Thinking about removing your breast implants? Let’s explore your options.
Whether your reasons are personal, aesthetic, or related to symptoms, you deserve a thoughtful conversation about implant removal.
Breast Implant Illness (BII) is a set of systemic symptoms that a growing number of women associate with the presence of silicone implants. Chronic fatigue, joint pain, cognitive impairment, skin changes, and low immunity are the most frequent reports. The scientific debate on causality is still evolving. In Dr. Charão's experience, some patients report improvement in symptoms after explantation, but this cannot be promised: the symptoms may come from other underlying conditions, which are investigated before surgery.
Whether due to BII, capsular contracture, implant rupture, personal preference, or simply a lifestyle change, breast explant surgery is now one of the fastest-growing procedures in the world — and it requires a surgeon with genuine experience in this type of surgery.
Explant with or without capsulectomy — implant removal: what changes?
There is no single right answer. There is only the right answer for your case.
Dr. Alexandre Charão, a plastic surgeon recognized by SBCP, AMB and CFM, and a member of BAPS, with more than 6,000 surgeries performed since 2004 at his clinic in Botafogo, Rio de Janeiro, follows the 2024 consensus of the Breast Surgery Collaborative Community (BSCC) — featuring representatives from the ASPS and The Aesthetic Society — which defines four distinct modalities of capsulectomy:
Partial capsulectomy
Removal of part of the capsule, with some capsule remaining.
Total capsulectomy
Complete removal of the capsule, not necessarily in a single piece; in a series of 248 patients with BII, capsular inflammation was associated with textured implants and silicone.
Intact total capsulectomy
Complete removal of the capsule as a single piece.
En Bloc Capsulectomy (When Medically Indicated)
Absolute indication reserved for implant-associated cancer (such as BIA-ALCL) after appropriate investigation, as complete surgical excision is essential in the management of BIA-ALCL.
The choice between these approaches is not made at the patient's request — it is a medical decision, based on clinical findings, implant history, surface type (smooth or textured), and the presence of symptoms. Dr. Charão performs a careful evaluation before each explant surgery, including imaging analysis when indicated.
What will your breasts look like after implant removal?
Removing implants does not mean giving up on breast shape. A breast lift or fat transfer may help reshape your breasts.
After explantation, depending on how long the implant was in place, the original breast volume, and skin quality, complementary procedures can be performed during the same intervention:
Breast lift (mastopexy)
Repositioning and reshaping of the breast without a new implant.
Fat transfer
Using the patient's own fat to restore volume immediately following implant removal.
Clinical series show that explantation with capsulectomy and mastopexy in the same procedure improves satisfaction and psychosocial well-being. The indication for a complementary procedure is defined individually, based on anatomy, the amount of available tissue, and the patient's expectations. Those considering a lift without implant replacement may also want to learn about mastopexy with reduced scarring.
Why surgeon experience matters for breast implant removal
Removing an implant is technically more complex than placing one. Choosing who will perform this procedure matters as much as the decision to undergo an explant.
Explantation with capsulectomy involves dissection in anatomically complex planes, an increased risk of bleeding, and immediate reconstruction of the breast contour. In 2006, O Globo's “Faz a Diferença” (Makes a Difference) Award recognized Dr. Charão's real impact on his patients' lives, and more than 200 real patient reviews on Google document explant cases with rapid recovery and preserved aesthetic results.
Fast Track Recovery — a faster, more comfortable recovery and refined scars — is applied to all explants in line with accelerated recovery protocols in breast surgery1, with a private WhatsApp group for each patient throughout the postoperative period. The Weight-Loss and Metabolic Preparation Method begins as soon as the surgery is scheduled, aligned with perioperative nutritional and metabolic support guidelines. Surgeries are performed at Hospital Glória D'Or, in the Glória neighborhood, South Zone of Rio de Janeiro — part of the D'Or Network, with annual JCI accreditation. Journalists from The Washington Post personally accompanied Dr. Charão during body contouring surgeries in Rio de Janeiro.
Surgeries are performed at Hospital Glória D'Or, in the Glória neighborhood, South Zone of Rio de Janeiro — part of the D'Or Network, with annual JCI accreditation. Journalists from The Washington Post personally accompanied Dr. Charão during body contouring surgeries in Rio de Janeiro.
Technical Comparison of Procedures
Understand the differences between a conventional explant and Dr. Alexandre Charão's approach:
| Criteria | Conventional explant | Dr. Alexandre Charão |
|---|---|---|
|
Capsulectomy protocol
|
• Often a single approach | ✓ Four modalities defined by the 2024 BSCC consensus |
|
Technical indication
|
• Sometimes at the patient's request | ✓ Medical decision based on clinical findings and implant type |
|
Complementary procedure
|
• Rarely planned during the same procedure | ✓ Simultaneous mastopexy and/or fat transfer when indicated |
|
BII symptoms
|
• Variable treatment | ✓ Explant + total capsulectomy, with investigation of other causes |
|
Postoperative recovery
|
• 3 to 5 weeks of restrictions | ✓ Fast Track Recovery: faster, more comfortable recovery |
|
Preoperative preparation
|
• Fasting and basic lab tests | ✓ Weight-Loss and Metabolic Preparation Method |
|
Post-op monitoring
|
• Consultations at fixed intervals | ✓ Exclusive WhatsApp group with direct access to the doctor |
|
Surgical center
|
• Variable | ✓ Hospital Glória D'Or (Glória, South Zone) — D'Or Network, annual JCI accreditation |
Frequently Asked Questions about Breast Explant
01 — What is Breast Implant Illness (BII), and does an explant resolve it?
BII is a set of systemic symptoms attributed to silicone implants — fatigue, joint pain, brain fog, and immunological changes. Some patients report improvement in symptoms after explantation with total capsulectomy, but improvement cannot be promised: the symptoms may have other underlying causes, which are evaluated before surgery. Causality is still under study.
02 — What is the difference between a total capsulectomy and an en bloc explant?
A total capsulectomy removes the entire capsule, not necessarily in a single piece. En bloc is removal with an uninvolved tissue margin — an absolute indication for implant-associated cancer, such as BIA-ALCL, after appropriate investigation, since complete surgical excision is essential in BIA-ALCL management. Most cases of BII or capsular contracture do not require an en bloc resection.
03 — Is mastopexy possible during the same explant procedure?
Yes. In many cases, a mastopexy and/or fat transfer can be performed simultaneously with the explant, reshaping and restoring the breast contour without the need for a second procedure. Feasibility is assessed individually. See also the mastopexy with reduced scarring page.
04 — Do textured implants require a more extensive capsulectomy?
Studies show that textured implants are associated with greater capsular inflammation and a higher risk of BIA-ALCL. The 2024 BSCC consensus defines the modalities and reserves the en bloc technique for implant-associated cancer; the extent of capsulectomy when explanting textured implants is an individualized medical decision.
05 — Does an explant cause significant post-op pain?
With Fast Track Recovery, aligned with accelerated recovery protocols in breast surgery, postoperative discomfort tends to be lower than in conventional augmentation. The private WhatsApp group guarantees direct access to Dr. Charão during recovery.
06 — Do I need tests before deciding on an explant?
Yes. Dr. Charão performs a complete clinical evaluation and may request a breast MRI to assess implant integrity, capsular thickness, and the presence of late seroma. The decision on the type of capsulectomy is based on these findings, not only on the reported symptoms.
07 — Is Metabolic Preparation necessary before an explant?
Yes. Perioperative nutritional status influences healing, according to nutritional and metabolic support guidelines. The Weight-Loss and Metabolic Preparation Method is especially relevant in explants with capsulectomy, which involve greater tissue dissection.
08 — Where does Dr. Charão perform breast explants?
At Hospital Glória D'Or, in the Glória neighborhood, South Zone of Rio de Janeiro — part of the D'Or Network, the largest hospital network in Brazil, with annual JCI accreditation. The clinic is located in Botafogo, also in the South Zone, making it easy to get around. Care is available in Portuguese, English and French.
Do you want to assess whether an explant is right for you?
Schedule an in-person consultation in Botafogo or a private virtual consultation directly with Dr. Alexandre Charão's team.
📅 Schedule your consultation on WhatsApp📚 Scientific Bibliography
- Seren JM, Cervantes A, Fontbona M, et al. A Decalogue on Enhanced Recovery After Breast Augmentation Surgery (ERABAS). Aesthetic Plast Surg. 2024. doi:10.1007/s00266-024-04231-7