The decision for breast implant removal is driven by the patient. Indications for breast implant removal include undesired implants, capsular contracture, implant failure or leakage. Breast implant illness is a relatively new term that has been applied to women who suffer from a range of symptoms including chronic fatigue, joint and muscle pain, sleep disturbance, anxiety, rashes and other symptoms who happen to have breast implants. Although the link between these symptoms and breast implants is weak at best, removal is a consideration.
Saline implants can usually be removed in the office under local anesthesia. For patients with significant capsular contracture, removal of the capsules (capsulectomies) may be required, and that is a surgery done under general anesthesia at the surgical facility. Leaking or calcified silicone implants are removed under general anesthesia at the surgical facility. This is the case because removal of any leaked silicone requires a thorough internal examination that can only be done under general anesthesia.
Many times a satisfactory cosmetic result can be obtained by removal of the implants alone. However, for women who have had their implants for many years, reshaping of the breasts may be required. Most commonly reshaping takes the form of a breast lift.