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Explants: Why Women Are Having Their Breast Implants Removed

Women who have previously undergone breast implant surgery are now deciding to have the procedure reversed -- a growing trend dubbed 'explants'.

Although there are still more women having them inserted than taken out, there is a growing trend to have breast implants removed.

For most women, the removal process is very straightforward.

It's a day surgery procedure that's done under a general anaesthetic and the implant can usually be taken out via the same incision used to insert it, which helps minimise additional scarring according to Sydney Cosmetic Sanctuary's Dr Rohit J Kumar. 

Spice-Girl-turned-fashion designer Victoria Beckham -- picutred in 2019 (left) and in 2003 -- has admitted to having her implants removed. Image: Getty.
Reason Behind Explants

These range from a poor cosmetic result to a physical problem with the implant itself such as a rupture and complications such as infections.

In most of these cases, Dr Kumar explained, after the implant is removed a plan is usually made to replace it in the near future.

Another motivation for explant surgery isn't problem-related but because the woman simply feels that she no longer needs them. "These tend to be women 55 years or older who feel that their implants have 'done their job' and prefer to have their 'natural' breasts age with them," Dr Kumar explained.

In a similar vein are women who have accepted their body as it is and would much rather return to their non-augmented shape and size. Dr Kumar puts this down to the recent strong social movement of body positivity and acceptance and he welcomes it -- it can be a "very positive experience for that patient," he said.

Dr Naveen Somia, president of the Australasian Society of Aesthetic Plastic Surgeons wants people to remember that breast implants are actually medical devices with a finite life and "will need replacing at some future point in time," he told 10 daily.

Breast implant illness

The final reason behind explant surgery is less straightforward and has become more common in the last 12 months according to Dr Kumar.

There are many women with a host of symptoms -- which they attribute to their breast implants.

Sufferers have termed this "breast implant illness" -- a catch-all for symptoms that include but are not limited to fatigue, memory loss, headaches, joint and muscle pain, hair loss, recurring infections and swollen lymph nodes.

Nicola Robinson Evans, the wife of Pete Evans, said that her breast implants were her "biggest regret" -- she had them removed in 2017 after experiencing what she called 'breast implant illness'. Image: Instagram/@nicolarobinsonevans.

The thing is, Dr Kumar explained breast implant illness has yet to be medically proven. 

Dr Somia  hasn't come across a case of breast implant illness himself, but told 10 daily some patients "just don’t co-exist comfortably with their implants."

"We can’t claim to know everything," he said, "and it may be that in the future with further research, we will understand more."

Breast implants and lymphoma

There is, however, a known association between breast implants and a very rare lymphoma known as anaplastic large cell lymphoma or BIA-ALCL.

To date, out of the 40 million or so people who have had implants between 300 to 500 have been diagnosed with genuine cases of anaplastic large cell lymphoma -- mostly in women with textured implants.

There are two basic types of breast implants: saline and silicone gel -- both can have either smooth or textured shells. Image: Getty.

If women notice a change in the size of their breast it should be investigated but most swellings turn out to be non-cancer related so it is important not to panic, he said.

While anaplastic large cell lymphoma is very rare there are some more common side effects following breast implant surgery such as an allergic reaction to anaesthetic, internal bleeding or infection and blood clotting or deep vein thrombosis.

There's a risk of changes in nipple sensation, inflamed or itchy scars, implant rupture or deflation, movement of the implant, breast unevenness, back pain and something called 'Double bubble' where the implant sits on top of, rather than into the existing breast tissue.

Women with a history of breast cancer are warned that there may be reduced effectiveness of breast cancer screening as an implant may hide breast tissue -- and tumours -- during a mammogram.

A.J.'s explant experience

Mum-of-four A.J. Kay, who lives in the US, had her implants removed in September 2018 after having had them for 12 years. It was something she'd been interested in doing for a while, she told 10 daily, but didn’t have to money to go through with it until then.

Kay had first gotten implants, in part, to please her former husband -- once her divorce was finalised in December 2017, she was ready to "reclaim" her body.

After her explant surgery, Kay had mixed feelings. Physically, she said her body feels much better. "I walk taller, my clothes fit correctly, and not to be dramatic, but I feel safe in own my skin," she explained.

She noticed fewer headaches and less muscle tension in her shoulders and relished the feeling of her body being her own again. Psychologically, it's another story.

It's a tough thing to go into a plastic surgeon's office and say, 'I want surgery that 99 out of 100 people will think makes me look less attractive because I need my real body back.'

Kay described the standards for female beauty as "warped and unrealistic" and that her choice of "small, saggy breasts in favour of oversized, unnatural ones" is essentially unheard of.

Kay doesn't personally know any other women who have undergone explant surgery -- if they have, it's in order to 'upgrade' to new implants -- but after sharing her story online several women from across the States reached out with their experiences.

"Most American women would choose the fake ones any day, probably even if the implants were making them sick," she said.

While Kay didn't suffer any of the symptoms attributed to breast implant illness.

Kay before (left) and after her explant procedure. Image: supplied.
The future on implants

In Dr Somia's opinion, breast implant surgery is too safe and too popular to be going anywhere.

"Whilst it would be ideological to see a point in time when all women feel 100 percent comfortable in their own skin without the need for cosmetic surgery, I highly doubt this is probable, at least in my lifetime," he said.

The number of removals is not documented as yet, Dr Somina explained, but he hopes that the Australian Breast Device Register will help to capture this information in the future.

Featured image: Getty

Contact the author gwolski@networkten.com.au