Breast implant removal and breast lift in Switzerland: regaining natural breasts

More and more women who have had breast implants for many years are choosing to part with them. The reasons vary: capsular contracture that hardens and distorts the breasts, a rupture discovered at a check-up, concerns linked to information about certain implants, systemic symptoms they attribute to their implants, or simply the wish to regain a body without implants, lighter and in keeping with a new stage of life. But removing implants, especially when they have been in place for ten, fifteen or twenty years, often leaves empty breasts with stretched skin that sag. That is why explantation is frequently combined with a breast lift, which raises the areola and tightens the skin envelope around the remaining volume. This page explains why and how implants are removed, what is done with the capsule that surrounds them, when and how to combine a lift, what the breasts will become, how recovery unfolds, the risks, the question of insurance and provision in Switzerland.

Under general anaesthesia, the surgeon removes both implants, usually through the old scar or through the lift incisions, and treats the capsule surrounding them: they may leave it in place, open it, or remove part or all of it, depending on its condition and the type of implant. They then perform a lift that raises the areola, removes excess skin and reshapes the remaining gland, sometimes with fat transfer to restore a little volume. The procedure generally takes two and a half to four hours, often with one night at the clinic. The resulting breasts are smaller than with implants, but higher and firmer than breasts that have simply been emptied. When removal responds to a medical complication, a coverage request can be sent to the insurer; the lift usually remains cosmetic. Budget guidelines are on the page on breast implant removal with lift prices in Switzerland.

Explantation involves removing breast implants without replacing them. The lift, or mastopexy, involves raising the areola and nipple, removing excess skin and reshaping the gland to give the breast a higher, firmer shape. Combined, these two procedures aim to transform breasts that have long carried implants into harmonious natural breasts of more modest volume.

The procedure should not be confused with implant replacement, which swaps the implants for new ones, possibly combined with a lift; our page on implant replacement with a breast lift covers this other option.

Reasons for removal fall into several broad groups. Some are medical: painful or distorting capsular contracture, rupture, fluid accumulation around the implant, infection, malposition. Others relate to health in the broad sense: concerns linked to information about certain types of implant, systemic symptoms the patient attributes to her implants. Others still are personal: weariness, the wish to regain a natural body, discomfort during sport, a changing view of one's body with age. All these reasons are legitimate; the surgeon's role is to hear them and check that no medical cause requires a particular assessment.

Over the past ten years or so, the number of women asking for their implants to be removed without replacement has risen markedly. Several factors contribute: the withdrawal of certain textured implant models from the market, media coverage of implant-associated lymphoma, testimonials about systemic symptoms, particularly on social media, but also a shift in taste towards more natural, discreet breasts. Many women operated on in the 1990s and 2000s are also reaching an age when their relationship with their body changes. Surgeons have adapted their practice to this demand, developing techniques for capsulectomy and reshaping breasts without implants.

Breast implants have changed a great deal since they appeared in the 1960s. The first generations had a thin shell and very fluid gel, which could bleed or spread in the event of rupture. Later generations reinforced the shell and made the gel more cohesive. Textured surfaces, widely used for several decades, have largely been abandoned in favour of smooth or microtextured surfaces. Women with old implants may therefore have implants very different from those placed today, which influences the condition of the capsule and the removal technique.

Implants placed more than twenty or thirty years ago are more likely to have ruptured, with gel that may have migrated into the capsule or neighbouring tissues. The capsule is often thickened, sometimes calcified. Removing these implants requires particular care: precise imaging before the procedure, often a capsulectomy, and careful cleaning of the tissues. A lift is almost always indicated after so many years.

Some women have implants filled with saline rather than silicone gel. In the event of rupture, the saline is absorbed by the body and the implant deflates, which is noticed immediately. Removing these implants is generally simpler, and the capsule is often thin. A lift is still frequently needed to reshape the breasts.

The decision to explant rests on a dialogue between the patient and the surgeon. The patient expresses her reasons, fears and expectations; the surgeon provides their analysis of the condition of the implants and capsule, explains the options and the benefits and risks of each, and checks that expectations are realistic. They do not have to persuade the patient to keep her implants, nor promise uncertain benefits. This shared decision is the best guarantee of a calm choice.

Many women who want their implants removed feel they have not been listened to, whether about their symptoms or their wish to live without implants. Good support begins with attentive listening, without judgement. It is also a criterion for choosing your surgeon: feeling understood and respected in your decision counts as much as technical skill.

Information about implants circulates widely, particularly online, with sincere testimonials but also unverified claims. Plastic surgery societies, health authorities and manufacturers publish regularly updated information about implant safety. It is useful to rely on these sources, and to discuss what you have read with the surgeon, to distinguish what is established from what remains uncertain.

Over the years, certain implants have been the subject of alerts, sometimes market withdrawals, because of manufacturing defects or an increased risk of complications. If your implants belong to an affected model, your surgeon or the facility where they were placed may have been informed. The authorities and professional societies then issue recommendations, which do not always call for systematic removal but for appropriate surveillance. The decision to remove is then made case by case.

Some women experience the wish to remove their implants as a step backwards or an admission of a mistake. It is nothing of the sort: needs and wishes change over a lifetime, and a decision made at thirty can legitimately be revisited at fifty. Implants have often brought years of satisfaction; removing them is simply a new stage. The surgeon supports this choice without judgement.

During the years with implants, the breasts have adapted: the skin has stretched, the gland has often thinned under the pressure of the implant, and the tissues may have slackened with age and pregnancies. After removal, a skin envelope too large for the remaining volume is left. The breasts then look empty, flat at the top and saggy. The extent of this change depends on the volume of the implants, how long they have been in place, skin quality and the volume of gland remaining.

Implants are not designed to last a lifetime. Their shell can wear, and the risk of rupture increases over the years. Many women keep them for more than ten or fifteen years without problems; others encounter complications sooner. When old implants need changing, the question naturally arises: replace them or remove them permanently.

The breasts you had before your implants were placed do not return as they were. During the years with implants, the gland has often been compressed and has thinned, the skin has stretched, and pregnancies and time have changed the tissues. The remaining natural volume is often slightly smaller than the original. That is why a lift and sometimes fat transfer are useful to achieve a harmonious shape. Being aware of this difference helps set fair expectations.

An implant exerts continuous pressure on the gland and fat covering it, especially when it is placed under the gland or is large. Over the years, these tissues thin, rather like skin that is stretched. After removal, this tissue loss is not spontaneously recovered. The surgeon assesses the remaining thickness on examination and imaging, which helps predict the final volume.

No. In a young woman with elastic skin who has had small implants for a short time, the skin may retract sufficiently after removal, and the breasts may regain an acceptable appearance without a lift. In most cases, however, especially after years with implants, large volumes, pregnancies or weight loss, the skin does not retract enough and the areola stays low: a lift is then necessary to achieve a satisfactory shape.

As soon as an implant is placed, the body forms a thin membrane of scar tissue around it: the capsule. It is normal and, most of the time, supple and thin. Over time, it can thicken, contract and harden, causing capsular contracture; it can also calcify, be accompanied by fluid accumulation or, very rarely, be the site of implant-associated lymphoma. In explantation, the central question is therefore what to do with this capsule.

Capsular contracture shows as a breast that gradually hardens, changes shape, rides up or becomes spherical, and may become painful. It may affect only one side. Surgeons classify it in several grades, from a soft, normal breast to a hard, distorted and painful one.

In explantation for capsular contracture, the thickened capsule is generally removed, which makes the hardness and pain disappear.

Sometimes capsular contracture affects only one breast. The patient may then hesitate to remove both implants. In most cases, both sides are treated, to keep symmetry of volume and shape. The work on the capsule may differ on each side, more extensive on the affected side.

Modern implants, filled with cohesive gel, often rupture without symptoms: the gel stays within the capsule. This is called intracapsular rupture. It is discovered on a check-up MRI or ultrasound. More rarely, the gel escapes from the capsule and may migrate into neighbouring tissues, even towards the lymph nodes of the armpit; this is called extracapsular rupture. A change in shape, pain or a new lump may then appear. A rupture justifies scheduling removal or replacement of the implant.

Fluid accumulating around an implant, especially when it occurs more than a year after placement, shows as swelling of a breast, often rapid. It must always be investigated with an ultrasound and, if necessary, aspiration with analysis of the fluid, notably to look for implant-associated lymphoma. In most cases the cause is benign, but this examination is essential.

Over the years, particularly around old implants, the capsule can calcify, becoming rigid and sometimes visible on mammography. A calcified capsule hardens the breast and can interfere with the interpretation of imaging. In explantation, it is generally removed, which may require delicate dissection.

The choice depends on the condition of the capsule on imaging and during the procedure, the type of implant, the reasons for removal and the risks of each procedure.

When the implant was placed behind the pectoral muscle, the back of the capsule lies directly on the ribs and intercostal muscles. It is often very adherent and very thin there. Removing it completely carries a risk of bleeding and of breaching the chest wall. Many surgeons then remove the front of the capsule, which is more accessible, and leave the back when it is healthy, after discussing it with the patient. This compromise reduces the risks without compromising the result in most situations.

When the implant was placed under the gland, in front of the muscle, the capsule is more accessible. Its back lies on the pectoral muscle, which makes dissection easier. A total capsulectomy is generally simpler and less risky there. It may, however, thin the gland tissue further, which the surgeon takes into account for the lift.

The capsule is supplied by small vessels, and its removal leaves a large surface that may bleed. The surgeon carefully cauterises these vessels and often places a drain. This risk of bleeding partly explains why total capsulectomy is not systematic, and why monitoring in the first few hours is important.

The question of routinely removing the entire capsule is debated. Some patients ask for it, particularly when they attribute systemic symptoms to their implants. Total capsulectomy is justified when the capsule is thickened, calcified, associated with a fluid collection or suspected lymphoma, or after certain ruptures. But it is not without risk: when the capsule is very thin and stuck to the ribs or muscle, complete removal can cause bleeding, injury to the chest wall and, rarely, a pneumothorax. A reputable surgeon weighs the benefits and risks in each situation and explains their choice.

En bloc removal involves removing the implant and its capsule in one piece, without opening the capsule. It is recommended when implant-associated lymphoma is suspected, and can be useful in the event of rupture with gel contained in the capsule. It often requires a longer incision and more delicate dissection, especially when the implant is behind the muscle. It is not always feasible without excessive risk; the surgeon adapts it to each situation.

When the capsule is removed, it is generally sent for analysis. If there is fluid around the implant, it is sampled and analysed, notably to look for implant-associated lymphoma. These analyses confirm that the tissues are benign in the vast majority of cases and, rarely, detect an abnormality requiring specific management.

The result of the capsule analysis is generally available a few days to two weeks after the procedure. In the vast majority of cases, it shows a benign fibrous capsule, sometimes with silicone deposits or calcifications. Very rarely, an abnormality requires further management, organised with specialists. The surgeon gives you the result at a check-up.

Breast implant-associated anaplastic large cell lymphoma is a rare cancer of the immune system that develops in the capsule, mainly around textured-surface implants. It most often shows, years after placement, as swelling of a breast due to fluid accumulation, more rarely as a lump. Diagnosed early, it is generally treated by en bloc removal of the implant and capsule. According to current recommendations, having textured implants without symptoms does not justify routine preventive removal, but it may prompt a personal decision to remove them, after being informed.

Certain signs justify a prompt consultation, regardless of any decision about explantation: a breast that swells markedly and rapidly years after placement; a new lump near the implant; lymph nodes under the arm; unusual redness or pain. These signs often have a benign cause, but they must be investigated, notably to rule out implant-associated lymphoma.

Some women with implants describe a set of systemic symptoms: fatigue, joint and muscle pain, problems with concentration or sleep, rashes, digestive problems. This is sometimes called breast implant illness. A cause-and-effect link has not been established scientifically, and these symptoms have many other possible causes. Studies do, however, report an improvement in some patients after implant removal, though it is impossible to predict who will benefit. An overall medical assessment with the GP is recommended before the procedure, so as not to miss another illness.

Women who attribute problems to their implants often describe a combination of symptoms: persistent fatigue, joint or muscle pain, sleep problems, difficulty concentrating, headaches, skin rashes, hair loss, digestive problems and a feeling of general malaise. These symptoms are real and can greatly affect quality of life, but they are also common in the general population and can have many causes, medical or otherwise.

Before removing implants for systemic symptoms, a medical assessment is recommended: clinical examination, blood tests, and checks for inflammatory or thyroid disease, a deficiency or a sleep disorder, depending on the symptoms. This assessment is not intended to discourage removal, but to avoid missing another cause that would require specific treatment. It also makes it possible to follow progress after the procedure.

Published studies on symptoms attributed to implants are of variable quality. Some report an improvement in symptoms in a significant proportion of patients after removal; others find no clear difference from the general population. Any mechanism has not been established. Professional societies recognise the reality of the distress expressed by patients and recommend listening to them, informing them honestly and respecting their choice to have their implants removed.

When removal is prompted by systemic symptoms, it is important to talk about it openly with the surgeon: the procedure may relieve some patients, but it does not guarantee that the symptoms will disappear. Assessment by the GP or a specialist, before and after, allows progress to be followed and other causes to be looked for if the symptoms persist. This transparency avoids disappointment and points towards the best overall care.

Some patients ask for total or en bloc capsulectomy in the hope of further improving their symptoms. The available data do not establish that complete removal of the capsule brings a greater benefit than partial removal for these symptoms. The decision is made by weighing the risks of capsulectomy, especially behind the muscle, against the patient's wishes, after a frank discussion.

It is useful to note the intensity of your symptoms before the procedure, then follow how they change in the following months. Some patients report a rapid improvement, others a gradual one, others none. If the symptoms persist, the GP continues looking for a cause and the appropriate management. Removing the implants does not prevent these steps from continuing.

The combination is for women who want to remove their implants without replacing them and whose breasts, after removal, would risk looking empty and saggy. They accept smaller breasts than with implants, but want a harmonious shape. They are in good health, do not smoke or agree to stop, and understand that the lift leaves scars on the breasts.

Many women have intact, soft implants without complications and simply want to part with them. This is an entirely legitimate choice. In this case, the work on the capsule is generally limited, and most of the procedure concerns the lift and, if needed, fat transfer. Prior imaging checks that everything is in order.

Some women without complications wonder whether it is better to remove their implants before a problem arises, for example as they approach an age at which surgery would be more demanding. There is no recommendation for preventive removal in the absence of complications or an alert about the model concerned. The decision is a personal choice, which may take into account age, health, the wish to no longer need surveillance and the prospect of an inevitable future replacement. Having the procedure at a chosen time, in good health, rather than as an emergency during a complication, can be an argument for some women. The surgeon helps you weigh these elements without pushing you one way or the other.

If you choose to keep your implants, regular imaging surveillance, according to recommendations, allows rupture or another complication to be detected early and surgery to be scheduled in good conditions when the time comes.

An infection around an implant, whether it occurs shortly after placement or years later, generally requires removal of the implant. In this context, the lift is not performed at the same time: the priority is to treat the infection, let the breasts heal, then decide several months later on any reshaping. This is a particular situation, distinct from planned explantation.

Some women have had several procedures for recurrent capsular contracture, with implants changed each time. After several recurrences, many choose to give up implants permanently. Explantation with capsulectomy and a lift ends this cycle, at the cost of smaller breasts. The tissues, often weakened by successive procedures, require a cautious technique, sometimes in two stages.

An implant that has moved downwards or to the side, rotated or created a distortion may prompt removal, especially if several corrections have already been attempted. Removal followed by a lift restores a natural shape, without the risk of further displacement. The fold and the position of the gland are then corrected during the lift.

Very large implants greatly stretch the skin and thin the gland. After their removal, the excess skin is significant and the breasts look very empty. The lift is then more extensive, often an inverted T, and fat transfer is frequently proposed. The result is clearly smaller but reshaped breasts. These situations particularly benefit from a well-planned strategy.

After breast reconstruction or in some cases of asymmetry, a woman may have only one implant. Its removal raises the question of balance with the other breast. The surgeon may then propose reshaping the other side, or fat transfer, to restore symmetry. These situations, often linked to reconstruction, require specific management.

Many women considering explantation are between forty and sixty. They have had their implants for a long time, have often had pregnancies, and their relationship with their body has changed. Menopause also changes the breasts: the gland shrinks and the skin slackens. At this age, the skin retracts less well, which makes a lift more often necessary. General health is carefully assessed, and breast imaging is systematic.

Some women want their implants removed at seventy or older, to simplify their lives or because of a complication. The procedure remains possible if health allows. The lift may be more limited, the aim being mainly comfort. The anaesthetist carefully assesses the risks, and the procedure is adapted to each situation.

In women under forty, the skin often retracts better, and the lift may be more limited or performed as a second stage if necessary. Between forty and sixty, combining removal and a lift in one stage is the most common situation. After sixty, the aim is often comfort above all, with a lift adapted to health and expectations.

The result depends greatly on the volume of gland and fat remaining after removal. Breasts that kept a reasonable natural volume under the implant will give, after a lift, medium-sized, full, firm breasts. Breasts greatly thinned by years of a large implant will give small breasts. The surgeon assesses this volume on examination and imaging, and may propose fat transfer to supplement it.

The surgeon estimates the final volume by palpating the gland through the implant, measuring tissue thickness on ultrasound and taking into account age, weight and history. This estimate remains approximate, as the tissues' reaction after removal varies from one woman to another. It is therefore wise to expect rather small breasts, and be pleasantly surprised if they are fuller.

After removal, the skin retracts gradually over several months. In a young woman with small implants, this retraction may be sufficient. In most others, it remains incomplete, hence the need for a lift. Stretch marks, thin skin and older age limit retraction.

Before explantation, recent imaging is essential: ultrasound, often MRI to check the integrity of the implants and the condition of the capsule, and mammography depending on age. It detects rupture, fluid accumulation, a thickened or calcified capsule, and checks that there is no abnormality of the gland. It guides the choice of procedure for the capsule and serves as a reference for future surveillance.

It is very useful to find information about the implants in place: implant card, operative report, brand, model, surface, volume, date of placement and placement plane. These elements help the surgeon plan the work on the capsule and anticipate difficulties. If you no longer have them, the facility where you had surgery can sometimes find them, and imaging provides indications.

Many women no longer remember exactly what type of implants they have, especially when they were placed long ago. This information is nevertheless valuable: a smooth or textured surface guides the work on the capsule; the placement plane, in front of or behind the muscle, determines the technique; the date of placement and any replacements indicate the likely condition of the implants. The implant card, the operative report or a letter from the facility where the procedure took place allow these elements to be found. Failing that, imaging provides indications, and examination of the implants removed completes the information.

The plane in which the implant was placed influences the procedure. An implant placed in front of the muscle, under the gland, is simpler to remove, and the capsule is accessible. An implant placed behind the muscle requires working under the pectoral muscle; the capsule there often adheres to the ribs, which makes total capsulectomy more delicate. After removal of a submuscular implant, the muscle must regain its position, and the surgeon may reattach it.

The consultation begins with your reasons for wanting your implants removed and your expectations for your breasts. The surgeon takes the history of your implants, any symptoms, your pregnancies, weight history, and your own and your family's medical history. They examine the breasts, skin suppleness, areola position and breast consistency, look for capsular contracture and assess the volume of gland. They discuss with you the options for the capsule, the type of lift, possible fat transfer and the choice between one and two stages, and give you a quote.

Before the procedure, the surgeon provides written information describing the removal of the implants, the planned work on the capsule and its risks, the type of lift and its scars, any fat transfer, recovery and the alternatives. Take time to read it and ask your questions. When removal is prompted by systemic symptoms, this document also states that improvement is not guaranteed. Consent is signed after a reflection period.

A reflection period of several weeks is recommended, all the more so as the decision to live without implants has often been considered for a long time and is emotionally charged. It allows you to re-read the information, talk to those close to you, ask for a second opinion and, if coverage is being considered, obtain the insurer's reply. There is no hurry, except in particular complications such as a suspicious fluid collection.

Some situations warrant prompt management: sudden swelling of a breast years after placement, which requires looking for a fluid collection and possible lymphoma; an infection around an implant; extracapsular rupture with pain. In these cases, the assessment and procedure are organised without delay. For other situations, time for reflection is valuable.

Before the consultation, gather the documents about your implants, and note your reasons for wanting them removed, any symptoms and how they have changed, your pregnancies and breastfeeding, your weight history and your questions. Bring your latest breast imaging. If you have photographs of your breasts before your implants were placed, they can help the surgeon anticipate the result.

Photographs of your breasts before your implants were placed give an idea of the natural volume and original shape. They do not exactly predict the result, as the breasts have changed with the years, pregnancies and the pressure of the implant, but they help set realistic expectations and choose the technique.

A second consultation allows you to go back over points that remain unclear, confirm the plan for the capsule and the lift, and discuss the information documents. It is particularly useful when the decision is prompted by concerns or symptoms, to allow time for the choice to mature.

Imagining your breasts without implants is difficult, especially after many years. The surgeon can help by estimating the remaining volume, showing photographs of patients who have had the same procedure, and explaining how the lift will change the shape. Some patients find it useful to wear bras one size smaller before the procedure, to get used to their future figure.

Tell the surgeon what matters most to you: removing the implants above all, a harmonious shape, minimal scars, as much volume as possible without implants, a quick recovery. These priorities guide the plan: one or two stages, type of lift, fat transfer. It is sometimes impossible to have everything at once; the surgeon helps you find the best compromise.

Removing implants can be a liberating decision, but also a source of apprehension: fear of breasts that are too small, of scars, of your partner's reaction, or a feeling of going back on a past decision. These emotions are normal. Talking about them with the surgeon, with those close to you or, if needed, with a professional helps you make a calm decision. Many women describe, after the procedure, a feeling of lightness and of reclaiming their body.

For many women, explantation is part of a wider approach: a return to the natural, a rejection of any implanted device, a wish to simplify life, reconciliation with an ageing body. The surgeon does not have to judge these motivations, but to hear them and propose the most suitable surgical response. A decision in keeping with your values is often the most satisfying in the long run.

For most women, explantation is a positive experience. For some, it reawakens old emotions: memories of the reasons for the original placement, a complex relationship with the body, health concerns, difficulty accepting smaller breasts. When these emotions weigh heavily over time, support from a psychologist or psychotherapist can help. This support is not a sign of weakness, but a useful resource for going through this change calmly. Your GP can refer you to a suitable professional. Many women say that simply being able to express their fears before the procedure helped them approach recovery with confidence.

Two strategies exist. In the first, the lift is performed at the same time as the removal: a single anaesthetic, a single recovery and a result achieved straight away. In the second, the implants are removed first, then the breasts are left to retract for three to six months before deciding on a lift. This approach allows the actual retraction of the skin to be judged, sometimes avoids an unnecessary lift, and allows a lift better suited to the final volume.

A lift after explantation is not quite the same as a lift on breasts that have never had an implant. The surgeon must anticipate the shape of the breasts once the implant has been removed, while at the time of the pre-operative markings the implant is still in place. This difficulty explains why some surgeons prefer two stages, and why experience of this type of procedure matters particularly.

During a lift combined with implant removal, especially with extensive capsulectomy, the tissues that supply the areola are under more strain. The risk of areola compromise is slightly higher than with a simple lift. This is one of the reasons why some surgeons prefer two stages in at-risk situations: very extensive capsulectomy, past smoking, diabetes, a major lift. The surgeon chooses a tissue pedicle that best preserves the blood supply.

The choice of lift depends on how far the areola must be raised and the excess skin. For moderate sagging, a scar around the areola may be enough. For more marked sagging, the scar runs vertically below the areola. For significant sagging or considerable excess skin, a horizontal scar in the fold is added, forming an inverted T. Our page on the breast lift describes these techniques in detail.

During the lift, the areola remains connected to the breast by a pedicle of tissue that brings it blood and nerves. After years with implants, the gland is often thinned and the vessels running through it may be fewer. The surgeon carefully chooses the orientation and thickness of this pedicle, taking into account the work done on the capsule. It is one of the most important technical elements for the safety of the procedure.

Some lift techniques use part of the gland located at the bottom of the breast, which is preserved, folded over and placed under the rest of the gland, at the top, like a small natural implant. This step, sometimes called auto-augmentation, fills the upper breast and gives a rounder, more lasting shape. It is only possible if the volume of remaining gland is sufficient.

Under the effect of the implants, the areolas have often enlarged. The lift allows them to be reduced and given a round shape again. The surgeon chooses a diameter in proportion to the new breast volume. Excessive tension around the areola can cause later widening of the scar; closure techniques aim to limit this.

Implants have sometimes lowered the fold under the breast, especially when they were large or placed under the gland. After removal, the surgeon may raise this fold so that it matches the new breast size. This detail contributes to the harmony of the result and avoids the appearance of breasts slipping downwards.

In some cases, notably when the tissues are very thin and stretched, surgeons use internal support materials, sometimes absorbable, to strengthen the hold of the reshaped gland. Their use remains debated and depends on each team's practice. If such a technique is proposed to you, ask what it involves, what the expected benefits and risks are, and whether the material is absorbable.

Beyond the skin, the lift reshapes the gland: the surgeon mobilises it, gathers it and fixes it higher on the chest to create a more projected volume. Some techniques use a flap of gland placed under the rest of the breast, like a natural implant, to fill the upper breast. These steps give a rounder, more lasting shape than simply removing skin.

After years with implants, the skin may be thin, marked by stretch marks and not very elastic. The lift removes the excess skin, but the quality of the remaining skin determines how well the result holds over time. Thin skin will tend to slacken faster. The surgeon takes this into account in choosing the technique and in what they announce as the long-term result.

After twenty or thirty years with implants, the skin of the breasts is often thin, sometimes marked by stretch marks, and not very elastic. The lift removes the excess skin, but the remaining skin keeps its characteristics. Regular moisturising, sun protection and suitable support help preserve the result. The surgeon takes this into account by choosing a technique that relies as little as possible on the skin to support the gland.

The shape obtained depends on the remaining volume, skin quality and the technique. In most cases, the breasts are smaller and higher than before removal, with a natural, slightly teardrop shape, without the bulging upper breast characteristic of some implants. For many women, this shape better suits their figure and age.

After implant removal and a lift, the breasts regain an entirely natural feel, without the firmness or palpable edges of an implant. For women who suffered from capsular contracture, the difference is particularly clear: the breast becomes soft and mobile again. This change is often appreciated in intimacy and in everyday life, such as sleeping on your front or hugging.

Breasts without implants move with the body, spread slightly when lying down and follow movements, like natural breasts. Women whose implants were behind the muscle no longer experience distortion of the breasts when the pectorals contract. For many, this return to breasts that move with the body is one of the most pleasant benefits.

Without implants, the cleavage is less full and more natural. Women used to a pronounced cleavage should expect this change. Fat transfer to the inner and upper breasts can improve the cleavage, within the limits of the volume fat can provide.

When the remaining volume is small, transfer of fat harvested by liposuction can restore a little volume, especially in the upper breast and cleavage. It can be performed at the same time as the removal and lift, or at a later session once healing is complete. Some of the fat is resorbed, and the gain remains modest. Our page on breast fat transfer with liposuction presents this approach.

The fat is harvested by gentle liposuction, often from the abdomen, flanks or thighs, purified and then reinjected in fine threads into the breast tissue, especially at the top and in the cleavage. Some of it is resorbed in the following months. The gain per session is modest, generally less than one cup size. Several sessions may be needed for a more marked gain.

When the volume obtained after removal and the lift is considered insufficient, a second fat session can be performed at least four to six months later. It is often day surgery and lighter. The healed breast tissues accept the fat in better conditions than during the initial procedure.

Fat cannot replace the volume of an implant in a single session: the breast accepts only a limited amount of fat at a time, and some of it is resorbed. To regain a volume close to that of a medium-sized implant, several sessions would be needed, and the result would remain uncertain. Fat is therefore mainly a tool for improving shape and adding some volume, not for reproducing the volume of an implant.

If, at six months, your breasts seem too small or the upper breast remains hollow, fat transfer can be considered. The surgeon assesses your fat reserves, the quality of the breast tissues and the realistic gain. The session is often day surgery. It can be repeated if necessary, a few months apart.

Injecting fat into a pocket that has just been freed of its implant is delicate: the fat must not be deposited in the cavity left by the implant, where it would not survive. The surgeon injects it into the breast tissue. Some prefer to wait a few months for the cavity to close and the tissues to heal, to perform the transfer in better conditions. The choice depends on the condition of the tissues and the surgeon's experience.

After removal, the space the implant occupied must close. If the capsule is left in place, it may produce fluid for a while. The surgeon may place a drain for a few days, fix the walls of the cavity with stitches or remove the capsule to encourage the tissues to adhere. Fluid accumulation, or seroma, is possible in the first few weeks and is treated by aspiration.

After removal of the implant, an empty space remains between the gland and the muscle, or between the muscle and the ribs. For it to close, the walls must stick together. Removing the capsule encourages this adhesion. When the capsule is left, the surgeon may lightly scrape it or fix the walls with stitches. The support bra and drains complete these steps.

When the implant was placed behind the pectoralis major muscle, the muscle was lifted and sometimes partly detached from its lower attachments. After removal, the surgeon can put it back and reattach it to the chest wall, so that it regains its normal position and does not cause distortion when it contracts. Muscle recovery takes a few weeks.

The tests requested by the anaesthetist and breast imaging are carried out. All nicotine is stopped at least a month beforehand, as it markedly increases the risk of areola compromise and poor healing. Products that encourage bleeding are suspended on medical advice. Plan two support bras, clothes that open at the front and help for the first few days.

Before the procedure, plan what will make the first few days simpler: clothes that open at the front, easy meals, pillows to sleep with your upper body slightly raised, and everyday items stored at chest height so you do not have to raise your arms. If drains are planned, a small pouch or belt makes them easy to carry when moving around the house. Someone present on the first day and night is reassuring.

A relative present in the first few days helps with movements that require raising the arms, managing the drains, meals and children. They can also offer reassurance about the emotions the new breasts may arouse, and accompany you to the first check-ups. Explaining the course of recovery to them in advance is useful.

• Two front-fastening, wire-free support bras.
• The prescribed painkillers.
• Compresses and dressings as instructed.
• Pillows to sleep on your back.
• Loose, front-opening clothes.
• The team's number and the date of the first check-up.

Plan about two weeks off work for a desk job, help at home for the first few days, childcare if necessary, suitable clothes and simple meals. If drains are planned, find out how to manage them at home. Organise check-up appointments in advance and how to get there without driving for the first few days.

A lift after implant removal places great strain on the blood supply to the areola and skin. In smokers, the risk of areola compromise, delayed healing and wound opening is clearly higher. Stopping all nicotine for several weeks before and after the procedure is essential; some surgeons refuse to operate in one stage on a patient who continues to smoke.

The procedure takes place under general anaesthesia. The anaesthetist assesses your health and treatments. Local anaesthetic infiltration reduces pain on waking.

• What type of anaesthesia is planned?
• How will pain be treated on waking and at home?
• Should my usual treatments or contraception be adjusted?
• Is thrombosis prevention necessary?
• What should I do if I had nausea during a previous anaesthetic?

With you standing, the surgeon draws the midline, the fold under each breast, the future position of the areola and the pattern of skin to be removed. This drawing takes into account the volume remaining after removal of the implants, which requires experience: the surgeon must anticipate the shape of the breasts once the implant has been removed.

The surgeon begins by removing the implants, usually through the old scar or the lift incision. They treat the capsule according to the planned approach, sampling any fluid for analysis. They control bleeding, close or reduce the cavity, then perform the lift: raising the areola, reshaping the gland and removing excess skin. Fat transfer, if planned, is performed at the end of the procedure. They check symmetry in a semi-sitting position before closing.

When the implant was placed through the fold and an inverted-T lift is planned, the surgeon often uses the horizontal lift scar to remove the implant and capsule. If the implant was placed through the areola or the armpit, removal is generally done through the lift incisions. An en bloc capsulectomy may require a longer incision.

Drains are often placed in the cavity left by the implants to remove blood and fluid for one to several days. The lift scars are closed with fine stitches and protected by dressings. A support bra is put on before you wake up.

On waking, many patients immediately describe a feeling of lightness in the chest, especially after large implants or painful capsular contracture. The breasts are tender, tight under the dressings, and the scars pull a little. Pain is generally moderate, often less than after the original implant placement, particularly if the implants were behind the muscle. You first get up a few hours later.

In the first two or three days, the breasts are tender and the drains, if in place, limit movement a little. Avoid raising your arms high, carrying loads and making sudden movements. Bruising disappears within two to three weeks. The drains are removed when drainage becomes low, often after one to three days.

Sometimes you go home with one or two drains in place. The team explains how to note the amount of fluid collected and when to have them removed. Drains are not painful, but they limit movement a little and must be handled carefully when washing. They are removed when drainage becomes low, often after a few days.

The support bra, wire-free and fastening at the front, is worn day and night for four to six weeks. It supports the new shape, limits swelling, helps the walls of the cavity adhere and protects the scars. Some surgeons add a band or firmer compression to encourage closure of the cavity. Your usual bras wait until the shape has stabilised.

In the first few weeks, loose tops and shirts that open at the front avoid having to raise your arms. The support bra is easily concealed. Many women then discover with pleasure that they can wear clothes they avoided with large implants: button-up blouses, fitted dresses, lighter sportswear.

Pain is generally moderate and well relieved by simple painkillers. It is often less than after a submuscular augmentation, as there is no longer any volume stretching the tissues. Extensive capsulectomy can, however, cause more marked chest pain for a few days, particularly with deep breaths. Pain that suddenly increases, with tense swelling, requires calling the team.

Fatigue is common for one to two weeks, linked to the anaesthetic and healing. It is slightly more marked when the capsulectomy was extensive or fat transfer was performed. Naps, good hydration and a gradual return to activities help you get through it.

In the first few weeks, it is common to feel mixed emotions: relief at having parted with the implants, but also surprise at smaller breasts, scars that are still red and a shape that is not yet final. Some women experience a form of grief for their former figure. These emotions are normal and generally ease as the shape stabilises. Talking to those close to you, or to a professional if your mood stays low, helps you through this period.

After the procedure, it is common to feel pulling at the scars, small shooting sensations or tingling as the nerves recover, and an unusual feeling of lightness. When the implant was behind the muscle, sensations of contraction or cramps in the pectoral muscle may appear for a few weeks. These sensations are normal and gradually decrease.

After a capsulectomy behind the muscle, chest wall pain, accentuated by deep breathing or coughing, may persist for a few days to a few weeks. It is generally linked to irritation of the tissues and small nerves between the ribs. Painkillers relieve it. Breathlessness or sudden pain, however, require prompt medical attention.

After an extensive capsulectomy, it is useful to take a few deep breaths several times a day, to ventilate the lungs properly despite the chest pain. Regular walking also helps and prevents thrombosis.

You must sleep on your back, with your upper body slightly raised, in the first few weeks, so as not to press on the scars or distort the healing breasts. Sleeping on your side becomes possible again at around three to four weeks, on your front later. Many women who had large implants are delighted to find, after recovery, that sleeping on their front is comfortable again.

Women who had large implants often avoided sleeping on their front. After recovery, at around two to three months, this position becomes possible again and is often comfortable. It is an everyday detail, but many patients cite it among the benefits they appreciate.

Intimate life can resume when pain allows, often after two to three weeks, avoiding pressure on the breasts. Your partner's view of your new breasts matters to many women; talking about it before and after the procedure helps you welcome this change together.

Driving is possible once arm movements are no longer painful and strong painkillers have been stopped, often after one to two weeks. The seat belt must not press directly on the scars; a small cushion can help.

Autumn and winter are often preferred: the support bra is easier to wear under covering clothes, the scars are protected from the sun and the shape has time to stabilise before summer.

Apart from an urgent complication, you can choose the timing of the procedure. It is useful to take into account the season, work constraints, the availability of those around you for the first few days and, if coverage is being requested, the insurer's reply time. Avoiding busy periods, major trips or sunny holidays in the following weeks makes recovery easier. A well-thought-out schedule allows you to focus calmly on your recovery, without outside pressure, and to approach the first check-ups in good conditions. For working women, planning two weeks off followed by a gradual return is often the most comfortable. For mothers of young children, arranging help for at least a week avoids carrying and tiring yourself too soon, which contributes directly to good healing. Finally, keeping a few days' margin before any important commitment leaves time to recover without stress, even if recovery takes a little longer than expected. That is in fact quite common, and nothing to worry about in itself.

If you have young children, avoid carrying them for two to three weeks. Arrange help for anything that requires lifting them, and favour cuddles while seated, with the child beside you.

Long journeys are not advised in the first week. If you live far from the clinic, plan to stay nearby until the day after the procedure and arrange to be accompanied home. For later journeys, take breaks to walk and drink enough.

For a self-employed woman, time off for the cosmetic part of the procedure is generally not compensated. A return to sedentary work is often possible after two weeks. Scheduling the procedure during a quieter period makes recovery easier.

For many sportswomen, returning to sport is an opportunity to discover new comfort, without the weight or sometimes bothersome movement of implants.

Many sportswomen notice new comfort after explantation: no more feeling of weight or bothersome implant movement when running or jumping, and no more distortion when the pectorals contract if the implants were behind the muscle. Upper-body strength training becomes more natural again. A suitable sports bra is still recommended to protect the shape of the breasts during high-impact sports.

For some women, explantation is an opportunity to resume a sport abandoned because of large or painful implants, or to start a new one. Running, swimming, yoga and racket sports become more comfortable. Regular activity also contributes to general well-being and weight stability.

When the implants were behind the muscle, it was stretched and sometimes partly detached for years. After removal and reattachment, it needs a few weeks to regain its normal position and function. Some patients feel pulling during the first arm movements. A gradual return to strengthening, possibly guided by a physiotherapist, helps the muscle regain its strength.

The scars go around the areola, run vertically towards the fold and, with the inverted-T technique, follow the fold. They are pink at first, sometimes slightly thick, then fade over one to two years. Strict sun protection, gentle massage once the skin has closed and silicone gels help them mature. Their visibility is the main trade-off of the procedure; it is important to accept it before deciding.

The lift scars are the main trade-off of the combination. They go around the areola and run vertically, sometimes with a horizontal scar in the fold. They are visible close up, especially in the first year, then thin out and fade. Many women who worried about them before the procedure ultimately find them acceptable in view of the benefit achieved: natural, higher, harmonious breasts. It is useful to see photographs of scars at different stages to get an accurate idea.

In some women, the scars become red, thick and itchy a few months after the procedure. This risk is greater on olive skin or in those who have had this type of scar before. Silicone dressings, corticosteroid injections or certain lasers can often improve them. Report it early to the surgeon.

Once the scars have fully closed, gentle daily massage with a moisturising cream softens them. Silicone gels or sheets, worn for several months, help flatten and lighten them. Strict sun protection during the first year is essential. If a scar thickens or itches, report it to the surgeon; treatments exist.

The scars from the implant placement, in the fold, around the areola or in the armpit, are often incorporated into the new lift scars or used for the removal. An old scar in the armpit generally stays in place without being reopened. The surgeon explains how these old scars will fit with the new ones.

Just after the lift, the breasts look high, firm and sometimes slightly square at the bottom. They descend slightly and round out over the first few months. The final shape is judged at around six months, sometimes a year. When the gland has been greatly thinned by the implant, it may also reorganise slightly during this period.

After years with implants, particularly large ones behind the muscle, the chest wall may look slightly hollowed under the breasts, as the implant exerted pressure on the tissues. This appearance often fades over time. When it persists, fat transfer can improve it.

Slight asymmetry between the two breasts is common after explantation, especially as the two sides may have reacted differently to the implants: capsular contracture on one side only, a more thinned gland on one side. The lift corrects some of these differences. Marked asymmetry that persists after a year can be touched up, sometimes with fat transfer.

During the first month, the breasts are high, firm and sometimes slightly square at the bottom; the scars are pink; a seroma may appear and require aspiration. The support bra is worn day and night, you avoid raising your arms and carrying loads, and you gradually resume your activities. By the end of the month, most patients have resumed normal daily life.

Between three and six months, the breasts descend slightly and round out, the scars may thicken temporarily before thinning, and sensation gradually returns. This is the time to judge the volume and decide on possible fat transfer, or on a lift if removal was done alone as a first stage.

Once the shape has stabilised, at around three to six months, you will often need new bras, with a smaller cup. Many women discover a wider choice of light, wire-free styles that suit natural breasts reshaped by a lift.

After explantation with a lift, cup size decreases and the shape changes. Many women rediscover clothes they avoided: button-up blouses that no longer gape, fitted dresses, swimsuits without reinforced underwiring, lighter sportswear. It is advisable to wait three to six months, once the shape has stabilised, before renewing your wardrobe. This moment is often experienced as a positive milestone that accompanies reclaiming your body. Some patients also take the opportunity to adopt a style more in keeping with their new, lighter and more natural figure. Having your bra size checked by a specialist fitter is useful, as the band and cup have often changed, and well-fitting support contributes to comfort and to how well the breasts hold over time.

At one year, the shape has stabilised and the scars are beginning to fade. The one-year review takes stock of the shape, symmetry, scars and satisfaction, and organises the usual breast surveillance.

At around two to three months, most patients have resumed all their activities, including sport. Support bras are set aside in favour of soft styles, the breasts continue to stabilise, and the scars continue to mature. For many, the procedure then fades from mind.

Even after scheduled follow-up has ended, it is useful to know that you can consult your surgeon again for a question, a bothersome scar or a wish for a touch-up. A surgeon who remains available after the procedure is a sign of seriousness and trustworthiness.

Check-ups generally take place at one week, one month, three months, six months and one year. The surgeon monitors the scars, the blood supply to the areolas, the absence of fluid in the cavity, the shape and symmetry. They give you the result of the capsule analysis. Breast surveillance then resumes according to the usual recommendations, without specific implant surveillance.

At around one week, the surgeon checks the scars, the colour of the areolas and the absence of fluid in the cavity, removes any drains still in place and checks the fit of the bra. They give you the result of the capsule analysis as soon as it is available.

After explantation, specific implant surveillance is no longer necessary. Breast cancer screening continues according to the usual recommendations. Mammograms often become simpler to perform and interpret without implants. It is useful to tell the radiologist about the procedure and the work done on the capsule, as internal scars or small calcifications may appear. If fat transfer was performed, it should also be mentioned.

Keep the operative report, the result of the capsule analysis and, if possible, information about the implants removed. These documents will be useful for breast surveillance and for any doctor who examines you in the future.

The first mammogram after explantation is often simpler and more comfortable than those performed with implants, which required special views. It serves as a new reference for future examinations. Tell the radiologist about the procedure and its date, as well as any fat transfer.

When an old implant has ruptured and gel has migrated into the tissues, small clusters of silicone, sometimes called siliconomas, may persist in the breast or the lymph nodes of the armpit, even after removal. They are generally benign. The surgeon removes what is accessible without excessive risk. They may remain visible on imaging, which should be mentioned at future examinations.

After an old rupture, silicone may have migrated to the lymph nodes of the armpit, which enlarge slightly. These lymph nodes are generally benign and do not require routine removal. They may remain visible on imaging. The surgeon and radiologist take this into account during follow-up.

The combination brings together the risks of implant removal with work on the capsule and those of a lift.

The cavity left by the implant may fill with clear fluid in the following weeks, especially if the capsule was left in place. This seroma shows as a soft swelling, sometimes a feeling of moving fluid. It is treated with one or more aspirations. Wearing the support bra regularly, drains and steps that close the cavity reduce its frequency. A persistent seroma may require further surgery.

Blood can collect in the cavity or in the lift tissues, especially after a capsulectomy, whose surfaces bleed easily. It shows as rapid, tense, painful swelling on one side. It often requires a short return to theatre. Monitoring the drains and the first few hours allows it to be detected early.

The areola is supplied by the tissue connecting it to the rest of the breast. During a lift combined with implant removal, this blood supply can be weakened, especially when the areola has to be raised a long way, the capsule has been extensively removed or in a smoker. An areola that turns dark or purplish must be reported immediately. The two-stage strategy reduces this risk in the most exposed situations.

When the capsule of a submuscular implant is stuck to the ribs and its back wall is removed, there is a small risk of breaching the chest wall and allowing air to enter around the lung. This pneumothorax is rare. It shows as breathlessness or chest pain and may require a chest drain. This is one of the reasons why the surgeon does not always remove the entire capsule.

Even when well prepared, some patients find their breasts smaller than they imagined. First, wait for stabilisation, at around six months. If the volume remains insufficient, fat transfer can be offered, in one or more sessions. Some patients, more rarely, eventually consider a new small implant; this is a personal decision to be made without rushing.

Women rarely regret their explantation, especially when the decision has been carefully considered. If it happens, a new augmentation remains possible later, with implants, fat or a combination of both. Tissues reshaped by the lift may even offer better conditions than before. It is nevertheless preferable to take time for reflection before explantation, to avoid going back and forth.

After a lift, areola sensation may be reduced or altered for several months, then usually returns. Some patients whose sensation was impaired by the implant, notably with capsular contracture, notice an improvement instead. A lasting reduction remains possible.

In some women whose nipple sensation had decreased with implants, notably with capsular contracture or large implants, sensation improves after removal, sometimes after several months. This is not systematic, and the lift itself may temporarily alter sensation, but it is a benefit reported by several patients.

• A breast that swells rapidly and becomes painful.
• An areola that darkens or turns purplish.
• Fever, spreading redness or cloudy discharge.
• Breathlessness or chest pain.
• A scar that opens widely.
• A painful or swollen calf.

During recovery, contact the team with any question, particularly if a breast swells in a way that could be a seroma. Sending a photograph, if the team offers this, often allows a quick response. Report any fever or change in colour of an areola without delay.

A touch-up can be considered after six months to a year: asymmetry, a small excess of skin at the end of a scar, a widened scar, a slightly low areola, or insufficient volume supplemented with fat. It is often performed under local or light anaesthesia. The touch-up policy should be known from the quote stage.

When the procedure is successful, the breasts are natural, smaller than with implants, but high, firm and harmonious. The areolas are raised and often reduced. Patients who suffered from capsular contracture regain soft, pain-free breasts. Many describe a feeling of lightness, freedom and reconciliation with their body, which counts as much as the appearance itself.

Studies of women who have had their implants removed report, overall, high satisfaction, particularly when removal was prompted by painful capsular contracture or the wish to live without implants. Comfort, lightness and the disappearance of implant-related worries are often cited. Satisfaction with appearance depends greatly on the quality of the lift and initial expectations.

The most satisfied women are often those who knew in advance that their breasts would be smaller, that a lift would leave scars, and that the shape would stabilise over several months. They chose explantation to live without implants, and value this benefit above all. Those who hoped to regain full breasts without scars are more often disappointed. A frank discussion before the procedure is the best prevention against such disappointment.

Several observations come up repeatedly in testimonials. The feeling of lightness is immediate and much appreciated. The smaller volume is sometimes surprising in the first few weeks, then becomes familiar. The lift scars are worrying at first, then fade. Many also say they no longer think about their breasts day to day, with no imaging check-ups or questions about the condition of their implants.

Talking with other women who have been through explantation can help you prepare and feel less alone. You should, however, keep a critical eye on online testimonials, which reflect individual experiences and do not replace medical advice suited to your situation.

Removing implants changes self-image. For many women, it is a reclaiming of their body, more in keeping with their age and values. For others, adapting to smaller breasts takes time. It is useful to anticipate this change, talk about it with the surgeon and those close to you, and give yourself time to get used to your new figure.

After years with implants, it sometimes takes a few weeks to get used to lighter, smaller breasts: a different sensation when lying down, running or in clothes. This adjustment generally happens naturally. Many women say they had forgotten the feeling of natural breasts and rediscover it with pleasure.

With smaller breasts, the figure changes: the shoulders look wider in proportion, the waist less defined by contrast, and clothes hang differently. Many women find this new figure lighter and more in keeping with their build. Others need time to get used to it. Updating your wardrobe once the shape has stabilised is often part of this adjustment.

A partner is often involved in the decision and in recovery. Reactions vary, but many appreciate the regained natural look and their partner's relief. Sharing the information received at consultation, the reasons for the choice and the stages of recovery helps you go through this change together.

After explantation, those around you sometimes notice smaller breasts; some women dread such comments. There is no obligation to justify yourself. Many find that people mainly notice a more natural, lighter look, in keeping with their personality.

For many women, the strongest benefit of explantation is neither aesthetic nor strictly medical: it is the feeling of freedom. No more regular implant check-ups, no more worry at every piece of news about implants, no more prospect of another replacement procedure. This peace of mind is often cited as one of the main reasons for their satisfaction.

Without implants, there is no more specific surveillance or replacement to plan. The breasts then change naturally with age, weight and hormones; some sagging may reappear over the years, more slowly than before thanks to the reshaping of the gland. A stable weight and suitable support during sport help preserve the shape.

Without implants, breast volume depends entirely on the gland and fat. Weight gain therefore increases breast volume and weight loss reduces it. A stable weight preserves the shape achieved by the lift. If fat transfer was performed, the transferred fat also follows these changes.

Without implants, breast volume varies more with hormones: during the cycle, with hormonal contraception, pregnancy or menopausal treatment. These variations are natural. They may slightly change the shape achieved over time, without undermining the benefit of the lift.

At menopause, the gland shrinks and becomes fattier, and the skin slackens. The breasts then change naturally, like those of any woman. The reshaping performed during the lift slows this sagging without eliminating it. Some women choose explantation precisely at this time, when their relationship with their body changes.

A pregnancy is possible after explantation with a lift. The breasts will increase in volume during pregnancy and breastfeeding, then may empty or sag, which changes the result. Breastfeeding depends on the condition of the gland and the type of lift performed.

Stopping smoking, keeping a stable weight, regular physical activity and protecting your skin from the sun promote healing and help the result last. After a lift, the weight of the breasts and the quality of the skin determine how quickly the breasts may slacken over the years. Suitable support during sport limits stretching of the tissues.

After the one-year review, annual follow-up by the surgeon is generally not necessary. Breast surveillance is carried out by the gynaecologist or GP, according to the usual recommendations. It is nevertheless useful to consult the surgeon again if the shape changes, a scar is bothersome or you would like a touch-up.

Faced with old or problematic implants, three broad options exist: keep them and monitor them, replace them, or remove them permanently. Keeping intact, well-tolerated implants is a reasonable option, with regular surveillance. Replacing them suits women who want to keep volume, knowing that another replacement will probably be needed one day. Removing them suits those who want to live without implants and accept smaller breasts. There is no universal right answer; each option has its advantages and constraints.

In some women, removal alone is enough: small implants, few years with them, young, elastic skin, an areola that has stayed high. The skin retracts within a few months and the breasts regain an acceptable appearance. When there is doubt, the two-stage strategy allows the implants to be removed first, then the lift to be decided after seeing the result.

When the surgeon is not certain that the skin will retract sufficiently, they may propose removing the implants first, with the necessary work on the capsule, then waiting three to six months. During this period, the skin partly retracts, the gland reorganises and the breasts take an intermediate shape. At the check-up, the patient and the surgeon decide together whether a lift is necessary, and of what type. This approach sometimes avoids an unnecessary lift or allows a more limited one. It does, however, involve a period with less harmonious breasts and a second procedure if the lift proves necessary.

Between removal and a possible second-stage lift, the breasts may look empty, flat at the top and saggy. Some women cope well with this period, others find it difficult. Padded bras or external breast forms can help you feel comfortable in clothes. It is useful to know in advance what to expect.

Performing the lift a few months after removal improves the safety of the areola's blood supply: the tissues have healed, the cavity has closed and the surgeon operates on breasts whose actual shape they know. It is a particularly attractive option when the capsulectomy was extensive, in former smokers or when the lift required is significant.

During a second-stage lift, fat transfer can be performed at the same time, into healed tissues and outside any cavity. This combination often gives a good result, filling the upper breast and reshaping it. It allows the reshaping steps to be grouped into a single procedure after removal.

In one stage, the journey from consultation to stabilised result generally takes six months to a year. In two stages, it lengthens by three to six months. It is useful to take this into account when organising your professional and personal life, and to choose the strategy not only on medical criteria, but also according to what is manageable for you.

If the wish for volume remains strong, replacing the implants with new ones, often smaller, possibly with a lift, is an alternative. It keeps more volume, but means continuing implant surveillance and considering another replacement later. Our page on implant replacement with a lift and the one on breast implant replacement present these options.

Some women hesitate between removal and replacement. Replacing the implants with clearly smaller ones, possibly with a lift and fat transfer, can be a compromise: the breasts are lightened and the volume remains satisfactory, but the implants will still need monitoring. This compromise is discussed with the surgeon according to the original motivations.

To compare without amounts, each option is expressed relative to a base of 100: removal of both implants with partial capsulectomy and a vertical lift, performed in Geneva and entirely at the patient's expense.

Details are on our page on breast implant removal with lift prices.

Coverage depends on the reason. When removal responds to a medical complication, such as severe capsular contracture, rupture, a fluid collection or suspected lymphoma, a coverage request can be sent to compulsory insurance before the procedure; the decision is made case by case, and the rules on complications of a previous cosmetic procedure may limit reimbursement. The lift, however, is generally considered cosmetic. Removal by personal choice, without complications, remains at the patient's expense. It is essential to obtain a written reply from the insurer before scheduling the procedure.

When the removal is covered and the lift is not, the bill is split between a medical part and a cosmetic part, with shared theatre and anaesthesia costs apportioned. The quote must state this clearly, including the deductible (franchise) and co-payment (quote-part).

When removal responds to a complication, the surgeon writes a coverage request, accompanied by imaging results showing the rupture, fluid collection or capsular contracture, and a description of the symptoms. The insurer, through its medical adviser, examines the request and makes a decision. It is important to wait for this written reply before the procedure. The lift, almost always cosmetic, is billed separately.

For any covered part, a hospital stay in another canton may change the reimbursement depending on whether the facility is on your canton's hospital list and on your supplementary insurance. For the cosmetic part, the choice is free. Check with your insurer before choosing the facility.

The work on the capsule, the type of lift, fat transfer, length of stay, capsule analysis, the clinic and the surgeon's experience influence the amount. Total or en bloc capsulectomies behind the muscle, which are longer and more delicate, cost more.

The quote is sometimes supplemented by prior imaging, particularly MRI, capsule analyses, support bras, any later fat transfer session and, for self-employed women, loss of income. When removal is covered, the deductible and co-payment apply to the medical part. Adding these elements gives a realistic picture of the financial commitment.

Removing your implants ends the costs of imaging surveillance and the prospect of another implant replacement in a few years. For some women, this argument weighs in the decision, alongside health and comfort reasons. It should not, however, overshadow the cost of the procedure itself, which often includes a lift.

A complete quote specifies the work on the capsule, the type of lift, any fat transfer, tissue analysis, the stay, bras, check-ups, any split between medical and cosmetic parts, and the touch-up policy.

Explantation with a lift is performed by many plastic surgeons, but experience of total and en bloc capsulectomies, particularly behind the muscle, varies. The table compares provision and fees for the cosmetic part in twenty cities.

When removal is covered by insurance, the facility must be recognised; a hospital stay outside your canton may change the reimbursement depending on your cover.

In French-speaking Switzerland, Geneva and Lausanne have most of the surgeons experienced in complex capsulectomies; Sion, Neuchâtel and Fribourg complete the provision. In German-speaking Switzerland, Zurich, Basel and Bern are the main centres, followed by Lucerne, Zug and St. Gallen. In Ticino, Lugano has most of the practitioners. In the small cantons, consultation usually takes place in a large neighbouring centre.

Demand for explantation is no longer limited to the major cities. Women from all regions consult to have implants removed that were sometimes placed years earlier at another clinic or in another region of the country. Plastic surgeons in French-, German- and Italian-speaking Switzerland have developed growing experience of these procedures. For a simple explantation with a lift, good-quality provision exists in most medium-sized towns; for a complex capsulectomy behind the muscle or suspected lymphoma, the large centres are often preferred.

Explanations about the capsule, risks and expectations must be fully understood. In French-speaking Switzerland, everything takes place in French; in the major German-speaking centres and in Ticino, many practitioners see patients in French. Ask for written documents in a language you master.

The information documents, consent form and capsule analysis result must be understandable. If you consult in another language region, ask for them to be provided or explained in a language you master. This is particularly important for information about the risks of capsulectomy and about lymphoma.

For a complex capsulectomy, it may be worth choosing a more experienced surgeon further away. Plan a night nearby, travel home accompanied, and arrange a local contact for the first check-ups, particularly in the event of a seroma. Breast follow-up then takes place close to home.

If the procedure takes place far from home, organise local follow-up with the surgeon: your GP can check the scars and spot a seroma, and refer you to the surgeon if aspiration is needed. The six-month check-up, important for deciding on a second-stage lift or fat transfer, generally takes place with the surgeon.

A second opinion is useful to confirm the strategy for the capsule, the choice between one and two stages and the type of lift. It is particularly recommended when systemic symptoms prompt the removal, or when the capsule is complex.

When the question of total or en bloc capsulectomy arises, notably behind the muscle, a second opinion can help weigh the benefits and risks. Two surgeons may have slightly different approaches; understanding their arguments helps you make an informed choice.

The surgeon must master both implant removal, with the different procedures on the capsule, and breast lifts. Ask how many explantations they perform, how they decide on the work on the capsule and when they propose two stages, and look at photographs of results more than six months on. A surgeon who respects your decision to live without implants, without trying to persuade you to have new ones, and who informs you honestly about systemic symptoms, is a good partner.

The procedure involves a surgeon, an anaesthetist, the theatre team and the ward team. The pathology laboratory analyses the capsule and fluid. After discharge, the GP can handle part of the follow-up. Ask who your contact is after the procedure and how to reach the team at any time.

The GP plays an important role, particularly when systemic symptoms prompt the removal: they carry out the prior assessment, look for other causes and follow progress after the procedure. They then handle breast surveillance with the gynaecologist. Sending them the operative report and the result of the capsule analysis is useful.

A reputable surgeon will explain what is and is not established about symptoms attributed to implants, present honestly the benefits and risks of the different procedures on the capsule, tell you whether a lift is necessary and with what scars, and give you a realistic idea of the final volume. They will respect your choice to live without implants, without pushing you to have new ones or to remove more than necessary.

Ask to see results of explantation with a lift, in women who had implants of comparable volume to yours, more than six months on. Look at the shape, the position of the areolas, the scars and the volume. These images are often reassuring, as they show that breasts without implants can be harmonious.

Explantation with a lift combines several difficulties: deciding on the work on the capsule, anticipating the shape of the breasts after removal, preserving the blood supply to the areola in thinned tissues, and reshaping a gland that is sometimes very thin. These difficulties explain why the surgeon's experience with this type of procedure matters so much. Ask how many explantations with a lift they perform each year and look at results comparable to your situation.

• What do you propose for my capsule, and why?
• Is a lift necessary in my case, and which one?
• Do you recommend one or two stages?
• What breast volume can I expect?
• Is fat transfer useful?
• Will the capsule and fluid be analysed?
• Can my removal be the subject of a coverage request?
• Which complications do you see most often?

• Underestimating the reduction in volume after removal.
• Insisting on total capsulectomy without understanding its risks.
• Expecting the procedure to make systemic symptoms disappear for certain.
• Smoking before or after the procedure.
• Scheduling before receiving the insurer's reply when coverage is requested.
• Judging the shape before six months.

Painful capsular contracture

A forty-eight-year-old woman has had implants for sixteen years that have become hard and painful. MRI shows a thickened capsule. The surgeon proposes removal with total capsulectomy and a vertical lift. A coverage request is made for the removal. After the procedure, the pain disappears and the breasts regain their softness.

The wish for lightness

A fifty-two-year-old woman simply wants to live without implants. Her implants are soft and intact. The surgeon proposes removal with partial capsulectomy and an inverted-T lift, as the skin is very stretched. She accepts smaller breasts and appreciates the regained comfort.

Textured implants

A forty-one-year-old woman has textured implants and is worried by information about lymphoma. She has no symptoms. After being informed, she chooses removal. The surgeon performs a total capsulectomy with analysis and a moderate lift. The analysis is reassuring.

Little remaining volume

A forty-five-year-old woman has a very thin gland after twenty years of large implants. The surgeon proposes removal, a lift and fat transfer, completed by a second fat session six months later.

A fifty-year-old woman has had medium-volume round implants behind the muscle for eighteen years. She has no pain, but her left breast has hardened and her areolas have descended. She wants to live without implants. MRI shows an intracapsular rupture on the left and a thickened capsule. The surgeon proposes removal of both implants, capsulectomy of the front of both capsules and a more complete capsulectomy on the left, then a vertical lift. The procedure takes three and a half hours, with one night at the clinic. The drains are removed after two days. A coverage request is made for removal of the ruptured implant; the lift remains at her expense. She returns to work after two weeks. At six months, her breasts are smaller but high and soft, and she says she is relieved no longer to think about her implants.

Several moments mark the journey: the decision, often long considered; the consultation, where you discover the options for the capsule and the lift; imaging, which sometimes reveals a rupture or fluid collection; the day of the procedure and waking up, often marked by a feeling of lightness; the first check-up and the result of the capsule analysis; then stabilisation of the shape, between three and six months. Keeping these stages in mind helps you go through them calmly, with concrete milestones.

• I know my implants: brand, surface, plane, age.
• I have recent breast imaging.
• I understand the options for the capsule and their risks.
• I know whether a lift is necessary, and in how many stages.
• I accept smaller breasts and lift scars.
• I have stopped smoking.
• I have my insurer's reply if coverage is requested.
• If systemic symptoms are my reason, I have had a medical assessment.

Before deciding, it can be useful to ask yourself a few questions. Why do I want my implants removed: a complication, a concern, symptoms, or simply the wish to live without implants? Am I ready to have smaller breasts? Do the scars of a lift seem acceptable to me? Have I considered the option of smaller implants? Have I had a medical assessment if symptoms are my reason? The answers to these questions, shared with the surgeon, shed light on the choice and the strategy.

Explantation with a lift allows implants to be removed permanently while restoring a harmonious shape to the breasts. The work on the capsule is decided case by case, according to its condition, the type of implant and the reasons for removal. The lift, often necessary, raises the areola and tightens the skin; it can be performed at the same time or later. Fat transfer can supplement insufficient volume.

The resulting breasts are smaller than with implants, but natural, with no implant surveillance. Removal for a complication may be the subject of a coverage request; the lift generally remains cosmetic. Depending on the canton, fees can be up to fourteen per cent lower than in Geneva; the surgeon's experience with capsulectomies remains decisive.

Gather information about your implants. Have recent imaging. Discuss your motivations and expectations frankly. Understand the options for the capsule and their risks. Accept that a lift is often necessary, with its scars. Stop smoking. Take time to decide. And give yourself a few months to get used to your new breasts.

If you are considering having your implants removed, a consultation will assess the condition of your implants and capsule, the remaining volume and the need for a lift. Take time to gather your documents and ask your questions. Our team can direct you, free of charge and without obligation, to a surgeon experienced in this procedure.

Budget

Price differences between cities and cantons, the quote breakdown and ways to save are detailed on our page Breast implant removal and breast lift: prices in Switzerland.

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Our guides

• Combined procedures in Switzerland
• Cosmetic surgery in Switzerland

Capsule, lift, remaining volume, symptoms, insurance: the questions most often asked by women considering having their implants removed.

Understanding the procedure

What is explantation? It is the removal of breast implants without replacing them with new ones.

Why combine a lift? Because after years with implants, the skin is often too large for the remaining volume; the lift tightens it and raises the areola.

Is a lift always necessary? No. With small implants, a few years and firm skin, retraction may be enough.

Can the lift be done later? Yes, some surgeons prefer to wait three to six months after removal to judge how the skin retracts.

What is the capsule? The membrane the body forms around each implant.

Must the capsule always be removed? No. A thin, supple capsule can be left; a thickened, calcified or suspicious capsule is removed.

What is en bloc removal? Removal of the implant and its capsule in one piece, without opening the capsule.

When is en bloc removal recommended? Mainly when implant-associated lymphoma is suspected, and sometimes after a rupture.

Reasons for removal

What are the most common reasons? Capsular contracture, rupture, concern about certain implants, systemic symptoms, or simply the wish to live without implants.

Can implants be removed without a medical reason? Yes, it is an entirely legitimate personal choice.

Should textured implants be removed as a precaution? Current recommendations do not require this in the absence of symptoms, but removal can be a personal choice after being informed.

Will removal make my systemic symptoms disappear? It is not guaranteed. An improvement is reported in some patients, but it is impossible to predict who.

Is an assessment needed beforehand if I have symptoms? Yes, an assessment with your GP is recommended so as not to miss another cause.

For whom?

Who can have their implants removed? Any woman in good health with implants who wants to live without them.

Is there an age limit? No, but after sixty the medical assessment is more thorough.

Can smokers have surgery? After stopping completely, as smoking threatens the blood supply to the areola during the lift.

Will my breasts be very small? It depends on the volume of gland remaining; they are smaller than with implants, but the lift gives them a full shape.

Can volume be regained without implants? Yes, partly, through fat transfer.

Preparation

What examinations are needed beforehand? Recent imaging: ultrasound, often MRI, and mammography depending on age.

Should I find my implant card? It is very useful for knowing the brand, surface and volume of the implants.

Should I stop smoking? Yes, at least a month beforehand and during healing.

How can I picture the result? The surgeon estimates the remaining volume and can show comparable results.

The procedure

How long does the procedure take? From two and a half to four hours with a lift.

Do I need to stay at the clinic? Often one night when a lift is combined.

How are the implants removed? Through the old scar or through the lift incisions.

Is the capsule analysed? Yes, when it is removed, as is any fluid.

Are drains used? Often in the cavity left by the implant, for one to three days.

Is the muscle put back in place? If the implant was behind the muscle, the surgeon may reattach it.

Recovery

Is the pain severe? Generally moderate, often less than after implant placement.

How long should the support bra be worn? Four to six weeks, day and night.

When can I return to work? Ten to fourteen days for a desk job.

How should I sleep? On your back for the first few weeks.

When can I resume sport? Running at around five to six weeks, pectoral exercises at around six to eight weeks.

Is there an immediate difference? Many patients describe an immediate feeling of lightness.

Risks

What is the most common risk? Seroma, a collection of fluid in the cavity, treated by aspiration.

Can the areola be compromised? Rarely, especially with major lifts, in smokers or after extensive capsulectomy.

Is total capsulectomy risky? Behind the muscle, it carries a risk of bleeding and, rarely, pneumothorax.

What is a pneumothorax? Air between the lung and the chest wall, which causes breathlessness.

Are the scars visible? Yes, the lift scars remain visible close up, but fade over one to two years.

Does sensation return? Usually; it may even improve after capsular contracture.

Results

When is the final result visible? At around six months to a year.

Will the breasts sag again? They change naturally with age, but reshaping the gland slows this sagging.

Is special surveillance still needed? No, only usual breast cancer screening.

What if the volume seems too small? Wait six months, then consider fat transfer.

Can implants be put back later? It is possible, but it is a decision to make without rushing.

Insurance and price

Does insurance reimburse removal? For a medical complication, a request can be made; the decision is taken case by case.

And the lift? It is usually considered cosmetic.

Should I wait for the insurer's reply? Yes, if coverage is being requested.

Why do prices vary? Depending on the work on the capsule, the type of lift, fat transfer and the clinic.

Where are fees lowest? Depending on the canton, up to fourteen per cent less than in Geneva.

Choosing

How do I choose the surgeon? Check their experience of capsulectomies and lifts, and look at results more than six months on.

Is a second opinion needed? It is useful, particularly for the strategy regarding the capsule.

Can I consult in French in Zurich? Yes, many practitioners see patients in French.

Particular situations

My implants have ruptured; is it urgent? A rupture is generally not an emergency, but it justifies scheduling removal or replacement within a reasonable time.

Can the gel from a ruptured implant be removed completely? When it is contained within the capsule, removing the capsule removes it; if it has escaped, cleaning is more delicate.

Can just one implant be removed? It is possible, but the resulting asymmetry usually leads to treating both sides.

What should I do if a breast swells years after placement? Consult promptly for an ultrasound: fluid around the implant must be investigated.

Is implant-associated lymphoma common? No, it is rare, mainly linked to textured implants, and treats well when caught early.

Do smooth implants pose the same problem? Lymphoma is much rarer with smooth implants.

Can a lift be done without removing the capsule? Yes, if the capsule is healthy, the surgeon can leave it and perform the lift.

Does the cavity always close? Generally yes, within a few weeks; a persistent seroma may require an additional procedure.

Can fat transfer be done at the same time? It is possible, but many surgeons prefer to wait until the cavity has closed.

What happens to the implants removed? They are generally discarded; you can ask to take them home or to know their condition.

Can the model of my implants be identified if I no longer have my card? The facility where they were placed or imaging can sometimes provide indications.

Will the areolas be reduced? Usually, yes, during the lift, as they have often enlarged under the effect of the implants.

Will I be able to breastfeed after the procedure? It varies according to the lift and the condition of the gland; a pregnancy after the procedure will also change the breasts.

Does menopause change the result? The gland shrinks and the breasts may gradually slacken, like any breasts.

Might my partner be disappointed? Reactions vary; many appreciate the regained natural look. Talking about it beforehand helps.

Can I wear wire-free bras afterwards? Yes, lighter breasts are often well supported by soft styles.

Does pain from capsular contracture disappear? In the vast majority of cases, yes, once the contracted capsule has been removed.

Will the breasts be symmetrical? Slight asymmetry is common; a marked difference can be touched up.

Can I have my implants removed at seventy? Yes, if health allows, with a thorough medical assessment.

Should I stop certain medicines? Those that thin the blood, on medical advice; never change a treatment without discussing it.

Can the capsule contain silicone? After a rupture or gel bleed, gel may be found in the capsule; it is removed with it.

What if I have lymph nodes under the arm? Report them: silicone can migrate to the lymph nodes after a rupture, which is assessed on imaging.

Does removal leave hollows? Sometimes, especially in the upper breast; the lift and fat can correct them.

How long between removal and a second-stage lift? Generally three to six months.

Can implants be replaced with fat in one go? The volume of fat is limited; several sessions are often needed for a significant gain.

Does removal improve back pain? After large implants, some patients report this, but not systematically.

When can I go swimming? After complete healing, generally six weeks.

Are old scars reused? The surgeon often uses the old scar or incorporates it into the new ones.

Can removal be done under local anaesthesia? A simple removal, without capsulectomy or lift, can sometimes be done under local anaesthesia with sedation.

Is lymphatic drainage needed? It is generally not necessary, unless liposuction was combined.

What should I tell my employer? Nothing more than a sick note.

Which season should I choose? Cooler months make the support bra easier to wear and protect the scars from the sun.

Do I need someone with me? Yes, for the journey home and ideally the first night.

How can Medespoir Suisse help me? By directing you, free of charge, to a surgeon experienced in explantation and lifts.

Can I ask questions about my symptoms? Yes, and it is important to talk about them frankly with the surgeon and your GP.

What if I regret the volume afterwards? Wait for stabilisation, then discuss fat transfer or, more rarely, a new implant.

Is the result visible in a swimsuit? Yes, the breasts are higher and more harmonious, with a natural look.

Is MRI follow-up needed afterwards? No, without implants, only usual breast surveillance is necessary.

Are the implants removed analysed? They can be examined if an abnormality is suspected; the capsule is more often analysed.

Can other procedures be combined? It is possible for limited procedures, but it lengthens the operation.

Do stretch marks disappear? Those on the skin removed by the lift disappear; the others remain.

Will the shape be natural? Yes, that is the aim: breasts without implants, natural to the touch and in movement.

When should a second-stage lift be decided? At a check-up after three to six months, depending on how the skin has retracted.

What is the difference from implant replacement? Replacement swaps the implants; explantation removes them permanently.

Is the result lasting? Yes, the breasts then change naturally with age and weight.

Can I do intensive sport afterwards? Yes, after recovery, often with more comfort than before.

Are calcified capsules dangerous? No, but they harden the breast and are generally removed.

Tell us how long you have had your implants, what is leading you to consider their removal and where you would like to consult. We will direct you to a surgeon experienced in explantation and lifts, free of charge and without obligation.