I am looking to remove my over-the-muscle silicone implants. Can it be done under local anesthesia?

I've had silicone implants (over-the-muscle) for 17 years. There haven't been any complications, just want them removed. To reduce cost, and to not put my body through general anesthesia, could this be done under local anesthesia? Is that an option?

Answers from doctors (11)


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).

Answered by The Institute of Aesthetic Surgery (View Profile)

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


More About Doctor Vanek Plastic Surgery

Published on Feb 19, 2017

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!


Answered by Vanek Plastic Surgery (View Profile)

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


Robert Kearney, MD

Published on Feb 10, 2017

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.

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Answered by Robert Kearney, MD

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


Charles Slack M.D.

Published on Feb 10, 2017

Yes, it can done under local anesthesia.

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Answered by Charles Slack M.D.

Yes, it can done under local anesthesia.

Published on Jul 11, 2012


More About Doctor David J. Levens, MD

Published on Feb 10, 2017

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.

Answered by David J. Levens, MD (View Profile)

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


More About Doctor Tom Pousti, M.D.

Published on Feb 10, 2017

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.

Answered by Tom Pousti, M.D. (View Profile)

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


Edward Domanskis M.D.

Published on Feb 10, 2017

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

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Answered by Edward Domanskis M.D.

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

Published on Jul 11, 2012


More About Doctor Joseph Cruise, MD

Published on Feb 10, 2017

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.

Answered by Joseph Cruise, MD (View Profile)

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


Stephen Greenberg, MD

Published on Feb 10, 2017

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.

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Answered by Stephen Greenberg, MD

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


More About Doctor Susan Vasko MD, FACS

Published on Feb 10, 2017

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.

Answered by Susan Vasko MD, FACS (View Profile)

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


More About Doctor Salman Ashruf, MD, FACS

Published on Feb 10, 2017

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

Answered by Salman Ashruf, MD, FACS (View Profile)

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


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