Episode 24: Will I Have Scars After Breast Explant Surgery?

The frequent concern that I get from patients is whether or not they will have scars after they have their breast implants removed, known as explant surgery. This is understandable because scarring is a common concern for those undergoing any type of surgical procedure. Women who have had prior surgeries or procedures may have already dealt with scarring and are aware of possible negative surgery effects, so they tend to inquire about potential scarring to understand how it might differ or compare to their previous experiences. Today, I’m here to answer that question to help you learn more about the aftermath of breast explant surgery, particularly regarding scars. Excision of the nipple complex The first thing to know is that when we perform explant surgical operations, we do them through the fold, with a vertical periareolar approach. Factors like breast size and shape are also taken into consideration since the size and shape of a patient's natural breasts play a role in determining the outcome after implant removal. If you have wide breasts that extend into your armpits, you're going to want that narrowed. Otherwise, when you remove the device itself, it may be more flattened and boxy at the bottom. The usual approach when it comes to these instances is the vertical technique, which is basically like looking at the scar pattern as a lollipop. When we use the vertical technique, we are able to take and lift the tissue below the nipple complex as we close it. As a result, we get an increased or elevated nipple position without removing the nipple. For people who have already gone through lifting procedures, I revise the incision by carefully tangentially excising the skin around the areola for it to fit smaller breasts. When we speak of tangential excision, we’re not removing the nipple complex, but rather removing the tissue below in a way that allows us to close and lift at the end. When we’re done with the vertical excision, we now have a wide-open appearance, allowing us to view and even go through the tissues. The implant scar capsule is then exposed to us, which we take out circumferentially in an intact manner. On the other hand, we need a slightly bigger incision if we’re going underneath the breast to get everything out. In such a procedure, it becomes a bit more challenging because the tissue around it makes it difficult to get everything that we need out. In fact, we need a 6 to 7 cm incision to get that out, all hidden in the fold. What type of incision is needed? In doing a periareolar lift, we can diminish the stretched-out areola if that’s what you want to do – to downsize the areolas to match smaller breasts. That’s just going to leave you with one scar pattern around the outside of the areola. We’ve compared the vertical technique to a lollipop, as mentioned above. That technique leaves you with a lollipop-type of scar but allows you to take out excess skin and fatty tissue. As much as possible, we want to minimize scarring whenever we can. That is why we really do a careful assessment when it comes to these procedures. These are just some of the things that we discuss and evaluate to see what will work best for individual clients. In some cases, the patients consider additional procedures such as breast lift or fat transfer to improve breast shape after implant removal. These options can help restore a more youthful appearance or achieve the desired breast size. What I emphasize in my other episodes is to make sure to consult with a qualified plastic surgeon or provider who has a vast understanding of these things to ensure your overall health is taken into consideration and who will monitor your progress not just before and during the procedure, but also during your healing journey afterwards. Links and Resources Dr. Robert Whitfield’s Website