While breast augmentation remains the most popular cosmetic surgery in Canada and the U.S., more and more women are also opting to have their breast implants removed. For instance, in 2018 in the U.S., over 29,000 women has their implants removed, a sizeable increase from the 20,967 a decade earlier (Canada doesn’t release those statistics).
Dr. Ryan Frank performs implant removal surgery at his Calgary practice.
Why is implant removal suddenly in the news?
There is definitely a lot of buzz about implant removal. Much of it stems from the May 2019 announcement by Health Canada that it was banning sales of textured breast implants from Allergan. The U.S. FDA followed suit in July. These textured implants, under the brand name Biocell, have been linked to a very rare form of cancer: anaplastic large-cell lymphoma. In the announcement, the FDA called the cancer “breast implant-associated anaplastic large-cell lymphoma” (BIA-ALCL).
The occurrences of this lymphoma are exceedingly low — of the 40 million women who have had implants only between 300 to 500 have been diagnosed with genuine cases of anaplastic large cell lymphoma — but the news has brought implant removal to the forefront of the public consciousness.
The common reasons a woman would want to have her implants removed
There are different reasons a woman may opt for implant removal:
- Capsular contracture is the main reason. Capsular contracture is the process of excessive scar tissue forming around the implants causing tightness and pain in the chest. The implants are removed through revision surgery, along with most of the excess scar tissue. Most women opt to have new implants placed, however.
- Other women don’t feel they need implants any longer, whether they’ve reached older age (over 55 years of age, for instance), of whether they’ve come to accept their body without larger breasts. As they reach old age, they’d rather do so without an augmented chest.
- Other women are reporting symptoms that have been given the term “breast implant illness.” Although there isn’t any research to specifically link implants to health outcomes, patients anecdotally report these symptoms: fatigue, memory loss, headaches, joint and muscle pain, hair loss, recurring infections, and swollen lymph nodes. At this point, breast implant illness hasn’t been confirmed through research, but some women are worried about the potential and want their implants removed.
- There has been confirmation of BIA-ALCL, as discussed above. The incidence has been quite low, but it has led Health Canada to require Allergan to remove all textured Biocell implants from the market permanently. Health Canada has not, however, recommended that women with these implants have them removed.
“Dr. Frank and his staff were amazing from consultation to procedure. I had my procedure two days ago and zero discomfort, no pain and no bruising. I highly recommend him and his team!” – S.G.
How small can I go with a breast reduction?
The amount you choose to decrease your breast size is, of course, wholly up to you. If your large breasts have been out of proportion with the rest of your figure, it’s tempting to want to make a drastic decrease. But you will still want to keep your breasts in proportion with your figure. You want to decrease their burden, weight, and impact on your life, but you don’t want to regret going too far at a later date.
The best idea is to discuss with Dr. Frank the amount of decrease in cup size the two of you feel will downsize your breasts and bring them into proportion with the rest of your body. In breast reduction surgeries, most patients choose to reduce their breasts from one to two cup sizes.
How to prepare for breast reduction surgery in Calgary, Canada
Breast reduction surgery with Dr. Frank is major surgery, so you’ll need to prepare as you would for any surgery. You’ll stop taking any blood thinners, anti-inflammatory medications, aspirin, and most supplements for two weeks before your surgery. This is to eliminate the risk of excessive bleeding and bruising caused by these medications. If you smoke, you’ll need to stop AT LEAST six weeks before and six weeks after your surgery, as smoking impedes circulation and that greatly impacts healing.
You’ll need to take at least one week off work, better yet two. So, you need to make those preparations.
You won’t be able to lift anything more than a gallon of milk for a couple weeks. You also won’t be able to reach upward for that time. So, if you need to lighten the amounts that you use and lift regularly do so. Also bring things down from shelves so that you can easily grab them without reaching up.
Prepare your recovery nest. It’s important to really rest after reduction surgery, as Dr. Frank excises a fair amount of tissue and repositions remaining tissue, so there is a good amount of tissue trauma. By laying low, you make it easy for your body to start the healing process. We still want you up and walking around to help with circulation, but take it easy. Make your nest ultimately comfortable with lots of pillows and blankets. You’ll need to sleep mostly on your back, so pillows can help you stay in place.
How long do most breast reduction surgeries take?
Breast reduction surgery is performed with the patient under general anesthesia and takes from two to three hours. The variation in time depends upon the amount of tissue removed and the incision options Dr. Frank uses.
How breast implant removal is performed
These are not difficult surgeries. Dr. Frank enters through the original incisions used to place the implants. He then removes the implants. If you have any signs of capsular contracture, where scar tissue continues to build around the implant, the hardened capsule of scar tissue will also be removed. If the scar tissue is still soft, it will likely be left in place.
How will my breasts look after having my implants removed?
Once your implants are removed your breasts will not simply return to how they appeared prior to augmentation. This is because the weight of the implants will have stretched your skin and support tissues. Changes usually also occur in the rib area. It’s highly likely your breasts will be sagging and flattened. They may be uneven.
Will I need a breast lift after having my implants removed?
For the reasons mentioned above, Dr. Frank typically recommends a breast lift for patients having their implants removed. This is because with a breast lift, Dr. Frank is able to remove the loose hanging skin, reposition the remaining breast tissue, and likely relocate the nipple/areola complex.
The goal with a breast lift is to return the breasts to a higher position on the chest, which will be important for you to be satisfied with the appearance of your breasts after removing your implants. As mentioned, without a lift, it’s likely your breasts will be quite flat and saggy without the implants. This is especially true the longer you have had implants, and with larger implant sizes.
Are there risks involved in breast implant removal?
Because Dr. Frank can enter through your original incisions to remove your implants, simply removing them doesn’t involve much risk. Yes, it is surgery, so there are the usual risks of infection, excessive bleeding, and such. Also, there may be slightly more risk if he needs to remove the capsule of scar tissue.
The real risks are that your breasts will not look the way you’d like after the implants are removed. That’s why Dr Frank recommends a breast lift with implant removal procedures.
“Professional, accommodating and an excellent bedside manner. Nothing but good things to say from my experience” –R.S.
What will my scarring be like from breast reduction surgery?
Due to the need to remove both excess glandular tissue and excess skin, the incisions necessary for breast reduction are extensive. In most cases, to gain the access necessary Dr. Frank uses the anchor incision described above. This incision circles the areola, drops down to the breast crease, and usually moves outward in both directions along that crease. As with any surgical incision, this will leave a scar. The scars will lighten over time, but they will always be there.
Again, when weighing the value of smaller, more manageable breasts against having some scarring, our reduction patients are happy to make that tradeoff.
How painful is recovery from breast reduction?
More than acute pain, recovery involves more soreness. This can last for 2 to 3 weeks. You’ll feel weak for a few days. You may also have a feeling of pulling and stretching in your breasts because of the firmer, tighter contour created by Dr. Frank through the removal of excess skin and fatty tissue. You’ll need your pain medication for a week, but after the first couple days of your recovery you’ll feel better every day. Our patients from Calgary and the surrounding areas feel the freedom they achieve with their breast reduction is well worth a little pain with their initial recovery.
What you need to avoid after having your breast reduction surgery
While not necessarily something to avoid, the most important part of your recovery is to take care to keep all stress off your incisions. This involves wearing a surgical bra, then transitioning to a full support bra, and then to a strong sports bra at all times for at least 6 weeks after your surgery. Dr. Frank will stress the importance of this during your consultation. If you keep all stress off your incisions, they can heal more quickly and will be thinner than if you choose to sleep without your bra, for instance. Yes, it’s a little bit of an inconvenience, but being diligent with your support bra will benefit you in the end.
Otherwise, you need to keep all sun exposure off your incisions. Any sun exposure can cause the incisions to darken and have hyperpigmentation.
You’ll also need to avoid any strenuous exercise or activity, especially anything that causes your breasts to bounce, for six weeks.
When can I resume exercise after having breast implant removal?
Your recovery and return to exercise timelines depend if you simply had Dr. Frank remove your implants and close the incisions, or whether you also had him perform a breast lift to remove sagging skin. Since most patients have a lift, you will be able to return to most types of exercise in a month or so. This won’t include heavy lifting, however. You’ll need to wait around six weeks to resume heavy lifting.
How should I sleep after having implant removal surgery?
You cannot sleep on your stomach for the complete duration of your recovery, from 4-6 weeks. You can sleep on your side, your back, or sitting up. You’ll need to strategically place pillows to ensure you don’t roll onto your front side. If you’ve only had your implants removed without a lift, this timeframe will be shorter. Dr. Frank will discuss this with you when he removes your sutures and checks on your recovery progress.