Breast Implant Removal: Explantation and En Bloc Surgery

Breast implant removal (explantation) is the surgical removal of breast implants. It may be combined with total capsulectomy (removal of the surrounding fibrous capsule). Reasons for removal vary from elective personal choice to medical necessity.

Reasons for Removal

Personal preference — desire to return to natural breast or downsize
Capsular contracture (hardening) — Grade III–IV
Implant rupture or deflation
Breast Implant Illness (BII) — a controversial but reported syndrome of systemic symptoms
BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma) — rare, associated with textured implants
Implant displacement or malposition

Surgical Options

Simple Implant Removal

Implant removed, capsule left in place. Lower complexity, shorter recovery. Used when capsule is thin and shows no signs of disease.

Capsulectomy (Partial or Total)

Capsule partially or fully removed alongside the implant. Preferred when capsule is hardened, calcified or when BII/BIA-ALCL is a concern.

En Bloc Capsulectomy

Implant and surrounding capsule removed as a single unit without opening the capsule. More complex procedure; requires experienced surgeon. Preferred for BIA-ALCL, suspected silicone rupture, or BII patients wanting thorough removal.

What Happens to the Breast After Removal?

Without replacement, the breast will appear smaller, softer and potentially droopy depending on original size, skin elasticity and how long implants were in place. A breast lift (mastopexy) can be performed simultaneously or later.

Costs

Procedure	Cost
Simple explantation (both sides)	€2,500–€4,500
Explantation + total capsulectomy	€4,000–€8,000
Explantation + lift (mastopexy)	€6,000–€10,000