Simple removal of non-ruptured silicone implants can be performed under local anesthesia. However, at 17 years post-implantation, there exists the potential for a silent rupture or gel bleed of which you are unaware. This cannot be determined via exam and requires imaging (MRI). The removal of a ruptured silicone gel implant is more complicated, requiring a total capsulectomy (which would require more than local anesthesia).

As always, discuss your concerns with a board-certified plastic surgeon (ABPS).

Published on Jul 11, 2012

Of course, anything is possible but you need a specific workup to determine if you can get away with this procedure under local anesthesia. I don’t think that is a good option for you for several reasons.

First, why subject yourself to pain, anxiety, and uncertainty for revision surgery? Your implants are likely a case of gel bleed rupture, and you will most likely benefit from a capsulectomy. Microscopic silicone will need to be washed out of your peri-prosthetic space (the space where the implant and silicone material reside). This is more efficiently done with you comfortably anesthetized.

General anesthesia is far less stressful on your physiology than procedures that require the type of chest wall block you will need to perform your revision surgery. Side effects and toxicities are avoidable when board-certified anesthesiologists are the ones providing you state-of-the-art anesthesia, like the ones in my practice. Look up the concept of MAC, which are the units of anesthesia using sedation vs general anesthesia techniques.

Your best course of action is to have a board-certified plastic surgeon evaluate your physical examination, your needs, and your specific circumstances--and make your decision based on their assessment.

Because your implants are 17 years old, you may wish to replace them with smaller ones, consider harvesting your fat and doing an autologous fat transfer to your implant-free breasts. I understand you want your implants removed, but I would discuss your situation sensitively, as you have lived with full-figured breasts for 17 years.

If you wish to explore this further, please contact my office. I look forward to serving you!

Published on Jul 11, 2012

I would not do that as I prefer to take out 50% of the scar capsule to assure closure of the pocket. I would suggest a light general anesthesia. The procedure should not take more than 1 hour, which is about $1,400 in my OR.

Published on Jul 11, 2012

Yes, it can done under local anesthesia.

Published on Jul 11, 2012

Most commonly breast implant surgery is performed under general anesthesia for maximal comfort and safety. Other considerations include the appearance of your breasts without implant replacements, which can be unpredictable, and you may not be comfortable with that appearance. The next best step is to have a consultation with a plastic surgeon to discuss your options.

Published on Jul 11, 2012

Thank you for your question. I generally remove breast implants under general anesthesia for the comfort and safety of the patient. I hope this helps.

Published on Jul 11, 2012

Yes, I can remove silicone breast implants under local anesthesia in our certified operating room.

Published on Jul 11, 2012

Although I perform such cases under general anesthesia, there may be some plastic surgeons out there who would consider performing implant removal under general anesthesia. Your implants have been implanted for 17 years, so it's hard to know what could be found during surgery. Silicone leakage is a possibility, which would require a more involved procedure, which is why I prefer general anesthesia as a precaution.

Published on Jul 11, 2012

Thank you for your question.

In my opinion, it is not a good idea to perform a breast implant removal under local anesthesia. In fact, I would only perform this procedure under general anesthesia. There are increased complication risks associated with performing this procedure under anything other than general anesthesia.

Published on Jul 11, 2012

It may be an option to remove your breast implants under local anesthesia instead of general, but you would need to discuss this with your surgeon. Each patient is different, and although it has been done under local before, this may not be the right choice for you. If you were going to do a lift after removing them, I would recommend being under general anesthesia.

Published on Jul 11, 2012

Yes, the implants may be removed under local anesthesia. There will be minimal discomfort and pain, and the duration of the procedure is minimal.

Published on Jul 11, 2012