Odstranění prsních implantátů

Standard explantation means removing the implant. The fibrous capsule that the body naturally formed around it does not automatically need to be removed. If there is no reason to remove it, it may remain in place.

Capsulectomy is removal of this capsule. Partial capsulectomy removes only part of it; total capsulectomy removes the whole capsule, possibly in pieces. Reasons may include significant painful capsule contraction or findings associated with implant damage.

Total intact capsulectomy means removing the entire capsule as one unbroken unit. However, removing an implant inside a closed capsule is not the same as a true en bloc resection.
En Bloc resection represents the highest degree of complexity and safety in removing a breast implant and its fibrous capsule. In this procedure, the implant is removed together with the intact capsule and, when indicated, a thin layer of surrounding tissue. This approach may be chosen particularly when the most complete removal of the capsule and surrounding structures is desirable; the specific indication always depends on findings, the patient’s health and the operating surgeon’s decision.

A more extensive operation does not itself guarantee a better result. If the capsule adheres firmly to the chest wall, removing it may increase the risk of injury to surrounding structures. The approach therefore depends on specific findings and a shared assessment of benefits and risks.

Explantation may be appropriate if you no longer want implants, are unhappy with breast size or shape, or develop pain, capsular contracture or implant damage. For systemic symptoms described as breast implant illness, other possible causes must also be assessed. Some women report improvement after implant removal, but a causal relationship has not been clearly established and symptom relief cannot be promised.

Planned aesthetic surgery may be postponed during acute illness, inadequately treated chronic disease or an unresolved clotting disorder. Smoking impairs healing. Pregnancy and breastfeeding require individual assessment of timing. If an implant complication needs treatment, the doctor determines the approach and urgency according to its nature.

Bring available reports from the previous operation and your implant card to the consultation. The surgeon assesses the breasts, scars and skin quality and recommends ultrasound or further imaging and preoperative examinations according to findings. You discuss medicines, dietary supplements, smoking and expected volume changes. Do not change medicines without doctor agreement. Arrange home help, transport after the procedure and follow-up dates in advance, especially if travelling from abroad for surgery.

New one-sided swelling, a lump or persistent pain, especially some time after the original operation, requires investigation before aesthetic surgery is planned. Fluid or tissue around the implant may also need examination.

The operation is usually performed under general anaesthesia. The surgeon selects access according to previous scars and procedure extent, often through the inframammary fold. They remove the implant and address the capsule to the agreed extent according to findings. Removed tissue or fluid may be sent for specialist examination if indicated. Drains are inserted if needed and the wound closed. Operation and stay duration depend on procedure complexity and any simultaneous breast reshaping.

After the procedure, the breasts are usually tender and swollen, and bruising may occur. The surgeon determines use of a supportive bra and wound or drain care. The first one to two weeks usually require restrictions on normal activities; physical exertion and lifting are postponed longer according to healing. Return to work, sport and travel is agreed individually. Contact the clinic for fever, increasing swelling or worsening pain; shortness of breath or chest pain requires immediate medical attention.

After implant removal, the breasts will be smaller and may be loose, less full or asymmetrical. Results depend on the original tissue, skin elasticity and implant size, and settle over several months. A breast lift can correct excess skin and shape, sometimes simultaneously and sometimes after healing.

Possible risks include bleeding, infection, fluid accumulation, impaired healing, altered sensation, conspicuous scars, thrombosis and further surgery. More extensive capsulectomy can increase the risk of damage to surrounding tissues. Continue recommended follow-ups and routine breast disease prevention after explantation.
Professional references