the first 6 weeks. This helps to reduce swelling, pain and discomfort as well as controlling the position of the implants in the early post-operative period as the area heals.
  • You will be able to get the area wet after the drains are out, or when instructed by Dr Aggarwal. You will need to go back into the surgical bra after your shower. You will not be allowed to swim in a pool or beach for at least 2 weeks after surgery or when all drains are out (whichever is later).
  • You will be given a script for antibiotics by Dr Aggarwal which you must continue until the box runs out. You may be maintained on oral antibiotics as long as the drains stay in.
  • You will also be given pain relief medications.
  • You may elect to stay in hospital for a few nights to allow you to recover.
  • You should not drive for at least 1 week.
  • While most sedentary activities can be resumed in the first week, you must not do any exercise for the first few days after surgery that could raise your blood pressure. You will also not be allowed to do any heavy lifting or upper body exercises for the first 6 weeks.
  • Dr Aggarwal will see you a week after your procedure to inspect how the wound is healing. You will be given instructions how to look after the wound as it continues to heal. You will be able to ask questions about what you can and cannot do. Generally we will see you at 1 week, 3 weeks, 6 weeks, 3 month, 6 months and 1 year post surgery.

Risks & Complications

Every surgery carries risks, and therefore one must consider if risks outweigh the benefits for your own personal situation. If they do then the surgery may be well worth it. Dr Aggarwal will discuss the pros and cons of surgery with you during your consultation.

  • Risks of anaesthetic – there are general risks of going under an anaesthetic such as a mild stress on the heart and lungs, risk of reaction to anaesthetic drugs and risk of blotting in the legs. These risks are generally low in patients who are otherwise fit and healthy.
  • Bleeding (1-2%) – any bleeding is controlled during surgery however unexpected bleeding can occur in the immediate postoperative period. If this occurs it will necessitate a return to theatre to control the bleeding.
  • Infection (<1%) – this is extremely rare. However you are given antibiotics during induction (when you are going to sleep), as well as a course of oral antibiotics after your surgery to keep this risk to a minimum.
  • Seroma (5-10%) – The empty space created by removal of implants can fill with fluid. Furthermore removal of capsule is recognised by the body as a reasonable injury and further fluid enters the operated space. Therefore drains are placed at the time of surgery which stay in until minimal fluid is draining. You will also be required to wear a compressive surgical bra and reduce physical activity to minimise this risk.
  • Atrophy of tissues/Breast ptosis/poor breast shape – a foreign object like silicone pushing against the normal breast causes it to thin. The bigger and heavier the implant that has been there the greater the degree to which this will occur. Once the implant is removed it can leave a loose soft tissue envelope and looseness, and drooping of the breast that may require a breast lift to correct the deformity.
  • Change in nipple sensation – this can occur if a concurrent procedure such as breast lift is performed. See our section on breast lift for a full list of potential issues.

Procedure FAQs

  • It is advisable to obtain a referral for breast implant revision as it is possible to claim a Medicare rebate of approximately $73 for the consultation if you have a referral
  • It is also possible that a Medicare/Health Fund rebate may apply to you depending on what procedure you need, and having a referral allows you to claim this reducing out of pocket costs substantially.
  • You can see us at our main practice at Gordon, or at our other locations at Hornsby, Hunters Hill or Camperdown.
  • Please scroll to the bottom of the page to find out more information about these locations.
  • Any of the hospitals where Dr Aggarwal works – i.e. Sydney Adventist Hospital, SAN Day Surgery, Hunters Hill Private or Castlecrag Private hospitals
  • Stop smoking at least 2 weeks before surgery
  • Cease fish oil, and other supplements such as Ginkgo, Ginseng.
  • Please discuss with Dr Aggarwal if you are on blood thinning medications as to when you should stop and recommence those.
  • Yes you may be required to wear a compressive bra or binder for a total of 6 weeks.
  • You should not wear any bras with an underwire during this period
  • You should not do any exercise that raises your blood pressure for at least 72 hours after surgery to avoid the risk of an unexpected bleed
  • Heavy upper body exercise that activates the pectoralis major muscle should be avoided for 6 weeks
  • Dr Aggarwal will provide you with the necessary scripts for antibiotics and pain relief.
  • Antibiotics need to be continued as long as any drains are in place to reduce the risk of infection.
  • This depends on the breast shape. You may wish to have a breast lift and/or fat grafting at the time of implant removal or down the track to improve breast shape.
  • It is safe to undertake air travel after having implants
  • However we always encourage patients not to be away overseas shortly after having a procedure, so that we can closely follow your recovery and address any concerns that may arise.
  • You may swim in a pool or beach after 2 weeks or when the drains are out (whichever is later).
  • You should not drive for 24-48 hours after an anaesthetic, but after this it should be relatively safe.
  • No
  • All our breast implant removals are performed under general anaesthesia given by an accredited anaesthetist
  • The surgery is performed in an accredited private hospital
  • It is usually a procedure that involves staying in hospital at least overnight or longer due to the drains that are placed at time of surgery.
  • Not usually unless breast lift or reduction has been performed at the same time.
  • Your capacity to breast feed should be the same as when you had the implants in place.
  • However even in the normal population (women who do not have breast implants) up to a third of women cannot breast feed at all, and a third require additional supplementation for their infant.
  • Yes
  • It is important for you to participate in regular screening as you would have otherwise done for breast cancer based on your age and family history.
  • There is no association between breast implants and breast cancer
  • Patients should still however continue their regular screening for breast cancer based on their age and family history. In Australia it is recommended for women who reach the age of 50 to undergo 2nd yearly mammography for breast cancer screening in the absence of other significant family history – if you have a strong family history you may be required to start breast cancer screening earlier
  • Implants more recently have been associated with a rare lymphoma called ALCL. The risk is extremely low and currently we do not recommend removing implants for this small risk. Affected women present with a delayed seroma many years after insertion of implants. Women with no issues with their implants do not have ALCL. Millions of women around the world have implants, and we continue to use them for cosmetic and reconstructive breast surgery. You are welcome to consult us if you are concerned about this.

Procedure Pricing

  • The out of pocket costs are approximately $4500 to $5000 for breast implant removal. This is for:
    • fully insured patients with appropriate health insurance cover, and
    • for whom a Medicare item number applies to the surgery (45551)
  • Patients who are not insured or for whom a Medicare item number does not apply: total cost can be around $9000 to $9500
  • All the above costs include:
    • Surgical fees
    • Anaesthetist fees
    • Hospital and theatre fees
    • Follow up
  • Please note that the above price does not include
    • Preoperative consultation fees – which are $280 for the initial consult and $140 for additional preoperative consultations
    • Breast lift (mastopexy) or fat grafting if requested at the time of surgery. Total out of pocket cost for implant removal and breast lift vary from $7000-8000 (this can increase to $12000 – 13000 in the absence of insurance or Medicare item number coverage).

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Meet Dr Aggarwal

Dr Aggarwal is a well regarded, respected, highly skilled and experienced Specialist Plastic Surgeon. Graduating at the top of his class throughout his training, Dr Aggarwal has completed fellowship training at some of the world’s most prestigious reconstructive and cosmetic plastic surgery institutions. He continues to publish research is prestigious plastic surgery journals, and is actively involved in the training of future plastic surgeons.

What sets Dr Aggarwal apart from others is his personal, affable and warm nature. Not only does he pay attention to detail, to producing natural, beautiful results but he ensures that the patient’s journey is just as special as their outcome. Dr Aggarwal looks after patients at two of Sydney’s most prestigious public hospital campuses (RPA and POWH/RHW), and operates privately on the North Shore.

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Why Choose Us

Highly Skilled

Highly skilled Fellowship Trained Plastic surgeon – know you are in the safest of hands with a Plastic Surgeon who is experienced, highly respected, and appointed at premier Sydney hospitals- including the SAN, RPA, POWH and RHW.

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If sedation or general anaesthetic is required, it is delivered by an accredited anaesthetist

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Have your surgery at premier, accredited Sydney private hospitals

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We make you our top priority. Need to ask a question, worried about dressings or something else post op? We will always be at your beck and call.

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Latest News

New Consulting Locations

In addition to our Hornsby and Camperdown locations, in 2018 we bring you:

  • Hunters Hill (Lower North Shore) – conventiently located near one of Dr Aggarwal’s operative locations at Hunters Hill Private Hospital, Hunters Hill offers the convenience of accessing Dr Aggarwal in the lower north shore.
  • Gordon (North Shore) – set to be our primary practice, our flagship rooms will be open for trading in August 2018. Follow our blog to see an update on progress.
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Consulting Locations

Gordon (Flagship)

Suite 13, Level 3, 924 Pacific Highway, Gordon NSW 2072

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Hornsby

85 Burdett St, Hornsby NSW 2077

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Camperdown

Level 2, Clinic D, Chris O’Brien Lifehouse, Camperdown NSW 2050

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Hunters Hill

Level 1, 6 Ryde Road, Hunters Hill NSW 2110

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Phone:

1300 80 9000

info@modeplasticsurgery.com.au

Suite 13, 924 Pacific Highway
Gordon NSW 2072, Australia

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