Your decision. Fully supported.
Whether you are experiencing complications, concerned about breast implant illness, or simply ready to move on, breast implant removal is a valid choice that deserves a surgeon who respects the decision. Dr. Larry Nichter performs explant surgery with the same precision and care he brings to every procedure.
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The procedure
Breast Implant Removal in Newport Beach
Breast implant removal — also called explant surgery — is a procedure to remove silicone or saline breast implants. It may be performed as a standalone surgery or combined with additional procedures such as a breast lift, fat transfer, or capsulectomy (removal of the scar tissue capsule that forms around every implant).
Patients seek implant removal for a wide range of reasons. Some have developed complications — capsular contracture, implant rupture, rippling, or pain. Others are experiencing symptoms they attribute to their implants, a condition commonly referred to as breast implant illness (BII). And many patients simply reach a point where their implants no longer feel right for their body or their life — a preference that changes over years and decades.
The decision to remove breast implants is personal and legitimate. Dr. Nichter brings the same rigor to explant surgery that he brings to augmentation. The goal is to remove the implants safely, address any complications present, and — if the patient desires it — restore a natural breast shape.
His approach
Thorough Removal, Thoughtful Restoration
Soft saline implants and intact silicone implants can be removed under local anesthesia in the office or under general anesthesia. Many patients do not realize that the shape of their breasts afterward will not be the same as what they were before the implants. Stretching from the implant and the aging process are the reasons for this.
For many patients, implant removal is not simply the reverse of implant placement. The tissue has changed around the implant — scar tissue has formed, breast tissue may have thinned, and skin elasticity may have decreased. How the implants are removed, and what is done with the capsule and remaining tissue, significantly affects the outcome.
Dr. Nichter performs three levels of capsulectomy depending on the clinical situation:
- Partial capsulectomy — Removing only the portion of the capsule that is thickened or problematic, preserving healthy tissue
- Total capsulectomy — Removing the entire capsule (front and back walls) while separating it from the implant
- En bloc capsulectomy — Removing the implant and the entire capsule as a single intact unit, without opening the capsule
En bloc capsulectomy is the most technically demanding approach and the one most commonly requested by patients concerned about breast implant illness. Dr. Nichter performs en bloc removal when indicated and will explain during consultation whether it is appropriate and achievable for your specific anatomy. In some cases — particularly when the capsule is adherent to the chest wall — a total capsulectomy may be safer and equally effective.
For patients who want to restore breast shape after removal, Dr. Nichter may combine the explant with a breast lift to address sagging, or with fat transfer via his California Breast Lift® technique to add modest natural volume. These decisions are made collaboratively, based on what the patient wants and what the tissue can support.
Is it right for you
Am I a Good Candidate for Breast Implant Removal?
You may be a candidate for implant removal if any of the following apply:
- Capsular contracture — Your breast feels firm, tight, or distorted due to hardened scar tissue
- Implant rupture or deflation — Imaging has detected a rupture, or a saline implant has visibly deflated
- Rippling or deformity — Visible wrinkling or distortion of the implant through the skin
- Pain or discomfort — Persistent breast, chest, or shoulder pain related to the implants
- Breast implant illness — Systemic symptoms (fatigue, joint pain, cognitive changes, hair loss) that you believe are related to your implants
- Personal preference — You no longer want implants, regardless of whether you are experiencing symptoms
- Lifestyle change — Your body, preferences, or priorities have changed since your original augmentation
Good candidates are in overall good health. If you are considering replacement with new implants rather than permanent removal, breast augmentation revision may be the more appropriate procedure.
What to expect
Your Breast Implant Removal Experience
Consultation and Planning
Dr. Nichter examines your breasts, reviews your implant history (type, age, placement, any prior complications), and discusses your goals. If you are concerned about BII, the consultation covers your full symptom history and timeline. He explains the capsulectomy options — partial, total, or en bloc — and recommends the approach best suited to your situation. If you want breast reshaping after removal, he discusses lift and fat transfer options during the same consultation.
How Implant Removal Is Performed
Explant surgery is performed under general anesthesia and typically takes one to three hours, depending on the complexity and whether additional procedures are included.
Dr. Nichter uses the existing augmentation incision whenever possible to avoid creating new scars. Through the incision, he carefully removes the implant and the scar tissue capsule according to the surgical plan. If performing an en bloc capsulectomy, the capsule is dissected from the surrounding tissue and chest wall and removed intact with the implant inside.
If a breast lift is being performed simultaneously, excess skin is removed and the remaining breast tissue is reshaped and elevated. If fat transfer is included, fat is harvested through liposuction from another area of the body, processed, and injected into the breasts for modest volume restoration.
Immediately After
You are monitored as anesthesia clears. Drains may be placed to prevent fluid accumulation, depending on the extent of capsule removal. You will wear a compression bra or garment. Most patients go home the same day.
Recovery
Recovery and Downtime
Recovery from implant removal is generally less demanding than recovery from augmentation, though this depends on whether a capsulectomy, lift, or fat transfer was performed simultaneously.
The First Few Days
Expect soreness, swelling, and tenderness in the chest. If drains are placed, you will receive instructions on their care — they are typically removed within the first week. Prescription medication manages discomfort. Rest with your upper body slightly elevated.
Week One
Swelling begins to diminish. Bruising, if present, fades. Most patients manage light daily activities by the end of the first week. Continue wearing your compression bra. Avoid raising your arms overhead or lifting anything heavy.
Weeks Two Through Four
Most patients return to work within one to two weeks. Swelling continues to resolve. The breast shape evolves as the tissue adjusts to the absence of the implants. If a lift was performed, the breasts gradually settle into their reshaped position. Avoid exercise and heavy lifting.
Six Weeks and Beyond
By six weeks, most restrictions are lifted and exercise can resume gradually. The breasts continue to settle and reshape over the following months. If fat transfer was included, the transferred fat stabilizes over three to six months. Final breast shape is typically apparent at three to six months after surgery.
Results
A natural result, on your terms.
The result of implant removal depends on the patient's anatomy, the condition of the breast tissue, how long the implants were in place, and whether additional procedures were performed.
Patients whose tissue has retained good elasticity — and whose implants were relatively modest in size — often see their breasts return to a natural shape without additional intervention. Patients who had larger implants or who had them for many years may experience some degree of sagging, loose skin, or volume loss. A breast lift or fat transfer addresses these concerns.
Many patients who undergo removal for BII symptoms report significant improvement. Recovery timelines vary — some notice changes within weeks, others over several months.
The breasts continue to evolve in shape for several months after removal. Final results are typically visible at three to six months.
Investment
Cost and Financing
The cost of implant removal depends on the type of capsulectomy performed, whether additional procedures (lift, fat transfer) are included, anesthesia time, and facility fees. En bloc capsulectomy is more complex and time-intensive than simple removal, and the cost reflects that. A detailed quote is provided after consultation.
Financing options are available — please ask at your consultation.
Common questions
Frequently Asked Questions
What is en bloc capsulectomy?
En bloc capsulectomy removes the implant and the entire scar tissue capsule as one intact piece, without opening the capsule. It is the most thorough form of implant removal and is commonly requested by patients with breast implant illness concerns. Dr. Nichter performs this technique when it is anatomically safe and indicated.
What is breast implant illness?
Breast implant illness (BII) refers to a range of systemic symptoms — including fatigue, joint pain, brain fog, hair loss, and immune-related issues — that some patients experience after breast augmentation. The medical understanding of BII is still evolving. Dr. Nichter takes these concerns seriously and supports patients who choose removal based on their experience.
Will my breasts sag after implant removal?
This depends on your natural breast tissue, skin elasticity, the size and duration of your implants, and your anatomy. Some patients see minimal change; others experience noticeable sagging or deflation. A breast lift can be performed at the same time as removal to reshape and elevate the breasts. Fat transfer can restore modest volume naturally.
Can I have new implants placed at the same time?
Yes. If you want to exchange your current implants rather than remove them permanently, Dr. Nichter can perform an augmentation revision — replacing the implants with a different size, type, or placement. He may also recommend a capsulectomy during the exchange.
How long does explant surgery take?
One to three hours, depending on the type of capsulectomy and whether additional procedures (lift, fat transfer) are included.
What is BIA-ALCL?
Breast Implant-Associated Anaplastic Large Cell Lymphoma is a rare cancer of the immune system that can develop in the tissue surrounding certain breast implants. Symptoms include persistent swelling, lumps, or pain around the implant, typically appearing years after placement. If you have concerns, Dr. Nichter can evaluate your situation and discuss appropriate next steps.
How soon will I feel better if I have BII symptoms?
Recovery timelines for BII symptoms vary. Some patients report improvement within weeks of removal; others notice gradual changes over months. There is no guarantee that removal will resolve all symptoms, but many patients experience meaningful relief.
Schedule Your Consultation
If you are considering breast implant removal — for any reason — Dr. Nichter will evaluate your situation, explain your capsulectomy options, discuss whether a lift or fat transfer would benefit your outcome, and answer every question. Your reasons are your own, and the consultation is yours to use however you need.
Request a Private ConsultationDr. Nichter sees patients from across the United States and internationally. The office is located in Newport Beach, CA.