Removal of breast prosthesis with or without capsule (Explant)
After the insertion of breast prostheses, some women may experience asymmetry due to incorrect placement of the prosthesis, or that a hard membrane has formed around the prosthesis, a so-called capsule formation/capsular contracture. Capsule formation is not dangerous, but the breasts can become hard, tender and cause pain. This can also be both cosmetically and physically troublesome and cause tenderness and pain. The degree of capsule formation varies from 1 to 4, the strongest form (3 and 4) occurs in 5-8% of women with prostheses. The reason for this has to do with how the body reacts to silicone as a foreign object. Some may experience silicone leakage in the form of knots or reduced volume which can be examined with ultrasound or MRI.
Other reasons for removing prostheses can be that the patient feels that «the prostheses have done their job, or I’m done with them». Other increasing reasons for removing implants are ALCL (a rare type of non-Hodgkin’s lymphoma) and silicone disease – so-called BII; breast implant illness, with symptoms such as headaches, muscle and joint pain and autoimmune diseases. In this case, the prostheses can be removed with or without the capsule, depending on the thickness of the capsule. Read more here
Regardless of the reason for removing the implants, if desired by the patient, the breasts can be restored to their original size by replacing the implants with the patient’s own fat. This is advantageously done at the same time when the skin has already expanded. But this can also be done secondarily after removal of the implant. The result is better by doing this at the same time, the so called Conversion of implant with fat (se link til Conversion)
See our article about this treatment: Excerpt from our KK interview; https://www.kk.no/helse/janelica-fjernet-silikonbrystene/72751045
The procedure itself is performed under deep sedation and takes approx. 1-1 ½ hours. Depending on the type/degree of the capsule formed, it is considered whether to remove all or only parts of the capsule. In some cases where only the prosthesis is removed, it may be sufficient to only split the capsule from the inside.
As a rule, the incision is made where the old scar is, this is to avoid creating new scars. After removing the old prosthesis, the same cavity will be used for the new prosthesis, possibly also filled with the patient’s own fat. During surgery, thorough homeostasis is done to stop bleeding, as capsule removal can cause small bleeding.
Replacing the prosthesis can easily be combined with a breast lift if the breasts also hang down.
Pick-up and accommodation
If you live some distance from the clinic, we recommend that you spend one night in or near Oslo Plastic Surgery Clinic so that our caring staff are on hand to reassure you should any issue arise, that will cause you concern.
You must agree in advance with a person to pick you up at the clinic approx. 1 hour after the end of the operation, as you cannot drive, take public transport or taxi alone. You should also have someone with you the same day and the first night.
If you live far from the clinic, we recommend that you spend the night in Oslo, either with family / friends or at a hotel.
Hotels near Oslo Plastic Surgery.
-Frogner House Apartments, Bygdøy Allé 53. Website: https://frognerhouse.no (We have an agreement with Frogner House Apartments).
-Hotel Gabel’s Hus in Gabel gate 16. Website; www.nordicchoicehotels.no
To get optimal results and avoid complications – Avoid stress, stay out of the sun, eat healthily, keep your weight within a normal BMI range, exercise regularly, and refrain from alcohol for 2 days prior to surgery and 2 weeks after surgery. Please refrain from smoking/snoozing for at least 2 weeks before surgery and a minimum of 2 weeks after surgery as smoking can interfere with the result.
You must ensure your personal health on the day of surgery. Please contact us as soon as possible if you are in doubt, as we may have to postpone your surgery therefore saving you a journey to our clinic.
Prior to surgery you will have received a prescription for antibiotics, pain killers and Hibiscrub 40 mg/ml which are all available from your local pharmacy. The day before surgery you must shower using the Hibiscrub and again on the day of the procedure immediately before surgery. Use a clean towel for drying and put on clean clothes when you leave home and change the sheets on your bed.
YOU MUST NOT EAT ANYTHING 6 HOURS BEFORE SURGERY, but you may drink water and light juice (not milk) and chew gum up to 4 hours prior to your surgery. You may take necessary medication/s with a sip of water on the morning of the operation.
Please decide for an adult friend to pick you up after surgery, as you will not be able to drive or take a cab alone. We also advise you to have a responsible adult person staying with you during the first 24 hours.
Taking medications prior to surgery:
It is very important that you stop using the following medications 2 weeks before surgery: Acetylsalisyre, Albyl, Albyl-E and other medications that cause extended bleeding as Ibux, Alka-Seltzer, Antineuralgica, Asacol, Artrizin Alka, Brufen, Butazolidin Alka, Codacetyl, Confortid, Dispril, Dispril med kodein, Doloxene Forte, Denobid, Felden, Fenylbutazon, Gamaquil Comp, Globentyl, Globoid, Indocin, Kodein-Magnyl, Kodifen, Licyl, Magnyl, Magnyl-Koffein, Mundisal, Napren, Naprosyn, Novid, Novid with koffein, Paraflex Comp., Tanderil, Vitamin E, and Selen, Tricycliske antidepressiva.
We also recommend you omit Garlic, evening primrose oil, Gingko Bilabo, Aspirin and any drug containing blood thinners.
The above products are known blood thinners therefore not beneficial when you are having surgery.
For Marivan we have individual arrangement. Please request this information on your consultation.
Day of Surgery
After a final discussion with your surgeon the planning process will begin. You will be photographed, and markings will be made on your surgical areas. At this stage you will have time and the opportunity to ask any questions that you may have forgotten so that your surgeon can reassure you that he fully understands your goals and expectations.
You will be introduced to your anesthetist (who will be happy to discuss any fears or issues you have regarding your anesthetization). You will also meet your theatre nurse.
The sedation which you are given in your arm is a quick and painless procedure and you will fall asleep very quickly.
You should be ready to go home within 1 hour following surgery and remember to arrange for someone to pick you up. You should have adult company with you for the next 24 hours to assist you with general tasks, so that you can relax and take it relatively easy.
We will provide you with the cell phone numbers to call us should you feel the need, but this is very rare. We just need to reassure you that we are there for you 24 hours a day.
We will require you to come to the clinic for a follow up check. WITH ALL SURGERY THIS IS IMPORTANT AS YOUR SURGEON NEEDS TO SEE HOW YOU ARE SETTLING.
We do not recommend you fly for 48 hours post-surgery. You may feel nauseous and tired in the hours following surgery. It is important to take your painkillers and drink enough fluids.
We close the wound with stitches that dissolve on their own. We do not usually insert the drain (tube), only in very few cases is it inserted to remove blood and fluid from the wound area under the chest. These are usually removed at the clinic 1-2 days after the operation.
You may experience dizziness if you get up quickly from a chair or perhaps when you are lying in bed, so be sensible, take it easy and move slowly. This is quite normal following surgery and should pass within a couple of days.
The first 2-5 days following your breast surgery you may feel stiff and sore in the chest region. You should be calm and lie as still as possible, with your upper body raised. For the next five days, you can move gently. If you have an active job, it is a good idea to stay home.
After the operation, you get a special bandage that is removed after 2 days, the tape is kept on for 2 weeks. You will be required to wear a sports bra for approximately 6 weeks after surgery day and night and 6 more week at daytime. Your breasts may feel tight and sensitive to the touch and your skin may feel warm or itchy.
After the tape is removed (after 2 weeks) you can shower the area and put on new tape. It is recommended that you tape the scars with skin-friendly tape for at least 2 months. Surgical tape such as Micropore or Steri-Strip can be bought at the pharmacy, alternatively silicone tape.
Follow ups will be carried out at the clinic/alternatively through phone or video consultation:
1 day after surgery, after 1-2 weeks, after 3-6 months and finally after 1 year when our guarantee to you is completed.
Bleeding and infection are unusual and if they do occur, they may need to be treated with a small operation and/or an antibiotic. Asymmetry, incorrectly placed implants, or the formation of hard capsules” capsular contracture” can also occur. If corrections are needed, they will be scheduled free of charge within one year after your surgery. Anesthesia allergy is extremely rare.
If correction is necessary due to complications or unsatisfactory results, this is done free of charge within one year, if there is a medical indication and a clear potential for improvement. This is our warranty period.
Heavy physical exercise and strenuous body movement or lifting must not be undertaken for a minimum of 4 weeks following the surgery.
The results will emerge between 3 to 6 months following surgery.
On this page you will find:
If you want to know more or have questions, use the form and we will reply to you within a short time.
Dr. Amin Kalaaji
The responsible physician is Dr. Amin Kalaaji, senior physician MD, specialist in plastic surgery and head of clinic at Oslo Plastic Surgery, and head of the Norwegian Association for Aesthetic Plastic Surgery (NFEP) 2018-2020.
Dr. Kalaaji holds many positions and gives lectures and training around the world. This benefits all our patients as he is always up to date on the latest and most advanced treatments and surgical techniques.
Patient safety, high quality and individual treatment always weigh the most at Oslo Plastic Surgery.
Oslo Plastikkirurgi answers here frequently asked questions, and we hope that this will give you good information. We want to be helpful in the process before an operation. If you have more questions, just write or call us.
When you have breasts with older prostheses.
When you have had hard and painful capsule formation and a negative change in the shape of the breast.
Feel that «the prostheses have done their job, or I’m done with them»
By entering the scar from the insertion of the prosthesis. The old prosthesis is removed together with the capsule in cases of capsule contraction.
Yes, you can easily combine the exchange of breast implants with, for example, a breast augmentation. And or fat transplantation. This is agreed with the surgeon prior to the operation.
For the first 6 weeks you should only wear a sports bra, the first 3 weeks both night and day, together with a chest strap. Avoid wired bras for the first 6 months
You can shower your body after the operation but avoid the bandage that will be on for 3 days, we recommend that you wait until after this. After 2 weeks, you should shower the chest area and put on new surgical tape Micropore or Steri-Strips which can be bought at the pharmacy.
Normally you can exercise carefully after 2 weeks, and you must use your arms carefully during the same time. That is, do not raise your arms high or carry heavy things.
You can calmly start work two to three days after the operation if you do not have hard physical work. Sick leave is not normally issued for breast surgery, but we issue a certificate of medical examination and treatment upon request.
You must be healthy on the day of surgery. If you are in doubt about whether you have a cold or the like, you must contact us. The operation is not performed when you have the flu and / or fever or cough or other infection in the body. Our staff will receive you and together complete you for the operation, the surgeon looks at you before the procedure and draws up the planned procedure, as well as answers your questions. Anesthesia staff also come to greet you and answer your questions. After the operation, you will be served food and plenty of drinks in the form of bread, yoghurt, and juice (tell us if you want another diet / have allergies).
In Norway, it is not allowed to show before and after pictures from cosmetic procedures during marketing or on the clinic’s website. However, we can show great pictures from previous patients when you come for a consultation with the surgeon. This can be very helpful when choosing the shape and size of the implant, and it can make it easier for you to imagine a result. We do not send photos.
We have a 1-year warranty. If correction is necessary due to complications or unsatisfactory results, this is done free of charge within one year if there is a medical indication and a clear potential for improvement. This is our one-year warranty agreement.