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San Antonio Breast Implant Removal

Breast Implant Removal can be done for multiple reasons including capsular contracture (hard painful scarring around the implant), malposition, or simply desire to remove the implants. The procedure is performed by making an incision in the breast and removing the implants, then closing up the incision. If there is a thick shell (capsule) around the implant, this is removed along with the implant.

There are multiple options for breast implant removal surgery:

  • Breast Implant removal only

    This option is for patients who wish to remove their implants but are not having any symptoms.

  • Breast Implant removal with capsulectomy

    The scar tissue around the implant is removed.

  • Breast implant removal and replacement of implant

  • Breast implant removal and lift with or without fat grafting

How is the procedure performed?

Breast implant removals are performed in a surgical center or hospital under general anesthesia with licensed anesthesiologists.  The technique used for your breast reimplant removal is determined during your pre-operative consultation with your surgeon and depends on the size and shape of your breasts and the previous incision used.  If possible, we will use the previous incision used to place the implants if the incision is under the breast.

The length of the surgery also depends on the size and shape of your breasts and if there is a thickened capsule that needs to be removed.  All of your incisions are closed with sutures that dissolve so you will not have to remove any sutures after surgery. You can go home the same day after the surgery.

You will be placed in a compression garment after your breast reduction which you will need to wear for the first 6 weeks. If you need drains, they usually stay in for one week. Depending on your incision type, it is recommended that you do not wear any bras with an underwire until cleared by your surgeon.

What can I expect during my consultation?

During your initial consultation with your surgeon at Hill Country Plastic Surgery, we will discuss your concerns and goals before recommending treatment options that are tailored specifically to your needs. Prior to your consultation, we recommend that you review the procedures on our website so you are familiar with the terms we will be using during our discussion. If you have pictures of how you would like your breasts to look after surgery, please bring them and have them easily available.

Once we identify your concerns and surgical goals, we will discuss all of the treatment options that are available to you. Every patient is unique and we will develop a tailored surgical plan that addresses your specific goals. In addition, we will thoroughly review your medical history, surgical history, medications, allergies, family medical history, and other important details such as your family breast cancer history. It is very important that we obtain accurate information in all of these areas as it may impact the outcome of your surgery.  If you have had a recent mammogram or other breast imaging, please have it sent to the office prior to your first appointment with your surgeon.

While discussing different treatment options, we will examine your breasts and take measurements of your breasts and evaluate your skin quality and the location of your nipples and areolas to help us plan your surgery. Pre-operative (before surgery) photos will be taken either at your initial consultation, or during your pre-operative visit.

After your consultation, you will receive access to your notes on the patient portal in addition to  information about your specific surgery. If you have not activated your patient portal, this can be done at your appointment by asking any of our staff to assist you. If you have questions after your appointment, you can contact our office or message us through the patient portal. Some patients will require medical clearance from their primary care physician or a specialist or additional tests before undergoing surgery.

Once you have determined that you would like to have surgery and have completed any clearances and tests that were requested, contact our office at (210) 658-3555 to schedule a pre-operative appointment with one of our surgeons.

Pre-operative Appointment

On the day of your pre-operative appointment, we will review your procedure in detail and go over the surgical plan with you. We will also address any questions and concerns you may have. Please read over the procedure consent prior to this appointment and have any questions ready so we can discuss them.

During your pre-operative visit, we will provide you with all of the after-care instructions as well as necessary medication prescriptions. You will also be provided with a post-operative appointment for follow up after your surgery.

Before the Day of Surgery

Please do not smoke (cigarettes, vape, or pipe) or use any nicotine products 4 weeks prior to and after your surgery. Smoking and nicotine greatly impair healing, which can cause increased risk for infection and complications, such as delayed incisional healing or wound opening which lead to worse scarring. Please stay away from second hand smoke as well, as this can also cause wound healing problems. If you use nicotine products, you will need to stop 4 weeks prior to surgery and then you will need to undergo a cotinine test prior to surgery to ensure that the nicotine is out of your system.

Please do not drink alcohol before or after your surgery (until cleared by your surgeon). In addition, please do not drink alcohol while taking pain medication, as this can have serious, and life threatening side effects.

Please leave all valuables at home. If you have body piercings, kindly remove them prior to surgery.

Please have someone available to drive you home. Due to the lasting effects of the general anesthesia, you will be unable to operate a car after surgery. A taxi or car service is not adequate either. You will need a family member or friend who can assist you.

You may have been asked to obtain pre-operative tests at a lab facility or your primary care physician. Your pre-operative tests (labs, X-rays, EKG, etc) need to be completed at least three days before your surgery. If you have them done at your doctor’s office, the results will need to be faxed to (210) 362-1582.

The surgery facility will call you the day before your surgery to let you know what time and where you should arrive.

Shower the morning of or the night before your surgery with your normal soap and water. Do not use deodorant, lotion, cream, perfume, aftershave, oils, or makeup after bathing.

Do not take Advil, Aleve, Naproxen, Fish Oil, Garlic, CoQ10, Omega 3,6, Motrin, Excedrin, Ibuprofen, Aspirin, medications for arthritis or any medication that contains these medications for ten days prior to your surgery and two weeks after.

Do not eat or drink anything after midnight the night before your surgery.

Please call our office if you have an infection of any kind prior to your surgery.

Day of surgery

On the day of surgery do not take the following blood pressure medications with generic names that end in “-pril”, “-sartan” before your surgery. If you are on metformin, you will be asked to not take it on the day of surgery.

On the day of surgery, your plastic surgeon will meet you in the pre-operative area to go over any last minute questions or concerns you may have. Your plastic surgeon may make some preoperative markings and will perform extensive checks with careful attention to detail, ensuring high quality care and safety. You will meet the anesthesiologist and their team, as well as the members of our plastic surgery operative team.

Throughout the procedure, your family will be updated of your status periodically and will be able to talk with the plastic surgeon in person after the procedure is completed. The incisions will be placed in a dressing or a compression bandage. Instructions for care on these will be given to you in your preoperative paperwork.

Aftercare

In order to make your recovery faster and more comfortable, we recommend that you prepare before your surgery. Things you can do are:

  • Prepare a sleeping area that is easy to get to. For example, set up a couch downstairs instead of having to walk up to an upstairs bedroom. Keep your toiletries close by and prepare food ahead of time. Arrange for someone to be with you the first night after surgery.
  • You may receive your post-operative medications at your pre-operative appointment. You should pick up these medications prior to your surgery.
  • If you’re having an outpatient same-day procedure you will be released to go home the same day and will need someone to drive you home.
  • Review your post-surgery instructions given to you at your pre-operative appointment

If you have a history of nausea or vomiting after anesthesia, please let us and your anesthesia provider know. We can prescribe anti-nausea medications and take extra steps to prevent nausea and vomiting after surgery.

When undergoing general anesthesia, you will need to have someone drive you home.  You will not be allowed to undergo surgery if there is no confirmed designated driver.

Medications

After surgery you will have discomfort and the goal of pain medications is to reduce pain, but it will not completely remove all pain. A good measure for if you need more pain control is that you should be able to take a deep breath without severe pain. Do not wait until your pain is unbearable to take the next dose of pain medication because it will take longer to get your pain under control again.

You may resume your home medications after surgery except blood thinners and as determined by your surgeon.  We will give you a prescription for a pain medication.  If you are prescribed medications that contain acetaminophen (tylenol) it is important that you not exceed 3500 milligrams of acetaminophen (tylenol) per day..  Do not drive, operate heavy machinery or make important decisions while taking narcotic pain medications.

Narcotic medications may cause constipation. Ensure you have adequate (>25 grams/day) of fiber in your diet and drink at least 64 oz. of water daily. You may also wish to take an over the counter stool softener such as Miralax or Colace once or twice daily.

You can alternate your narcotic medication with Ibuprofen 600mg every 6 hours and/or Gabapentin 300mg three times a day.  Take ibuprofen with food to protect your stomach from irritation.

If you have a history of nausea or vomiting after anesthesia, you may be prescribed an anti-nausea medication (Ondansetron) which can be taken as needed.

Before prescribing any narcotic medications, we are required to check the Texas controlled substance history database (Texas Prescription Monitoring Program).  If you currently have a pain medication contract with another physician or are currently on narcotic medications, we will have to coordinate your medications with that physician.

We will prescribe pain medications for recovery after surgery, but do not prescribe long-term pain medications and do not do more than one refill for any pain medications. If you have pain that is beyond what is usually anticipated for your surgery and there is no surgical reason that can be found, we will help by referring you to one of the many pain management specialists that we work with.

Surgical Site Care:

You may shower 48 hours after your surgery. Do not scrub the incisions, just let the water run over them and gently dab them dry afterwards. Apply gauze over the surgical site daily as needed for light drainage. Do not immerse your incisions in baths or hot tubs until at least 2 weeks after surgery.

Drain Care:

Sometimes it is necessary to place a drain after surgery. The purpose of a drain is to remove excess fluid from the surgical area. Empty the bulbs and measure the output whenever the bulbs are half full or at least twice a day. You will be given a sheet to record how much is coming out of the drains. Bring this sheet to your follow-up appointment. In general, drains remain in place until there is less than 30mL (1oz) out of the drain for two days in a row.

Please Call Immediately if:

Please call if you have the following signs/symptoms:

  • temperature greater than 100.5 F
  • bleeding or pus draining from the wound site. If you have bleeding, apply direct pressure to the area for 20 minutes
  • increasing pain that is not controlled on oral pain medications
  • increasing redness or size at the surgical site
  • your drain is not holding suction
  • if your wounds come apart
  • Any other concerns

For non-emergency questions:

During business hours (8 AM – 430 PM): call (210) 658-3555.

After hours and on weekends/holidays: call (210) 658-3555 and you will be forwarded to the on call surgeon.

If you are having any serious problems or symptoms such as difficulty breathing or chest pain, call 911 or proceed to your nearest emergency room.

Activity restrictions:

No vigorous activity: no pushing, pulling, bouncing, housecleaning, yoga, running, heavy lifting greater than 5 lbs until your follow up appointment.  Avoid activities that raise your blood pressure or heart rate. You are encouraged to walk around and you can climb stairs after surgery. You should not lay in bed and not move.

Follow-up Clinic appointment:

Your clinic appointment will be scheduled at your pre-operative appointment before surgery.  If you need to change your appointment time or date, please contact our clinic at (210) 658-3555.

Breast Implant Removal FAQs

This depends on multiple factors including how long the implants have been, where in the breast they were placed, how large the implants are, and the quality of the skin and tissue.

Your surgeon will be able to discuss predicted outcomes after surgery.  If you have saline implants from breast augmentation, in-clinic deflation before surgery is an option to allow the skin and breast tissue to contract.

Interested?

Are you interested in learning more about this procedure? To schedule a consultation, please contact us. Hill Country Plastic Surgery is the premier plastic surgery center in the San Antonio and Austin area, and our friendly team members are here to help you and will reach out promptly.

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