Explanting After Reconstruction

More and more women are explanting after reconstruction. Women explant their reconstruction after mastectomy due to a number of complications. These complications include pain or discomfort caused by capsular contracture, various infections, discovering symptoms of breast implant illness and the possibility that many symptoms they attributed to their cancer treatment, (i.e. chemotherapy, radiation, preventative hysterectomies causing surgical menopause in premenopausal women, as well as side effects from breast cancer related drugs) could actually be caused by their breast implants instead.  Some of these women have immediate reactions to their implants while others take longer to accumulate symptoms and some are suffering more severely than others.

Regardless, when women discover many of the negative effects of breast implants such as capsules and implants harboring mold or bacteria that could be making them ill or the silicone implant could be decomposing and leaking or ruptured inside of their chest cavity contaminating them with silicone chemicals and heavy metals they move to explant their reconstruction.

While the possibility of going through yet another surgery or second mastectomy and contemplating the idea of further reconstruction without implants versus going flat, is definitely agonizing, and fear-producing for women who have already been through the trauma of breast cancer treatment and loosing their natural breasts completely, it is a place many come to when discovering and researching breast implant illness and the negative effects of having breast implants inside of their body.

Breast cancer and subsequent breast implant illness survivors repeatedly express they were not informed of the possible negative health affects of either saline or silicone breast implants, the multiple surgeries involved going forward with reconstruction, nor were they provided other essential information to enable proper informed consent before they decided to reconstruct with breast implants. Most express that had they been provided the long list of possible risks and other complications, they would never have chosen reconstruction for themselves. These women commonly feel they were too quickly steered toward breast implants, or another type of flap reconstruction (that also sometimes includes implants), and never provided the option to “go flat.” Many women who had expressed the desire to go flat often say they were dissuaded or discouraged from doing so. Another common theme is the pressure and rapid pace by which these reconstruction decisions are required to be made, in the middle of a life-altering diagnosis, without the time to carefully consider all options.

Our knowledge and experience of going flat is evolving and we would like to point out there is a difference between going flat (explanting your breast implants) and aesthetic flat closure which is a procedure which removes excess skin and breast tissue to create a smooth chest.  Not everyone is a candidate for aesthetic flat closure and it’s not an easy procedure to do well. In one surgeon’s words, “Flat closure is very confusing and most people don’t understand what’s involved. Flat closure requires tight skin as well as even contour at the mastectomy site and surrounding tissues. I have to remove that excess skin after the implant removal or patients will have loose skin fault that will prevent a flat appearance. But more importantly, the surrounding tissues especially subcutaneous fat cannot be very thick. After the mastectomy the breast area only has skin on top of the muscle with no subcutaneous fat. So if the patient is heavier and has thicker subcutaneous fat of the surrounding areas, the contrast between thicker surrounding areas and the mastectomy site where there’s no subcutaneous fat, is the reason for the concavity at the mastectomy site. As a result flat closures can only be achieved in thinner patients with very thin subcutaneous fat in the surrounding areas.”

The most significant points we would like to stress to women facing explanting their reconstruction breast implants due to breast implant illness is that proper explant which procedure is an En Bloc Capsulectomy or Total Capsulectomy (remove implant and all capsule tissue plus any other foreign body such as mesh or dermal matrix if used) is paramount to your healing from symptoms of breast implant illness and to preventing more cancer.  At this time oncologic surgeons and reconstruction surgeons may not remove capsules or think it’s necessary. For your best healing, choose a surgeon dedicated to removing all the capsule tissue.  Also, going flat without aesthetic flat closure may be the norm for most as many won’t be a good candidate for aesthetic flat closure.   

Women ask if fat transfer to the breast works and the answer is it’s not suitable to replace breast reconstruction. In order to build a small breast mound you would need a series of five or so fat transfers that don’t fail but the truth is most fat transferred to the breast fails and especially when done at the time of explanting.  When fat transfer fails other risks can occur such as the fat turns cystic and necrotic causing further problems in the breast.  Women also report deformities at the harvest sites as well. 

Further many women consider flap reconstruction such as DIEP (deep inferior epigastric perforator, the main blood vessel moved) right after mastectomy or as an option later during or following implant removal. Branches of blood vessels are relocated during the procedure as well as nerves and muscles. Sadly, we are hearing increasing reports of complications after flap surgery. Flaps of all kinds require skilled microsurgeons with special equipment. Explant and flat closure do NOT require microsurgery. Despite medical studies showing only 1 or 2 percent flap failure, anecdotally those percentages are looking much higher. One woman in our group referred to her flap as “barbaric.” Cancer survivors may heal more slowly after chemotherapy and radiation too and should carefully research flaps in groups devoted to that topic and in medical literature. Flaps are very long surgeries — often more than eight hours (for both breasts). Mortality risks increase with length of anesthesia. Cognitive changes are not infrequent with any long surgeries and are especially common over the age of 60. Complications from flaps include major necrosis of the newly created “breast,” hematomas, infections — including severe ones requiring months of wound vacuums — at the donor site, and blood clots. Typically women spend at least a night in the ICU following flap surgery and then several days in the hospital. Flaps are MAJOR surgical procedures for purely cosmetic purposes to achieve a mound simulating a breast. They have no advantages for cancer treatment or further screening. Some women have reported extreme pain for months, disfigurement and an inability to drive even after half a year after DIEP. Others have had entire breasts turn necrotic when blood flow and nerves fail to regenerate. Since both the abdominal area used for harvesting tissue and the chest muscles will be very sore, mobility will be challenging for most for months. The chest and abdomen/core are used for getting up from sitting or reclining as well as for walking. Some women report that they have never regained full use of their abdominal muscles, resulting in poor quality of life and disability. Cosmetic results also vary and flaps typically require several revisions, requiring more surgery and more anesthesia. Each surgery will then entail further detoxing and recovery.

The safest option for women after breast cancer is going flat and more and more women are refusing complicated invasive revisions to their post-mastectomy body.

The resources in our group focus on surgeons who are experienced in proper explant and we are now adding a notation if they also do good aesthetic flat closure, not that aesthetic flat closure is necessary.  

Below are some additional resources we gathered to support women explanting their breast implants placed following reconstruction for breast cancer related surgeries.

Facebook support groups for those considering or explanting to FLAT-i.e., no further reconstruction of breast mounds but still able to use breast forms or prosthesis if desired:

Fabulously Flat

Fierce, Flat, Forward

For women considering further surgical reconstruction of breast mounds post-explant:

DIEP Flap Support Group

Website(s) listing flat friendly surgeons:

Flat Closure Now

Not Putting On a Shirt

Please join our Facebook group of over 150,000 women for support through your healing journey.

We look forward to your comments, feedback and personal stories about your symptoms due to breast implants. Please see the comment form below. Thank you.

This Post Has 22 Comments

  1. Marisa

    Hi I was diagnosed with b/c in 2019 had a double mastectomy followed by chemo and targeted therapy ( her2+) I also ha immediate reconstruction. I now have a list of problems! I went to my PS he recommended a lift to these heavy gel implants! But
    I’m not doing that!!!! I’m choosing to go flat and hopefully feel better? I do see the women who choose to do explant have a better quality of life! I’m hoping this will be my case! I’m 61 years old and it’s now about how I feel and not how I look as far as breasts go! Please let me know if any of you went through the same. And how long of a recovery was the explant healing process! thank you in advance!

  2. TamiKay

    I had a bilateral subcutaneous mastectomy at age 26! I have had a total of 13 reconstructive surgeries the last one being almost 25. years ago I am currently turning 60 this year.
    My health has been on a down ward spiral for years. But my mother also has MS.. so all the neuro symptoms I have the docs kept thinking I have Ms
    one said it was prednisone related from taking steroids for my lungs. But it has progressively gotten worse and they diagnosed me with progressive , degenerative full body idiopathy neuropathy. Muscle weakness, severe nerve pain can settle in my ear, my toes.. my hands my face.. Numbness and tingling in toes and feet and legs and hands and upper back.. brain fog and fatigue.. Burning sensations like tortuous fire on my legs and feet if I spend any time in the sun I pay for it all night. I could go on with more neuro symptoms.. I know my triggers.. but My biggest fear is what if I take these out and I have nothing but a concave chest and saggy skin and turns out the neuro stuff was not from the implants.. but actually what the docs said? did anyone have the symptoms not go away?? Has anyone else had similar to my sysmptoms that were aggravated by heat and or extensive standing /walking or stress? I made the first appt and its on July 18th but can’t get into actual surgery til Nov.. I have to decide for just explant or to replace these with cohesive gel.

    1. Lorraine

      Hi Tami,
      Thinking of you and your upcoming consult. I’ve had cohesive gel implants for 2.5 yrs after my double Mastectomy and can not wait to get them out July 20. I definitely believe in BII and encourage you to research as saline or cohesive they still can be bad for our health.

  3. Donna

    I had double mastectomy and chemo in 2010. Around 2014 i started getting give and facial edema. No one and I mean no one could figure out why. After a slew of blood tests, My oncologist diagnosed me with immunoglobulin deficiencies and I started getting IVIG infusions every 3 weeks. Lots of inflammation, upper resp illness, sleeping problems, depression … still getting hives and always feel like crap. Now I’m also gett 309 mg Xolair shots every month. They say that supposed to help with hives and edema. But we shall see. Everyone says the chemo damaged my immune system. I had implants checked with mri and ultrasound I’m feeling confused. I’m not happy about going flat. Wish there was a way to know if it’s the implants or

    1. Nicole

      Hi Donna,
      Many women are explanting their reconstruction breast implants and getting their health back. Breast implants are two large foreign objects implanted in your chest and made of toxic chemicals and heavy metals which disperse into your body affecting your organs and glands and health processes. On the Breast Implant Safety page of this website review the chemicals of silicone and you’ll understand why you are sick.

  4. Cheryl

    I had a bilateral mastectomy with reconstruction about at 26 and am turning 60 next month . I plan to have them removed but I’m nervous, i look disfigured without them. My breastbone is concave on one side. I would like any advice and experience with have this done and any alternative reconstruction options. I’ve already had doner muscle implanted and fat injections in order to have the saline implants i have now. They’ve been in since 2010 and i just experienced a TIA so explant is a definite

  5. Leisha

    I had a double mastectomy at 44 and now I’m 52 and suffer terribly with certain things … no one has any answers. I have high bp, inflammation, huge amount of weight gain.. I am starting to wander if I need them out. Yet I’m afraid of looking like a freak. 🙁

    1. Becky Richard

      Leisha, I explanted to flat at the end of 2020. I absolutely love being flat. Although it is an adjustment, it’s a beautiful, freeing feeling. For the first time since my diagnosis in 2017, I feel healthy! I am very happy. 🌈❤️

    2. Julie

      I’ve had 20-25 pounds of weight gain. I’m getting mine removed (single) and getting the Diep procedure (I think that’s the one..only taking fat and skin if needed) to create a new more natural breast.

      1. Susie

        Hi Julie – I have a single implant as well and would like to explant, but don’t know what to do. Can you share with me what you’ve done? DIEP, fat transfer, flat closure. Is there another choice for one small B cup breast that is less invasive than DIEP?

  6. Mandie Sabo

    I was diagnosed in 2014 at 35 years old and had a double mastectomy. I had reconstruction and everything looks really good after everything I’ve been through with chemo and radiation. In the last couple years I’ve developed joint pain and inflammation in my wrists knee joints and have had unnecessary knee procedures when it’s only the inflammatory process that’s happening there’s nothing wrong with my knee. It’s the synovial fluid and I have no idea why I keep developing it in my knees. Sometimes I feel like my elbows are breaking when I just try to work out. I’ve always had migraines ever since I had children with my hormones changed. They are few and far between. I am stuck because I am on tamoxifen for 10 years because my cancer was estrogen driven and the tamoxifen has a lot of similar side effects. I am happy to see your stories because I felt like I got bashed by other people that have no idea what it’s like to have their original breasts completely removed see yourself sunken in and flat and abnormal looking. You just want to feel like a woman again. I don’t want to keep them just for that but I’m scared what my mental state will be. I’m not debilitating in bed like someone say I feel like I can push through it but I recently got put on medication for my rheumatoid arthritis. Now that I’ve been diagnosed with that it makes me want to look into BII more

    1. Terry Rimer

      I am on tamoxifen as well, but symptoms greatly improved after explant.

    2. Denise

      Hi Mandir
      I had BC in 2012 at 30 years old. Double mastectomy and reconstruction.
      I am also es+. I was on tamoxifen for about 6 years then letrozole for almost 1 year and now on anastrozole. I have about 1.5 years left (I think) I am in constant pain and wonder if it is from the implants or anastrozle. I’m sure it’s a combo, but makes me wonder about the implants. I’m on my second d set as I got them done in 2003 because I wanted them. And I’ve always had some problems…. I wish you well

  7. Sherie Robson

    I’ve been wanting to be Ex implanted for a while now, and after researching more about the implants I’ve made a decision to move forward to doing this. I’ve been dealing with several issues that are a result of my silicone implants and didn’t realize it. I have felt tired even after sleeping at night, hair loss, itching in my chest, sometimes sharp pains in my chest, trouble losing weight, anxiety brain fog, eczema, etc…

  8. Lisa

    I had a bilateral mastectomy with reconstruction about 17 years ago. The more I read the more I am contemplating have them removed. I would like to anyones experience with have this done.

      1. Donna

        Thank you so much for the information. I too had a double Mastectomy and reconstructive surgery in 2009. I had a year of expanders and then implants put in. I did have them exchanged in 2016 but ironically they were replaced with textured implants. I have so so many symptoms and more each year. I feel as if I’m being to die from inside out. Thank you Thank you for your video. I definitely want these removed 😡. I live in New Jersey and starting to research Doctors in my area or states near me. I hope you are continuing to feel better and better. Thanks for sharing ❤️

      2. Gina Woodlee

        Becky, thank you so much for the video. I am in the process of deciding what to do once I have my Allergan textured implants removed – to have them replaced with non textured or to go flat. Both are hard choices for me. I have a question about the scars and after surgery. Why did the surgeon not leave your nipples? Thank you so much and also, we’re you able to build your muscle up in your chest afterwards too? I would think this might help to look better. Thanks again.

  9. Susan dagleu

    Educational information needed

    1. Maria Cruz

      Couldn’t explained my experience better. I’m having such hard time finding a surgeon willing to explant me in Puerto Rico. I’ll not surrender until I found one. Nothing is more important than been healthy, I feel I was lied to. I asked several times for extra operations that would be required, safety and even expressed the possibility of been flat and got an assurance that no extra operations or safety issues will be needed. Yes, and now here I am, with a broken implant inside me and tons of extra symptoms I don’t need.

  10. Donna Guerrero

    Thank you ever so much. I’m 66 years old and I’ve been a widow for over 6 years, the second time I was diagnosed with cancer I was alone and technically I’m still alone.. so this site is a Blessing

  11. Cheryl

    Thank you so 💓 very much. Grateful for a spot to read learn and connect with women who are going through or who have gone through this terrifying situation of yet one more hurdle.

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