Breast Implant Removal (Explant Surgery) on the Gold Coast and in Toowoomba
Breast Implant Removal (Explant)
Breast implant removal, also called explant surgery, takes out one or both breast implants and, where needed, some or all of the scar tissue capsule around them. A/Prof Mark Magnusson is a Specialist Plastic Surgeon (FRACS) who performs breast implant removal from his consulting rooms in Southport on the Gold Coast and in East Toowoomba. The right approach depends on why you want your implants removed, the condition of the capsule, and how you would like your breasts to look afterwards.
Some women remove their implants because of a problem such as rupture or capsular contracture. Others simply no longer want them. Either way, a consultation is the place to talk through your options, including removal alone, removal with a capsulectomy, removal with a breast lift, or replacement with new implants.
A referral from your GP or another specialist is required before your consultation.
What is breast implant removal?
Breast implant removal is an operation under general anaesthetic to take out breast implants without necessarily replacing them. It is usually performed through the original incision, often the fold under the breast. The surgery can be as simple as removing the implant and leaving a thin, healthy capsule in place, or it can involve removing the entire capsule, sometimes with the implant still inside it.
If you would like to keep some breast volume or improve breast shape, removal can be combined with a breast lift or fat transfer, or the implants can be exchanged. Implant exchange is covered on the breast implant replacement page, and correction of problems such as malposition or rippling is covered on the breast revision page.
Reasons women consider breast implant removal
- Capsular contracture: the scar tissue capsule tightens, making the breast firm, misshapen or painful.
- Implant rupture: a suspected or confirmed rupture, often found on ultrasound or MRI.
- Changes in the breast over time: pregnancy, breastfeeding, weight change or ageing can change how the implants sit and look.
- Size or lifestyle: some women find their implants are larger than they now want, or would rather not have implants at all.
- Symptoms they attribute to their implants: sometimes described as breast implant illness (see below).
- BIA-ALCL: breast implant associated anaplastic large cell lymphoma is rare, and when it is diagnosed the implant and capsule are removed.
- Implant age: implants are not lifetime devices, and some women choose to remove rather than replace them when they need attention.
Your options for breast implant removal
A/Prof Magnusson will recommend an approach based on your examination, imaging and goals. The main options are:
- Implant removal only (explant): the implant is removed and a thin, soft capsule is left in place, where it usually softens and is absorbed over time. This generally has the shortest operation and recovery.
- Partial capsulectomy: part of the capsule is removed, for example where it is thickened or calcified in one area.
- Total capsulectomy: the implant and the whole capsule are removed. The capsule may come out in more than one piece, which is acceptable surgically. It is a longer operation with more swelling than removal alone.
- En bloc capsulectomy: the implant and the entire capsule are removed as one intact specimen without opening the capsule. It is usually recommended for confirmed or suspected silicone rupture and for BIA-ALCL. It needs a longer incision and is not always possible when the capsule is very thin or firmly attached to the ribs, in which case a total capsulectomy is completed instead.
- Removal with a breast lift: after removal the skin and breast tissue may sag or look deflated. A breast lift (mastopexy) can be done at the same operation or as a second stage, usually 6 to 12 months later.
- Removal with fat transfer: fat taken by liposuction from another area can restore some volume. It adds volume but does not tighten loose skin, and not everyone is a suitable candidate.
For a detailed comparison of these techniques, read en bloc, total capsulectomy or simple removal and breast implant removal with or without a breast lift.
Breast implant illness and explant surgery
Breast implant illness (BII) is a term women use to describe symptoms they attribute to their implants, such as fatigue, difficulty concentrating, joint pain, dry eyes and skin rashes. BII is not currently a formal medical diagnosis, and there is no single test that confirms it. Australian specialist plastic surgery societies have acknowledged BII as a patient concern that warrants careful assessment and further research.
Outcomes after removal are mixed. Some women report that their symptoms improve, some notice little change, and it is not possible to predict in advance who will improve. A/Prof Magnusson has published on breast implant illness in Plastic and Reconstructive Surgery, and at your consultation he will take a full history, examine you, review any imaging and discuss what removal can and cannot be expected to do. Where symptoms suggest another condition, he may recommend assessment by your GP or another specialist.
BIA-ALCL and breast implant removal
BIA-ALCL is a rare cancer of the immune system that forms in the fluid and scar tissue around a breast implant. It is not breast cancer. Its most common sign is swelling of one breast from fluid around the implant, usually years after the implant was inserted. The risk is linked to textured implants, and the TGA reports no confirmed Australian cases with smooth implants.
When BIA-ALCL is diagnosed, treatment usually involves removing the implant and the whole capsule, and care is coordinated with other specialists. For women without symptoms, the TGA advises that removing implants is not recommended to prevent BIA-ALCL. If you are worried about the type of implants you have, the Breast Implant Health Check Clinic can review your implant details and any imaging before you decide on next steps. More information is on the ALCL information page.
Before your surgery
- Referral: a referral from your GP or another specialist is required.
- Consultation: A/Prof Magnusson will review your history, your original surgery and implant details where available, and your goals, and examine you.
- Imaging: an ultrasound or MRI may be arranged to check for rupture, fluid or other changes.
- Planning: you will discuss which technique suits you, whether a lift or fat transfer should be considered, which hospital your surgery will be performed at, and your expected recovery.
- Forms: patients complete the pre-explant form before surgery and the post-explant form afterwards.
- Second opinion: you are encouraged to take time to consider your decision and to seek a second opinion if you wish.
The operation and where it is performed
Breast implant removal is performed under general anaesthetic. A simple explant is often a day procedure, while a capsulectomy or combined lift may need a longer operation and sometimes an overnight stay. Removed capsule tissue is sent for histopathology, and implant details are recorded with the Australian Breast Device Registry where applicable.
On the Gold Coast, A/Prof Magnusson operates at Pindara Private Hospital in Benowa, Pacific Private Day Hospital in Southport and Gold Coast Private Hospital in Southport. In Toowoomba, surgery is performed at St Andrew’s Toowoomba Hospital or St Vincent’s Private Hospital Toowoomba. The hospital is chosen according to the complexity of your procedure, whether you need to stay overnight, and your private health cover.
Recovery after breast implant removal
- First week: expect soreness, swelling and tightness. Most women manage with simple pain relief and return to light activities within about a week after a simple explant.
- Time off work: most women need about one to two weeks, depending on their job and the extent of surgery.
- Exercise: strenuous exercise and heavy lifting are usually avoided for about six weeks, and longer after a capsulectomy or combined lift.
- Support garment: a compression garment or supportive bra is worn during the early recovery period.
- Final shape: the breasts continue to change as swelling settles and the skin retracts. Full settling can take 6 to 12 months, which is also the usual wait before a staged lift.
Recovery varies between individuals, and A/Prof Magnusson will give you specific instructions for your procedure.
Risks of breast implant removal
All surgery carries risks. Risks of breast implant removal include bleeding or haematoma, infection, fluid collection (seroma), changes in nipple or skin sensation, asymmetry, contour irregularities, loose or deflated-looking skin, scarring, and the risks of anaesthesia. Removing a capsule that is firmly attached to the chest wall carries additional risks, which will be discussed if this applies to you. Symptoms that you attribute to your implants may not improve after removal.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
Medicare and the cost of breast implant removal
The cost of breast implant removal depends on the technique, whether a lift or fat transfer is included, the hospital, and the anaesthetist’s fees, which are charged separately. You will receive a written quote once your surgical plan is finalised. A simple explant generally costs less than an en bloc capsulectomy or removal combined with a lift.
Medicare rebates may apply where removal is medically indicated, such as for a confirmed rupture, symptomatic capsular contracture or BIA-ALCL, and the criteria on the Medicare Benefits Schedule are met. Relevant items include:
- MBS item 45548: breast prosthesis, removal of, as an independent procedure.
- MBS item 45551: breast prosthesis, removal of, with excision of at least half of the fibrous capsule, not with insertion of any prosthesis. The removed tissue must be sent for histopathology.
Removal for purely cosmetic reasons does not attract a Medicare rebate. Item numbers and eligibility criteria change from time to time and will be confirmed at your consultation. Private health insurance may contribute to hospital and anaesthetic costs depending on your level of cover and waiting periods.
Why choose A/Prof Magnusson for breast implant removal on the Gold Coast & Toowoomba
- Specialist Plastic Surgeon: Fellow of the Royal Australasian College of Surgeons (FRACS), practising as a specialist plastic surgeon since 2000. AHPRA registration MED0001382689.
- Published research on breast implants: lead author of research on the epidemiology of BIA-ALCL in Australia and New Zealand and on breast implant illness, both published in Plastic and Reconstructive Surgery in 2019.
- Breast implant regulation: has served on Therapeutic Goods Administration expert groups on breast implants.
- Academic appointment: Associate Professor, Griffith University.
- Two locations: consulting rooms in Southport on the Gold Coast and in East Toowoomba, with surgery at accredited private hospitals in both regions.
- Breast Implant Health Check Clinic: an assessment service for women who want their implants reviewed before deciding on removal, replacement or monitoring.
Book a consultation for breast implant removal
To discuss breast implant removal with A/Prof Mark Magnusson, ask your GP for a referral and call 1300 662 960 or book online.
Gold Coast: Suite 6, Level 5, 123 Nerang Street, Southport QLD 4215
Toowoomba: 8 Margaret Street, East Toowoomba QLD 4350
Frequently asked questions
Do I need a referral for breast implant removal?
Yes. A referral from your GP or another specialist is required before your consultation. A referral also helps your GP stay involved in your care and is needed for any Medicare rebate.
Do I have to remove the capsule when my implants come out?
Not always. A thin, soft capsule without contracture, rupture or other concerns can often be left in place, where it usually softens and is absorbed. A total or en bloc capsulectomy is usually recommended for capsular contracture, silicone rupture or BIA-ALCL, and is often requested by women concerned about breast implant illness.
What is the difference between en bloc and total capsulectomy?
Both remove the whole capsule, but en bloc removes the implant and capsule together as one intact specimen. In a total capsulectomy the capsule may be removed in more than one piece. En bloc removal needs a longer incision and is not always technically possible, in which case a total capsulectomy is performed.
Will my breasts sag after implant removal?
Some change in shape is expected, and how much depends on your implant size, how long you have had them, your skin quality and your natural breast tissue. Some women are happy with their shape after removal alone. Others choose a breast lift, either at the same time or 6 to 12 months later, or fat transfer to restore some volume.
Will removing my implants cure breast implant illness?
This cannot be predicted. Some women report an improvement in their symptoms after removal, while others notice little change. A/Prof Magnusson will discuss your symptoms, history and examination findings, and what removal can reasonably be expected to achieve, before you decide.
Should I remove my implants because of BIA-ALCL?
If you have no symptoms, the TGA does not recommend removing implants to prevent BIA-ALCL. If you notice new swelling, a lump or a change in one breast, see your GP or contact the rooms for assessment. The Breast Implant Health Check Clinic can review your implant type and any imaging.
Does Medicare cover breast implant removal?
Medicare may contribute where removal is medically indicated and MBS criteria are met, for example for a confirmed rupture, symptomatic capsular contracture or BIA-ALCL. Relevant items include 45548 and 45551. Removal for cosmetic reasons alone does not attract a rebate, and eligibility is confirmed at your consultation.
How long is the recovery after explant surgery?
Most women take about one to two weeks off work and avoid strenuous exercise for about six weeks. Recovery is usually quicker after a simple explant and longer after a capsulectomy or combined breast lift. Your breasts will keep changing shape for 6 to 12 months.
Can I have my implants removed and replaced at the same time?
Yes, removal and replacement can be done in one operation. Options for implant exchange are explained on the breast implant replacement page, and A/Prof Magnusson will discuss whether replacement, removal alone or removal with a lift suits you best.
Where is breast implant removal surgery performed?
On the Gold Coast, surgery is performed at Pindara Private Hospital in Benowa, Pacific Private Day Hospital in Southport or Gold Coast Private Hospital in Southport. In Toowoomba, surgery is performed at St Andrew’s Toowoomba Hospital or St Vincent’s Private Hospital Toowoomba.
Further reading
- En bloc, total capsulectomy or simple removal: which is right for you?
- Breast implant removal with or without a breast lift
- Explant surgery: what you need to know about breast implant removal
- Breast implant removal surgery basics
- What is capsular contracture and can breast revision surgery fix it?
- Breast implant removal webinars
Medical references
- Therapeutic Goods Administration. Breast implant associated cancer (BIA-ALCL): consumer information. https://www.tga.gov.au/products/medical-devices/breast-implant-hub/breast-implant-associated-cancer-consumer-information
- Therapeutic Goods Administration. Breast implant illness. https://www.tga.gov.au/resources/explore-topic/breast-implant-hub/breast-implant-illness
- Magnusson M, Beath K, Cooter R, Locke M, Prince HM, Elder E, Deva AK. The epidemiology of breast implant-associated anaplastic large cell lymphoma in Australia and New Zealand confirms the highest risk for grade 4 surface breast implants. Plast Reconstr Surg. 2019;143(5):1285-1292. doi:10.1097/PRS.0000000000005500.
- Magnusson MR, Cooter RD, Rakhorst H, McGuire PA, Adams WP Jr, Deva AK. Breast implant illness: a way forward. Plast Reconstr Surg. 2019;143(3S):74S-81S.
- Australian Government Department of Health. Medicare Benefits Schedule items 45548 and 45551. https://privatehealth.gov.au/dynamic/MBSItems/BreastSurgery/45548 and https://privatehealth.gov.au/dynamic/MBSItems/BreastSurgery/45551
- Australasian Society of Aesthetic Plastic Surgeons. Specialist plastic surgeons aware and alert about breast implant illness. 6 March 2019. https://aestheticplasticsurgeons.org.au/2019/03/06/
- Australasian Society of Aesthetic Plastic Surgeons. Breast implant removal. https://aestheticplasticsurgeons.org.au/your-surgery/breast-surgeries/breast-implant-removal/
- Australian Breast Device Registry. Patient information. https://abdr.org.au/patients/