Dr. Karen Horton has either authored or reviewed and approved this content.
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Medically Reviewed by: Dr. Karen Horton, MD, MSc, FACS
If you’re considering breast implant removal in San Francisco, you’re not alone. Many women choose explantation surgery for various personal, medical, or aesthetic reasons. Dr. Karen Horton, a Board Certified Plastic Surgeon practicing in San Francisco, specializes in breast implant removal procedures, offering both traditional and innovative approaches to help patients achieve their desired outcomes safely and effectively.
Breast implant removal, also known as explantation surgery, is a surgical procedure designed to remove breast implants that were previously placed during breast augmentation or breast reconstruction. Whether you’re experiencing complications, lifestyle changes, or simply prefer a more natural appearance, explantation can help restore your confidence and comfort.
Dr. Karen Horton brings over 25 years of specialized experience in breast implant removal surgery to her San Francisco practice. She is internationally Board Certified in Plastic Surgery by both the American Board of Plastic Surgery and the Royal College of Surgeons of Canada—a rare dual certification that demonstrates her exceptional training and expertise.
Dr. Horton has successfully performed over 200 breast implant removal procedures since beginning her practice in San Francisco.
Patients considering breast implant removal can explore Dr. Horton’s detailed guidance in these related blog articles:
These posts share expert insights drawn from Dr. Horton’s extensive experience and are designed to help you make confident, informed decisions.
Breast implant removal involves the surgical extraction of saline or silicone breast implants from the breast pocket. The procedure can be performed as a standalone surgery or combined with other treatments such as breast lift (mastopexy) or implant replacement. While fat grafting is sometimes discussed as an option, Dr. Horton does not routinely recommend adding fat to a natural breast and explains why in her blog post on Fat Grafting to the Breasts. The complexity of the surgery depends on factors such as implant type, placement location, presence of scar tissue, and individual patient anatomy.
During the procedure, Dr. Horton makes an incision, typically using the existing scar from your original breast augmentation when possible. The implant is then carefully removed, and depending on your specific situation, the surrounding capsule (scar tissue) may also be addressed through capsulectomy techniques.
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Many women find that their preferences evolve over time. What felt right in their twenties or thirties may no longer align with their current lifestyle, career, or personal aesthetic goals.
"I realized my implants no longer reflected who I am today. I wanted to feel more like myself again, and Dr. Horton helped me achieve that natural look I was craving. The office-based procedure was so much easier than I expected, and I was back to work in just three days." - Sarah M., Age 42, Marketing Executive
„Capsular contracture occurs when the natural scar tissue that forms around the implant becomes thick and tight, potentially causing pain, distortion, or hardening of the breast. According to FDA data, capsular contracture affects approximately 10-15% of patients with breast implants over their lifetime.1
Saline implant deflation is immediately noticeable, as the breast will appear smaller and deflated. Silicone implant ruptures, however, may be “silent” and require imaging studies for detection. The American Society of Plastic Surgeons recommends regular monitoring of silicone implants with MRI or ultrasound.2
"When my saline implant deflated, I was initially upset, but it gave me the opportunity to see what my breast would look like naturally. Dr. Horton's gentle approach and expertise made the removal process smooth, and I'm thrilled with my natural results." - Jennifer L., Age 38
„Some women report experiencing a constellation of symptoms they attribute to their breast implants, collectively known as Breast Implant Illness (BII) or Systemic Symptoms related to Breast Implants (SSBI). While not officially recognized as an official medical diagnosis, symptoms may include a vague constellation of symptoms such as fatigue, joint pain, cognitive issues, and autoimmune-like symptoms.3 Research is ongoing to better understand these reported associations.
Read more about Systemic Symptoms Associated With Breast Implants (SSBI), in these articles:
Whether implants feel too large, too small, or simply don’t suit your current body proportions, size dissatisfaction is a valid reason for removal. Some patients choose to go completely natural, while others opt for different-sized implants during the same procedure.
Dr. Horton offers a unique approach for straightforward breast implant removal cases: office-based surgery under local anesthesia with an oral anti-anxiety medication and inhaled nitrous oxide. This innovative technique allows for:
"I was nervous about the procedure, but Dr. Horton's office-based approach was amazing. I was comfortable throughout, and the recovery was so much easier than I expected. I highly recommend this option for anyone considering explantation." - Maria R., Age 35
„For more complex cases or when combined with additional procedures, traditional explantation under general anesthesia may be recommended. This approach is typically used when:
Simple Capsulotomy
The capsule is opened internally but not removed, allowing it to naturally soften over time once the implant is removed. This approach is suitable for patients with minimal capsular thickening who require a larger pocket inside.
Partial Capsulectomy
Portions of the capsule are removed, particularly areas that are thick or problematic. This technique balances thorough treatment with minimal tissue disruption.
Total Capsulectomy
The entire capsule is removed, usually in several pieces, which may be recommended in cases of capsular contracture or when replacing older generation ruptured implants where the capsule may be thick and/or calcified. This approach ensures complete removal of all internal scar tissue to avoid future capsular contracture or deformity.
En Bloc Capsulectomy
Rarely required or recommended, en bloc capsulectomy involves removal of the implant and the entire surrounding capsule as one intact unit. According to The Aesthetic Society’s Consensus Statement on Breast Implant Capsulectomy Definitions, this technique involves removing the implant and capsule together without disrupting the capsule integrity.4 While this approach may be recommended in specific cases, it requires much longer incisions and extended recovery time. This procedure is reserved for invasive cancer cases.
Important Medical Consideration: The Aesthetic Society’s consensus statement emphasizes that while en bloc capsulectomy is sometimes requested by patients out of fear for BII/SSBI concerns, current medical literature does NOT establish this technique as superior to total capsulectomy for symptom resolution. Dr. Horton follows these evidence-based guidelines when discussing the most appropriate technique for your individual situation.
Recovery from office-based breast implant removal under local anesthesia typically involves:
For procedures performed under general anesthesia or with extensive capsulectomy:
Breast appearance after implant removal depends on several factors:
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Many patients choose to combine implant removal with a breast lift to address sagging or loose skin. This combination procedure can help achieve a more youthful, natural breast contour while removing implants. Dr. Horton performs the auto-augmentation mastopexy technique, where breast tissue is moved up higher on the chest into a pocket and reshaped internally, as is done for a breast augmentation – except the patient’s own breast tissue is used to fill the breast.
For patients desiring some volume restoration after implant removal, fat grafting using the patient’s own fat can provide natural-looking enhancement while maintaining a softer, more natural feel. However, Dr. Horton urges caution when considering fat grafting to the breast. Read her blog post about this topic.
Patients often use explantation as an opportunity to address other areas of concern through procedures such as:
Dr. Horton’s practice operates as a fee-for-service aesthetic practice and does not work with insurance companies. This allows for personalized care without insurance restrictions and ensures that treatment decisions are made solely between you and Dr. Horton based on your individual needs and goals.
Dr. Horton accepts a range of payment methods and offers convenient patient financing through CareCredit® and PatientFi™.
Benefits of Fee-for-Service Care:
While Dr. Horton’s practice does not bill insurance directly, many procedures may be eligible for payment using HSA or FSA funds. We recommend consulting with your HSA/FSA administrator to determine eligibility for your specific procedure.
"Dr. Horton's expertise and compassionate care made my explantation journey so much easier than I anticipated. Her office-based approach was perfect for my busy lifestyle, and the results exceeded my expectations. The transparent pricing and personalized care made the investment worthwhile." - Amanda K., Age 44, Attorney
„"After years of discomfort from capsular contracture, Dr. Horton's skillful removal gave me my life back. The detailed consultation process and her genuine concern for my wellbeing made all the difference. I appreciated the straightforward pricing without insurance complications." - Lisa T., Age 39, Teacher
„"I was worried about how my breasts would look after removal, but Dr. Horton's honest assessment and excellent surgical skills gave me beautiful, natural results. The fee-for-service model allowed for personalized care that exceeded my expectations." - Rachel M., Age 36, Registered Nurse
„How do I find the best breast implant removal Surgeon near me in San Francisco?
When selecting a surgeon for breast implant removal in San Francisco, look for:
Can I have breast implant removal performed in the office?
Yes, Dr. Horton offers office-based breast implant removal under local anesthesia for appropriate candidates. This innovative approach provides several advantages including reduced costs, faster recovery, and elimination of general anesthesia risks. During your consultation, Dr. Horton will evaluate whether you're a candidate for this approach.
Will my breasts return to their original size and shape?
Breast appearance after implant removal varies based on multiple factors including original breast size, implant duration, skin quality, and individual healing characteristics. While breasts often return closer to their pre-augmentation state, some changes in shape or position may occur. Dr. Horton will provide realistic expectations during your consultation based on your specific anatomy and/or other body changes you may have experienced since the time of your original breast augmentation surgery.
How long is the recovery from breast implant removal?
Recovery time depends on the surgical approach:
Why doesn't Dr. Horton work with insurance?
Dr. Horton operates a fee-for-service practice to provide personalized, high-quality care without insurance restrictions. This model ensures that insurance does not dictate your care, allowing for:
Can I use my HSA or FSA for breast implant removal?
Many breast implant removal procedures may be eligible for HSA or FSA payment, especially when performed for medical reasons such as implant complications. We recommend consulting with your HSA/FSA administrator to determine eligibility for your specific situation.
What are the risks of breast implant removal surgery?
Like any surgical procedure, breast implant removal carries some risks including bleeding, infection, changes in sensation, and scarring. However, complication rates are generally low, especially when performed by an experienced, Board Certified Plastic Surgeon. Dr. Horton will discuss all risks and benefits during your consultation.
Ready to take the next step toward breast implant removal in San Francisco? Schedule a comprehensive consultation with Dr. Karen Horton to discuss your goals, evaluate your options, and determine the best surgical approach for your individual needs.
Contact Information:
Phone:
(415) 923-3067
Address:
2100 Webster St, Suite 520
San Francisco, CA
94115
Office Hours:
Monday – Friday: 9:00 AM – 5:00 PM
Saturday: Closed
Sunday: Closed
Editorial Review and Medical Accuracy
Medical Review: This content has been medically reviewed by Dr. Karen Horton, MD, MSc, FACS, Board Certified Plastic Surgeon.
Editorial Process: All medical information is reviewed for accuracy and updated regularly to reflect current best practices and research findings.
Disclaimer: This information is for educational purposes only and does not constitute medical advice. Individual results may vary. Please consult with Dr. Horton for personalized medical recommendations based on your specific situation.
1 U.S. Food and Drug Administration. Risks and Complications of Breast Implants. Available: https://www.fda.gov/medical-devices/breast-implants/risks-and-complications-breast-implants. Accessed August 13, 2025.
2 American Society of Plastic Surgeons. What are the risks of breast augmentation? Available: https://www.plasticsurgery.org/cosmetic-procedures/breast-augmentation/safety. Accessed August 13, 2025.
3 Glicksman C, McGuire P, Barnes K, Shedden-Mora M, Faasse K. Systemic Symptoms Associated With Breast Implants: A Psychological Study of Beliefs and Emotions. Aesthet Surg J. 2025 Jun 25:sjaf125. doi: 10.1093/asj/sjaf125. Epub ahead of print. PMID: 40557983. Available: https://pubmed.ncbi.nlm.nih.gov/40557983/. Accessed August 13, 2025.
4 The Aesthetic Society. Consensus Statement on Breast Implant Capsulectomy Definitions and Management Created by Breast Surgery Collaborative Community. Available: https://www.theaestheticsociety.org/medical-professionals/patient-safety/consensus-statement-breast-implant-capsulectomy-definitions. Accessed August 13, 2025.
Dr. Karen Horton has either authored or reviewed and approved this content.
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Monday-Friday: 9am - 5pm
Saturday-Sunday: Closed
Monday:
9 AM to 5 PM
Tuesday:
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Wednesday:
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Thursday:
9 AM to 5 PM
Friday:
9 AM to 5 PM
Saturday:
Closed
Sunday:
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Dr. Karen M. Horton
2100 Webster St., Suite 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the
Pacific Heights District
in the Pacific Professional Building.
SHOP SKIN CARE*Please note: Our office is no longer a Participating Provider for insurance. We can provide a financial quote for what anticipated surgical fees will be after your consultation.
