Due to his vast experience working with breast implants and performing breast surgery, Mark Pinsky, MD is the Palm Beach plastic surgeon women (and even other surgeons) trust to help them resolve both breast implant-related health issues and cosmetic complications. These can be very complicated matters and a difficult journey for the patient. Generally speaking, patients have already been through one or more difficult surgeries, and the goal going forward is to have an insightful strategy that manages the issue(s) for the last time. Dr. Pinsky understands there are many reasons you may want to have your breast implants removed, and he conducts all of his professional interactions with the utmost compassion for your physical and emotional needs. Whether you are concerned that your implants are negatively affecting your health or you are unhappy with the current appearance of your augmented breasts, Dr. Pinsky can develop a fully personalized treatment approach aimed at achieving a proper diagnosis and reaching your personal breast goals.
As your plastic surgeon, your health, comfort, and delivering on your expectations are Dr. Pinsky’s primary concerns, and at each phase of the process he will strive to create an experience that fulfills your every need. Using knowledge gained as a top breast surgeon for more than 20 years, an FDA Clinical Investigator for both Mentor® Corporation and Allergan® breast implants, and as a frequent lecturer at Allergan Academies around the world, Dr. Pinsky has developed a reputation for delivering exceptional results in some of the most difficult cases.
We invite you to explore the informative sections provided below to learn more about the reasons for breast implant removal, BIA-ALCL, breast implant-related illness, and treatment techniques for restoring natural-looking breasts following explantation:
- Many Typical Reasons for Breast Explantation
- What Is BIA-ALCL?
- What is BII?
- Breast Implant Removal for BIA-ALCL
- Breast Restoration After Explantation
- Breast Implant Removal for BII
- En Bloc Capsulectomy Surgery
What Are Common Reasons for Breast Implant Explantation?
There are many personal reasons you may be considering the removal of your breast implants, and Dr. Pinsky has extensive experience in addressing virtually any concerns you may be having. During a one-on-one consultation, he will take the time to listen to your concerns, answer your questions in an easy to understand manner, thoroughly evaluate your needs, and develop the most appropriate treatment plan for your unique situation. If you are experiencing (or think you may be experiencing) any of the issues listed below, we welcome you to trust the health and care of your breasts to Dr. Pinsky’s experience.
Women who choose to have their breast implants removed commonly do so for one or more of the following reasons:
- To treat BIA-ALCL (breast implant-associated anaplastic large cell lymphoma)
- To treat breast implant illness (BII)
- To treat capsular contracture (hardening of the breast from scar tissue)
- To treat leaking or ruptured breast implants
- The desire to no longer have breast implants
- To exchange old breast implants for new implants
- To exchange breast implants for fat tissue
- To resolve pain related to breast implants
If you are worried about the possibility that you are suffering from a breast implant-related illness or that your breast implants need to be removed and/or replaced due to other serious concerns, please contact Pinsky Plastic Surgery today to schedule an appointment. We can book you for the soonest time available with Dr. Pinsky to discuss the breast related issues that are on your mind, evaluate your breasts and breast implants, and help you on the road to overcoming any related emotional and physical challenges you are experiencing.
What Is BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma) and What Is the Breast Implant Recall?
On July 24, 2019, at the request of the FDA (Food and Drug Administration) Allergan announced a voluntary worldwide withdrawal of unused stock of BIOCELL® textured breast implants and tissue expanders from doctors’ offices and hospitals. As a member of the Allergan Executive Council on Breast Aesthetics for 15 years Dr. Pinsky has personally been in meetings with Allergan management following this announcement. There are a few very important points to note:
- The recall does not pertain to smooth surfaced implants.
- It’s the shell of the implant, smooth or textured, that is important, not the contents of the implant, silicone or saline.
- The recall only pertains to unused inventory from doctors’ offices and hospitals.
The concern is that textured breast implants, and in particular Allergan textured breast implants, have been linked to an unusual, rare cancer called Breast Implant Associated Lymphoma (BIA-ALCL), a non-Hodgkin’s lymphoma (cancer of the immune system) which develops in the scar tissue (capsule) surrounding the implant. At this time, the likelihood of developing BIA-ALCL is thought to be low, occurring in less than 0.03% of patients with BIOCELL textured breast implants.
Patients may be able to identify their breast implant from the wallet sized information card provided from the office at the time the implant was inserted. If you cannot locate your information card, please call Dr. Pinsky’s office and we will assist you in finding out the type of breast implant you have.
This withdrawal of unused stock does not mean your textured implants need to be removed unless you are experiencing specific symptoms. According to the FDA, American Society of Plastic Surgeons (ASPS), and the American Society of Aesthetic Plastic Surgeons (ASAPS), women who do not have symptoms are being discouraged from having their implants removed because the inherent risks of surgery are greater than the risk of this rare condition.
Symptoms include breast enlargement or hardening, persistent pain, lump in the breast or armpit, or most commonly, swelling from a large fluid collection surrounding the implant—the latter of which would require an MRI and aspiration of the fluid for specific testing. These symptoms typically develop 8 to 10 years after the implant was placed.
Dr. Pinsky is aware that for some patients this news may be particularly alarming even if you do not have textured implants. A patient’s safety and sense of ease is of our utmost concern. For those reasons, Dr. Pinsky can discuss these issues in greater detail, such as what is BIA-ALCL and the relative risk, explantation, en-bloc capsulectomy (the technically more difficult task of removing the scar tissue in one complete piece), and SEIF (simultaneous exchange of implant with fat).
What is BII (Breast Implant Illness)?
There are concerns that breast implants may be linked to specific illnesses or symptoms in patients who have undergone breast augmentation, breast lift with augmentation, and breast reconstruction involving implants. The specific illnesses may be various autoimmune-related illnesses with symptoms that may include (but are not limited to) fatigue, weakness, muscle or joint aches and pains, cognitive dysfunction, hair falling out, and other health issues.
For patients diagnosed with a possible type of BII, breast implant removal—and, in some cases, the removal of the scar tissue capsules that surround the breast implants—is generally recommended as part of an effective plan for treatment.
In response to BIA-ALCL and BII developments, Dr. Pinsky has directed a significant focus of his practice to assessing women’s breast concerns, examining the breasts for potential complications, suggesting effective diagnostic methods, and performing procedures to remove implants while restoring natural-looking breasts. If you are worried about your breast implants, symptoms of illness, or the appearance of your augmented breasts, Dr. Pinsky is the plastic surgeon you can rely upon to provide you with the education and treatment you need.
Breast Implant Removal Related to BIA-ALCL or BII
If you have breast implants and are concerned about developing an illness or believe that you are showing symptoms of BIA-ALCL or BII, we encourage you to contact our practice to schedule a consultation with Dr. Pinsky. During this appointment, he can review your medical history, discuss your implant-related issues, assess the details of your specific breast implants (e.g. the type, date of placement, pocket location, etc.), and perform an examination to see if further diagnostic testing is indicated. An MRI and subsequent biopsy of the fluid surrounding the breast implant is required to diagnose BIA-ALCL. Should your breast implants need to be removed, Dr. Pinsky can perform explantation. You may also choose from the SIEF procedure or breast implant exchange to maintain a natural breast aesthetic, depending on your needs and cosmetic preferences. He may also recommend a more technically skilled procedure, en bloc capsulectomy to remove the scar tissue capsule that surrounds your breast implant in one single piece.
You may also choose from the SIEF procedure or breast implant exchange to maintain a natural breast aesthetic, depending on your needs and cosmetic preferences.
How Can I Restore Natural-Looking Breasts Following Explantation?
While some of our patients choose to exchange their old implants for new ones, others choose not to have implants any longer, and still other patients desire volume restoration through Simultaneous Implant Exchange with Fat (SIEF). Dr. Pinsky is known for his experience in breast revision surgeries. There are literally hundreds of breast implants to choose from when selecting breast implants. Dr. Pinsky has lectured all over the world on choosing breast implants utilizing Bio-Dimensional Planning Principles where the dimensions of the implant are matched to the proportions in each patients’ figure so a patient’s breasts look as natural and beautiful as possible. Dr. Pinsky specializes in using the latest techniques to create natural-looking results for women who no longer want breast implants, or for those who wish to replace their problematic implants with newer more advanced breast implants.
On the remainder of this page, we have several sections explaining every aspect of SIEF. If you are interested in learning more about replacing implants via fat transfer, we encourage you to continue reading. If, instead, you prefer the idea of breast implant exchange, please visit our page devoted to breast revision.
Simultaneous Implant Exchange with Fat
Simultaneous Implant Exchange with Fat, or SIEF, is a breast revision surgery in which breast implants are removed and then immediately replaced with the patient’s own fat. The fat transfer allows the breasts to maintain volume and shape, particularly upper pole fullness, without the need for new breast implants.
After breast augmentation, the breast skin may stretch in order to accommodate the size and shape of the implants. If the patient chooses to remove the implants in the future, breast volume loss and changes in breast shape may be noticeable. If the breast skin is still elastic, it may tighten naturally after implant removal; however, overly stretched or aging breast skin may appear depleted. Simultaneous Implant Exchange with Fat (SIEF) is an innovative technique that Dr. Pinsky uses to help patients who no longer want their breast implants, but want to maintain breast volume, fullness, and shape. The SIEF procedure can:
- Be performed at the time of explantation or delayed at a later time
- Be performed in combination with a breast lift
- Correct aesthetic abnormalities caused by breast implant complications, such as wrinkling or rippling of the implant
- Restore breast volume and shape with natural-looking results
- Create breasts that are soft and more symmetrical
- Even be performed at the time of breast augmentation in women with anticipated visible edging of the breast implant, called Composite Breast Augmentation.
As an added benefit, fat collection for transplantation is achieved with liposuction techniques, which creates a more slender appearance in the areas where fat is removed. Most commonly, liposuction is performed in the abdominal region, flanks, hips, thighs, or buttocks to obtain an adequate volume of fat to complete the SIEF procedure.
Candidates for Simultaneous Implant Exchange with Fat
Any woman who is in good health and has a sufficient amount of fat to complete the SIEF procedure may be a candidate for this technique. If you are considering removal of your breast implants and want to find out if SIEF is an option for you, we invite you to schedule a consultation with Dr. Pinsky. During your appointment, he will thoroughly examine your breasts, assess the condition of your health, and discuss the reasons and goals you have for the procedure. He will also evaluate how much fat can be liposuctioned from your body to accomplish the degree of augmentation you desire after implant removal. Finally, Dr. Pinsky will present you with the best surgical options for removing your implants and achieving the best results.
The SIEF Procedure
During surgery, the areas from which the fat is to be harvested is infiltrated with a numbing solution, which also reduces the bruising (see the liposuction section for more information). The breast implants are then removed from the body and, if necessary, the intracapsular spaces which held the breast implants are cleansed.
The liposuctioned fat is purified in a specific manner with a patented sterile device. The fat is then strategically re-injected into the breasts to achieve the desired shape, size, and fullness. Depending on the unique challenges your procedure might pose, Dr. Pinsky may vary his approach as needed to create an optimal outcome.
Recovery after Simultaneous Implant Exchange with Fat
Your recovery after SIEF will depend upon the unique details of your surgery; however, you should expect some degree of post-surgical tenderness, bruising, and/or swelling. In addition to your breasts, the area(s) of your body treated with liposuction will be recovering as well, and temporary bruising and/or swelling is common. Compression garments will be required to promote proper healing where fat was removed, and Dr. Pinsky will advise you on how long these garments need to be worn. Recovery after liposuction typically takes about two to three weeks before patients can return to vigorous activity, but most patients are able to go back to work a week after the procedure.
Results of Simultaneous Implant Exchange with Fat
The majority of patients who undergo SIEF are able to achieve a cup size that is slightly less than their augmented breast size with breast implants, or smaller if desired. For women who experience breast implant complications (i.e. capsular contracture and others that cause cosmetic abnormalities and/or discomfort) prior to SIEF, the natural-looking breast shape and feel they achieve after SIEF is often a tremendous relief and a boost to self-confidence. It is important to note that a certain percentage of the transferred fat is reabsorbed by the body during the healing process. This resorption process is accounted for during the initial procedure; however, occasionally patients who desire additional breast volume after the initial procedure may consider undergoing a second round of fat transfers six to twelve months later. To see SIEF before-and-after photos featuring Dr. Pinsky’s patients, we invite you to visit our photo gallery.
If you want to remove your breast implants for any reason, we welcome you to contact our practice to schedule a consultation with Dr. Pinsky.