Breast implant removal is not a dangerous surgery. In a study of nearly 100,000 breast implant procedures, the perioperative mortality rate was effectively zero. That puts it among the safest elective operations performed today. Like any surgery requiring general anesthesia, it carries some risk of complications, but serious ones are rare, and most people recover fully within weeks.
Complication Rates Are Low
The most common complications after breast implant removal are infection, bleeding, and fluid buildup around the surgical site. Infection rates fall between 1.9% and 2.5%. Pneumothorax, a condition where air leaks into the space around the lung, occurs in roughly 0.03% to 0.04% of cases. That’s about 3 to 4 in every 10,000 surgeries.
Mild tenderness, bruising, and swelling are expected parts of healing rather than true complications. More significant issues like hematoma (a collection of blood under the skin) or seroma (fluid buildup) sometimes require drainage but are typically manageable. Overall complication rates in studies of implant-related breast surgery range from about 12% to 36%, but the higher end of that range reflects complex reconstructive cases, not straightforward cosmetic removals.
The Type of Removal Matters
There are two main approaches to explant surgery, and they carry different levels of risk. The simpler option is removing the implant alone, leaving the scar tissue capsule that your body naturally formed around it. This involves less cutting, a shorter procedure, and a lower chance of bleeding.
The more involved option is called en bloc capsulectomy, where the surgeon removes the implant and the entire surrounding capsule together in one piece. This technique requires more extensive dissection, especially when the implant sits beneath the chest muscle. The additional risks include greater pain, a higher chance of hematoma, and a small risk of pneumothorax. Some women specifically request en bloc removal because of concerns about silicone residue or breast implant illness, but it’s not always necessary. The FDA recommends discussing both methods with your surgeon to determine which one fits your situation.
One scenario where the more extensive removal becomes important: if there’s a confirmed diagnosis of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a rare cancer linked to certain textured implants. In that case, removing the capsule along with the implant is the standard approach.
What Anesthesia Adds to the Risk
Breast implant removal is performed under general anesthesia, which carries its own small set of risks including allergic reactions, breathing difficulties, and blood pressure changes. In practice, these are uncommon for healthy patients undergoing elective procedures. Studies of explant surgery with regional nerve blocks found no cases of pneumothorax, dangerously low blood pressure, or vascular injury from the anesthesia itself. The procedure is typically done on an outpatient basis, meaning you go home the same day.
Recovery Timeline
For the first one to two weeks, you’ll need to avoid driving and limit your activity. Heavy lifting and strenuous exercise stay off the table longer. Many people feel tenderness or soreness for up to six weeks, though the intensity decreases steadily after the first few days.
During the initial 6 to 12 weeks, your breasts will look noticeably different as tissues settle. Mild asymmetry is common in this window and often resolves on its own. The final shape and feel of your breasts won’t be fully apparent until about six months after surgery, sometimes up to a year.
Changes in Breast Appearance
The most predictable outcome of implant removal isn’t a complication, but it can still catch people off guard: your breasts will look different than they did before the implants went in. Most women experience some degree of sagging afterward. The skin stretched to accommodate the implant, and once that volume is gone, the remaining tissue sits differently. You can expect less upper fullness, a softer and flatter contour where the implant was, and nipples that sit lower on the breast mound.
How pronounced these changes are depends on several factors: how large the implants were, how long they were in place, your age, skin elasticity, and natural breast tissue volume. Larger implants that were in place for many years tend to leave more noticeable changes. Some women opt for a breast lift at the same time as removal to address the excess skin, though adding a second procedure does slightly increase overall surgical risk.
If your nipple remains below the crease under your breast after 6 to 12 months, or if excess skin creates a distinct shelf or fold, those changes are likely permanent without additional surgery.
Symptom Relief for Breast Implant Illness
Many women seeking explant surgery are motivated by symptoms they attribute to their implants: fatigue, brain fog, joint pain, and other systemic complaints collectively called breast implant illness. A meta-analysis pooling data from over 1,000 patients who had their implants removed for systemic symptoms found that about 82% reported improvement afterward. That means roughly four out of five women felt better following explantation. The remaining patients saw partial or no improvement, which is worth knowing if symptom relief is your primary reason for the surgery.
Choosing a Surgeon
The single biggest factor in reducing your surgical risk is who performs the procedure. A board-certified plastic surgeon has completed at least six years of surgical training, with a minimum of three years focused specifically on plastic surgery. This matters especially for en bloc capsulectomy, which requires careful dissection around the chest wall. Surgeons who regularly perform explant procedures are more familiar with the tissue planes involved and better equipped to handle unexpected findings like a ruptured implant or calcified capsule.