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Before and after explantation in a 37 year old woman. Her “total submuscular” implants caused pain, a chronic sensation of tightness and loss of full arm and shoulder range of motion. She had lateral displacement of her implants (a wide space between them) which bothered her, and significant animation deformity, demonstrated when she flexed her pectoralis major muscles.

Because was right-handed; her right implant felt tighter and sat up higher than her left implant due to greater muscle use due to activating her right muscle from normal activities of daily living – this is no way to live! She was “over these implants” and wanted to go back to her natural breast state.

She did not want a new incision for breast implant removal. Although the inframammary fold incision is our preferred approach for breast implant insertion or removal, we agreed to use her existing infra-areolar incision (around the bottom of her areola) to remove the implants. She knew she would have more discomfort and deformity due to muscle swelling after surgery but we made a surgical plan based on shared decision-making.

Since there was no capsular contracture, capsulectomy was not required as part of her surgery. Explantation surgery was planned in the office under local anesthesia with an oral anti-anxiety medication and inhaled laughing gas.

Long-term follow up photos are shown three and a half years after surgery. She is very happy with her decision to have her breast implants removed, and grateful that she did not need another big surgery like the one she had to put them in.

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*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.

Dr Karen Horton