Breast revision and implant removal in Palm Beach, FL
Breast implants are not lifetime devices. That isn't a flaw. It is simply how implants work: they are durable, but they are not designed to stay in place, unchanged, for the rest of your life. Sooner or later, many women revisit their implants. Some want a different size or shape. Some develop a problem. Some just want them out.
In Palm Beach Gardens, Dr. Justin Bellamy performs breast revision, implant exchange and implant removal. Below: the reasons patients come in, how each procedure works, what recovery looks like and how to plan.
Do implants need to be replaced?
There is no expiration date. The FDA's position is that implants are not lifetime devices, and that the longer you have them, the more likely you are to need a revision or removal at some point. Many women keep the same implants for a decade or two, and some longer. What matters is how yours are doing, not how old they are.
For silicone gel implants, the FDA recommends periodic imaging, an ultrasound or MRI, to check for silent rupture, starting about five to six years after surgery and every two to three years after that. Your surgeon can tell you which schedule applies to your implants.
Reasons for breast revision or implant removal
Revision surgery is highly customized. Common reasons include:
- Increasing or decreasing implant size
- Repositioning the implants
- Updating the implant shape or materials
- Addressing pain from hardened scar tissue around the implant
- Resolving implant migration, leaks or rupture
- Correcting concerns such as rippling
- Removing implants because your lifestyle or preferred look has changed
Some patients also ask about removal because of symptoms such as fatigue, joint pain or brain fog that they attribute to their implants. The science on cause is unsettled, but the symptoms are real to the people experiencing them and deserve a serious evaluation. Dr. Bellamy will listen and go through your options with you.
Exchange, removal or removal with a lift
There are three broad paths, and the right one depends on what you want and what your breasts look like.
Exchange. Old implants are removed and new ones placed, possibly in a different size, shape or position. This is the most common revision.
Removal (explant). The implants come out and are not replaced. Depending on your anatomy and the scar tissue around them, the surrounding capsule may be removed as well. What your breasts look like afterward depends on your implant size, how much natural tissue you have and the quality of your skin.
Removal with a breast lift. After implants come out, the skin may be stretched and the breasts may sag. A breast lift reshapes and repositions the tissue, and many patients choose it to keep a shapely result. Some also combine revision with a breast reduction when balance is the goal.
Common implant problems, explained
Capsular contracture. Your body forms a thin scar capsule around every implant. In some people it thickens and tightens, making the breast feel firm, look round or become painful. Treatment usually involves surgery to release or remove the capsule and either exchange or remove the implant.
Rippling and visible edges. Implants, particularly in thin patients, can become visible or wrinkled under the skin. A change in implant type, size or position, or added tissue support, can help.
Malposition. An implant can sit too high, too low or too far to the side, or shift over time. Correcting it usually involves adjusting the pocket that holds the implant.
Rupture or leak. A saline implant that leaks deflates quickly and is easy to notice. A ruptured silicone gel implant can be silent, which is why periodic imaging is recommended. Either needs to be addressed.
Size dissatisfaction. Many revisions have nothing to do with a problem. Your preferences change, and going larger or smaller is a common and reasonable reason.
Who revision surgery helps
Revision surgery helps women whose implants no longer match what they want or need. That covers a lot of ground: someone with a hardened, painful breast, someone whose implant has shifted or leaked, someone who wants a size or shape change after years, and someone who wants the implants out altogether.
It works best when you are in good health, at a stable weight, not pregnant or breastfeeding and free of conditions that impair healing, and when you are not using nicotine, which is particularly important when tissue has been through surgery before. Beyond that, the best candidates have clear goals and realistic expectations, including an honest understanding of what their breasts will look like once the implants change.
What to bring and what to expect
Come prepared. If you have your original surgical records or implant identification cards, bring them, since knowing the type, size and placement of your implants makes planning far more precise. Bring recent mammogram results too.
Dr. Bellamy will listen to your concerns and what you would like your breasts to look like. Then comes a physical exam. He looks at your current and desired size and shape, the condition of your breast tissue, skin and scar tissue, your allergies and medical history, previous surgeries, current medications and supplements and your family history of breast cancer. He explains the risks and benefits and gives an honest recommendation for what is realistic.
Looking for the best plastic surgeon in Palm Beach?
Dr. Justin Bellamy uses his esteemed education, cutting-edge techniques, and state-of-the-art medical equipment to create customized treatment plans to meet his patients’ needs and expectations. He has published over thirty peer-reviewed articles and book chapters and is a thought-leader in the field of plastic surgery. Trust Dr. Bellamy for a comprehensive and modern plastic surgery experience.
Thinking through removal
If you are leaning toward taking your implants out without replacement, a few questions help. How large are your implants relative to your own tissue? Large implants stretch the skin and can leave the breasts looking deflated, so a lift is more likely. How long have you had them, and is there significant scar tissue? Do you want the capsule removed, and what are the trade-offs for your situation?
Then ask what you want the result to look like. Some women are happy with a smaller, softer natural shape. Others want a lift to restore position. There is no wrong answer, and a candid conversation with your surgeon is the best way to get to the right one.
Preparing
In the weeks before, eat protein-rich, low-sodium meals. Skip most herbal supplements, especially garlic, fish oil and zinc, and stop medicines containing aspirin, including Excedrin, ibuprofen and Aleve, while Dr. Bellamy reviews the rest of your medications with you. Smoking, vaping and all nicotine products are off limits for at least four weeks before and after, because nicotine slows healing, and healing is already a challenge when tissue has been stretched or scarred by earlier surgery.
In the operating room
Surgery happens at the practice's own facility, in one of two AAAASF-certified operating rooms. After a final review and surgical markings, Dr. Bellamy makes small, well-concealed incisions along the lower fold of each breast and around the areolas to reach the implants. He decides at your consultation how best to remove them and, if it is necessary, the capsule around them. New implants, if you're having them, are placed with the no-touch Keller Funnel method, which lowers contamination risk and allows smaller incisions. If you are not replacing them, he may lift the breasts, layering sutures deep in the tissue for support.
What recovery involves
Both revision and explant are outpatient procedures. Arrange a driver and a helper for the first day, especially if you care for children or pets. You will wear a surgical or support bra full-time for at least two to four weeks to hold the new shape and limit swelling. Most patients take one to two weeks off work. Strenuous exertion, particularly anything that uses the chest muscles, waits four to six weeks, and slow walking is encouraged as soon as you feel able.
Settling in
You may notice a difference immediately, depending on how much was done. Swelling takes several weeks to fade, sensation can take a while to return and scars fade over time. It can take six months to a year for your breasts to feel normal and for the final result to settle. What you end up with depends on your implant size, how much scar tissue is present and the amount and quality of your remaining breast tissue.
What affects the price
Revision costs vary widely because the operations do. An exchange is different from a removal with capsule removal, which is different again from removal with a lift. Dr. Bellamy's team gives you an estimate once they know what you are planning.
Making the call
To talk through your options, make an appointment or call (561) 705-0044. If you're weighing whether to keep, replace or remove your implants, the question of whether breast implants last forever is a good place to start. Dr. Bellamy's office is in Palm Beach Gardens, and patients travel from West Palm Beach, Jupiter and Boca Raton.
Frequently Asked Questions
There is no expiration date, but implants are not lifetime devices, and the longer you have them the more likely you are to need a revision or removal. Many women keep theirs for a decade or two or more. Your surgeon can advise you based on the type of implant you have.
When there is a specific reason: pain from hardened scar tissue, a leak or rupture, migration, rippling, or a desire to change size, shape or materials. If you have no problems and are happy, you don't have to replace them on a schedule, but regular check-ups and imaging are important.
Revision is a broad term for surgery that changes or corrects your implants, including exchanging them, repositioning them or adjusting their size or shape. Implant removal, or explant, takes the implants out without replacing them and may include a breast lift.
Plan on one to two weeks off work, wearing a support bra full-time for at least two to four weeks and avoiding strenuous activity for four to six weeks. It can take six months to a year for the breasts to feel normal and for the final result to settle.
Not always. If your skin is elastic and your breasts keep good shape without implants, you may not. If the skin is stretched, a breast lift can reposition the breasts and give a better shape. Dr. Bellamy can assess this at your consultation.
It depends on your implant size, the amount of scar tissue and how much natural breast tissue and skin quality you have. Dr. Bellamy will explain what to expect for you and whether a lift or other work would help.
Yes, an exchange is the most common revision. Old implants are removed and new ones placed, possibly in a different size, shape or position. Dr. Bellamy uses the no-touch Keller Funnel method for insertion.
It depends on the extent of surgery, whether the capsule is removed, whether you are replacing implants and whether a lift is included. Costs vary widely, and you will receive an estimate after your consultation.
The FDA recommends periodic ultrasound or MRI screening for silicone gel implants, starting about five to six years after surgery and every two to three years afterward, to check for silent rupture. Your surgeon can tell you which schedule applies.
Look for board certification, experience with revision and explant surgery, an accredited facility and healed before and after photos. Dr. Bellamy is a board-certified plastic surgeon and his Palm Beach Gardens office serves patients across Palm Beach County.
It is when the scar capsule that naturally forms around an implant thickens and tightens, causing firmness, a rounded look or pain. Treatment usually involves surgery to release or remove the capsule and either exchange or remove the implant.
