Why Explant Surgery Is On the Rise

The term “explant surgery” comes up frequently for women researching their breast augmentation revision options. Simply put, it refers to the removal of breast implants, sometimes with replacement or sometimes without.

As a female board-certified plastic surgeon, my goal with breast augmentation is always to create results that my patients will love for many years. But life changes, bodies change, and preferences change. Increasingly, women are choosing to remove or exchange their implants—and it’s not always because something has gone wrong.

In this blog post, I want to discuss why women may choose to have their implants removed or exchanged and how you can decide if this procedure is right for you.

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Why Women Choose Explant Surgery

The decision to remove breast implants is highly personal, and every woman’s reasons are unique. Some of the most common include:

• Lifestyle Changes: Becoming more active—running, strength training, or even taking up high-impact sports—can make larger implants feel uncomfortable or less practical. Others find their implants no longer match a leaner, more athletic body type.
• Aging and Skin Changes: Time naturally changes the skin and soft tissue. As we age, breasts can sag or lose volume, and implants may not sit the way they once did.
• Weight Fluctuations and Pregnancy: Gaining or losing weight or going through pregnancy can change your proportions and symmetry. What felt balanced before may now look out of place.
• Shifting Aesthetic Preferences: The full, round look popular a decade or two ago has given way to more natural, subtle results. Some women opt for smaller implants, while others choose no implants at all.
• Medical or Structural Concerns: Complications such as capsular contracture, implant rupture, or discomfort sometimes make removal the best option.

What Happens During Implant Removal

At my practice, I most often use the en bloc resection technique, which removes the implant and its surrounding capsule together. This can provide a more complete removal and may be preferred if there are concerns about rupture or scar tissue.

• Incisions: Often placed in the same location as your original augmentation scars.
• Anesthesia: Usually performed under general anesthesia. For some saline implants, we may deflate them under local anesthesia before removal.
• Breast Lift Option: Many women combine explant surgery with a breast lift (typically with fat transfer) to address stretched or sagging skin and restore a more youthful contour. Alternatively, we can combine this procedure with a nonsurgical injection of volumizing filler, such as Renuva®.

Recovery is usually straightforward: most women rest for a few days and return to their routine activities within about 2 weeks.

When To Consider Explant Surgery

There’s no one “right time” to remove or replace implants—some women choose it within a year of their original surgery, others 10 to 15 years later. The best time is when it aligns with your goals and lifestyle. Here are some questions to ask yourself:

• Have I seen my final results? Healing takes time. Implants often settle over 6 months, so wait until swelling and “drop and fluff” are complete before deciding.
• Are my implants affecting my daily life? Consider your comfort during exercise, work, travel, and when making wardrobe choices.
• Would I feel more confident with a smaller size or no implants at all? Your body and style evolve; your implants can, too.

Explants Are Not Always the End

Explant surgery doesn’t always mean “going flat.” Many women choose to:

• Exchange your implants for smaller or more natural options (such as cohesive silicone gel).
• Combine removal with fat grafting for subtle volume using their own tissue.
• Focus on lifting and reshaping the breast for a naturally youthful look.

Your Next Step

If you’re thinking about making a change, the best option is to work with a trusted board-certified plastic surgeon experienced in revision and explant surgery. Together, we’ll discuss your goals, evaluate your options, and create a plan that fits your lifestyle and vision.

Ready to explore your options? Request a consultation online or call our office at (713) 571-0600 to get started.

This post was originally published in 2019 and has been updated for 2025.