Breast Implant Removal (Explant Surgery) in Sydney

One of the most confusing parts of researching explant surgery is the terminology around how the implant and its surrounding capsule (the scar tissue your body forms around any implant) are removed. There are a few different approaches, and the right one depends on your history and the condition of your tissue.

Total Capsulectomy

This removes the implant along with the entire surrounding capsule, as a separate step from removing the implant itself. This is generally recommended when there’s evidence of contracture, calcification, rupture, or when a patient specifically wants all capsule tissue removed.

Partial Capsulectomy

This removes only the affected portion of the capsule, leaving healthy capsule tissue in place. This is a more conservative option, generally suited to patients without contracture, rupture or suspicious findings, where removing the entire capsule would mean unnecessary tissue loss.

En Bloc Capsulectomy

Sometimes called “en bloc removal”, this is a specific technique where the implant is removed together with the capsule as a single, intact unit, without opening the capsule during removal. It’s most often requested by patients concerned about BIA-ALCL or breast implant illness, as it limits the implant and capsule contents from contacting surrounding tissue during removal.

En bloc capsulectomy generally isn’t possible when:

• The capsule is very thin, fragile or firmly adhered to surrounding structures such as the chest wall or ribs
• The implant sits partially or fully behind the chest muscle (submuscular placement)
• Attempting en bloc removal would risk significant damage to the chest wall, lung lining or major blood vessels
• The capsule has calcified extensively or is scarred into surrounding tissue 

In these situations, a total capsulectomy performed in stages, or a partial capsulectomy, is usually the safer and more appropriate approach. Your surgeon will always confirm in consultation which technique is realistic for your anatomy. You can read more detail on these techniques in our guide to breast implant capsulectomy.

Breast implant illness (BII) is the term used to describe a wide range of symptoms some patients report experiencing with breast implants, including fatigue, joint and muscle pain, brain fog, headaches, hair loss and other systemic complaints. 

Many patients who undergo explant surgery for suspected BII report improvement in some symptoms following removal, particularly where implant rupture, contracture or infection were contributing factors. However, it’s important to have realistic expectations:

• Removal can’t be guaranteed to resolve all symptoms
• Symptom improvement may happen gradually over months rather than immediately
• Some patients experience significant relief, others experience partial improvement, and some see no change in non-implant-related symptoms

We take an individualised approach with every patient, considering explant surgery in Sydney for suspected BII, working through your symptom history and setting expectations honestly before you commit to surgery.

One of the biggest decisions to make ahead of implant removal in Australia is whether to combine it with a breast lift, fat transfer, or neither.

Combining explant with a breast lift is generally recommended when there’s noticeable skin laxity, sagging, or a change in nipple position expected once the implants are removed, particularly in patients with larger implants, longer implant duration, or reduced skin elasticity. You can see real outcomes in our explant with breast lift results gallery.

Fat transfer at the time of explant involves harvesting a patient’s own fat via liposuction and grafting it into the breast to restore some volume without using an implant. This suits patients who want a small to moderate amount of natural-feeling volume back, without returning to implants.

Explant alone, without a lift or fat transfer, is often appropriate for patients with good skin elasticity, smaller implants, or those who are comfortable with a smaller, softer result and prefer to avoid additional surgery.

Your surgeon will assess your skin quality, implant size, breast tissue and goals in consultation to recommend whether a lift, fat transfer, both, or neither best suits your anatomy, similar to the assessment used for breast implant revision patients weighing their options.

Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare cancer of the immune system that has been linked to certain textured breast implants. It typically presents as persistent swelling, fluid build-up or a lump around the implant, often years after the original surgery.

It’s important to understand that BIA-ALCL is rare, and current medical guidance does not recommend removing implants purely as a precaution in patients who have no symptoms. If you have textured implants and no symptoms, routine monitoring and awareness of the signs to watch for is the recommended approach, not pre-emptive removal.

If you notice new swelling, a lump, pain, or asymmetry after your implants have settled, it should be assessed promptly. Your surgeon can discuss your specific implant type and risk profile with you during consultation.

Medicare eligibility for implant removal depends on the reason for surgery. Removal may be eligible for a Medicare rebate when it’s performed for a medical reason, such as confirmed rupture, capsular contracture causing symptoms, or suspected BIA-ALCL, and your surgeon determines the relevant MBS item number applies to your case. Removal for cosmetic reasons alone, such as wanting a different size or no longer wanting implants without a qualifying medical indication, generally isn’t Medicare-eligible.

Whether or not you qualify for a rebate, private health fund cover can also contribute to hospital and anaesthetic costs where the procedure meets the relevant clinical criteria.

Because your final cost depends on whether removal is combined with a lift or fat transfer, the complexity of the capsulectomy required, your hospital and your surgeon, we’d always recommend a consultation for a personalised quote rather than relying on a general figure.

Explant surgery is a highly individual procedure, and not every patient’s implants or capsules present the same way. Rather than offering a one-size-fits-all technique, we assess each patient’s implant type, capsule condition, and goals to recommend a realistic, safe approach for their anatomy. 

Dr Yunaev is a specialist breast and general surgeon, not a general cosmetic or plastic surgeon. He has over 12 years of dedicated expertise in breast health and is accredited by the Royal Australasian College of Surgeons (RACS).

With his background in breast health, function and post-surgical complications, Dr Yunaev takes a thorough approach to assessing implant and capsule condition before recommending a removal technique, prioritising patient safety and realistic outcomes over promising a specific result before surgery.

You may be a good candidate for Sydney explant surgery if you:

• Are experiencing symptoms of capsular contracture, rupture or malposition
• Have implants that are ageing or beyond their expected lifespan
• Are experiencing symptoms you associate with breast implant illness
• Have textured implants and have noticed new swelling, a lump or asymmetry
• Have simply changed your mind about having implants
• Are in good general health with realistic expectations of your results

Your surgeon will assess your implant type, capsule condition and breast tissue in consultation to confirm suitability and the most appropriate technique for you.