Considering Explant Surgery? 5 Beautiful Breast Reconstruction Options for Women After Mastectomy with Dr. Schwartz

Introduction

Choosing breast reconstruction after a mastectomy is an intensely personal decision, one that countless women have made as part of their journey through breast cancer treatment. For some, however, the journey doesn’t end with reconstruction. If you’re a breast cancer survivor who underwent reconstruction with implants and are now considering explant surgery (implant removal) — you’re not alone. Many women, sometimes years after their mastectomy, begin to experience persistent physical discomfort, emotional unease, or emerging health concerns, some are dissatisfied with the appearance of their breasts or desire a natural look. This can lead them to explore implant removal and post-explant reconstruction options.

Whether it’s due to persistent pain, capsular contracture, or symptoms of Breast Implant Illness (BII), deciding to remove your implants is often an emotional decision. The empowering part? You have several beautiful, natural, and safe reconstruction options after explant surgery, and Dr. Schwartz, an internationally published expert in breast cancer and reconstructive surgery, who offers women not just surgical solutions, but a path toward restoring comfort, healing and self-reclamation.

Understanding Breast Reconstruction After Mastectomy

Breast reconstruction is a surgical procedure to rebuild the shape of the breast following a mastectomy. Traditionally, reconstruction is accomplished through implant-based procedures or autologous tissue methods, where a woman’s own tissue is used to create a new breast mound.

Implant-based reconstruction typically involves placing silicone or saline implants either beneath (subpectoral) or above (prepectoral) the chest muscle. Autologous options, such as latissimus dorsi flap reconstruction, use tissue from other areas of the body to form a natural breast shape. While many women initially find satisfaction with these reconstructions, some later experience complications or discomfort that prompt them to explore removal and alternative reconstruction techniques.

Why Some Women Choose to Remove Breast Implants

For many breast cancer survivors, the decision to remove breast implants—known as explant surgery—is influenced by a wide range of physical, emotional, and lifestyle factors. Every woman’s story is unique but here are some of the most common reasons women may consider this path:

1. Evolving Aesthetic and Lifestyle Needs

A Shift in Body Image: As women move through different life stages—whether aging, becoming mothers, or entering menopause—their relationship with their bodies often evolves. What once felt right or looked appealing may no longer align with how they see themselves today.

Embracing a More Natural Look: Some women simply prefer the appearance and feel of their natural breasts and no longer feel that implants reflect their personal style or values.

Dissatisfaction with Implant Size or Shape: Implants may feel too large, too small, or asymmetrical over time. As a result, some women seek a more balanced, natural silhouette that better suits their frame and current preferences.

Interference with Physical Activities:For active women, the weight or placement of implants may limit comfort or movement during workouts, sports, or daily activities.

2. Medical Complications Related to Implants

Scar Tissue (Capsular Contracture): This common condition occurs when the body forms an excessive, tight, sometimes painful scar tissue around the breast implant, causing the capsule to tighten and compress the implant, distorting the breast’s appearance and causing hardness and discomfort.

Implant Rupture or Leakage: Both saline and silicone implants can break down over time. Leakage may result in changes in breast shape, pain, or health concerns, especially in the case of silicone rupture.

Infection Risk: In some cases, infection after augmentation or reconstruction may require the implants to be removed for healing and safety.

Other Implant-Related Issues: These may include deflation, shifting, hardening, or changes in breast sensation, all of which can affect comfort and satisfaction.

3. Health and Wellness Considerations

Chronic Pain: Chronic pain after breast implant surgery can arise from various causes. While some pain is normal during recovery, but for some women, discomfort or tightness persists well beyond expected recovery. Common causes include implant malposition or nerve irritation, muscle-related discomfort from subpectoral placement or capsular contracture or implant rupture.  Women experiencing ongoing pain often find relief through implant removal, particularly when combined with techniques such as en-bloc capsulectomy.

Breast Implant Illness (BII): Breast Implant Illness is an unofficial term describing a range of physical and cognitive symptoms some women experience after receiving breast implants. These symptoms can include fatigue, brain fog, joint pain, hair loss, chest discomfort, and more.

While ongoing research aims to clarify the connection between implants and systemic symptoms, many women report significant improvement after implant removal. Dr. Schwartz acknowledges and respects his patients’ concerns, offering safe subpectoral and prepectoral explant procedures tailored to address these symptoms.

Autoimmune-Like Symptoms: Some women with implants report signs of autoimmune distress, including joint pain, dry eyes, and systemic inflammation, prompting them to consider implant removal as part of their healing journey.

4. A Desire to Reconnect With Their Bodies

Reclaiming Autonomy: For many, removing implants is about taking back ownership of their bodies. It’s a choice to honor how they feel now—physically, emotionally, and spiritually—and to return to a version of themselves that feels more authentic.

5. Seeking Greater Comfort and Confidence

Relief from Pain or Discomfort: Explant surgery can ease symptoms caused by implant complications, offering physical relief and peace of mind.

Boosted Self-Esteem and Body Confidence: Choosing to go implant-free can be empowering. Many women report feeling more in tune with themselves and experiencing a renewed sense of confidence and freedom.

Dr. Schwart’s Expertise: En-Bloc Capsulectomy & More

One of the most effective ways to safely remove breast implants and surrounding scar tissue is through an En-Bloc Capsulectomy. “En-bloc” is a French term meaning “as a whole”.

Dr. Schwartz is highly skilled in performing en-bloc capsulectomy, a meticulous surgical technique that removes the breast implant and the surrounding scar tissue (the capsule) as one piece, without opening the capsule inside your body.  He is sought after by women with subpectoral implants (placed under the chest muscle) as well as women with prepectoral implants (placed above the muscle).  This method:

• Minimizes the risk of contamination if silicone leakage has occurred.
• Removes potentially inflamed or unhealthy tissue.
• Is ideal for women with implant related complications or BII symptoms.

By removing the implant and capsule together, en-bloc capsulectomy minimizes the risk of contamination and helps some women experience symptom relief.

Dr. Schwartz ensures that every surgery is performed with both precision and sensitivity – his surgical center is equipped with state-of-the-art technology, and his team is dedicated to providing a nurturing and safe environment for your journey.

Reconstruction Options After Implant Removal

Dr. Schwartz’s care doesn’t stop at removal. Once the breast implants are removed, women face an important decision. Some choose to:

• Undergo reconstruction using their own tissue or fat to rebuild their breast shape naturally, while others
• Opt for an aesthetic flat closure with smooth, contoured chest wall closure.

You have options, and Dr. Schwartz customizes each plan to your health, anatomy, and preferences.

Let’s take a closer look at some of these post-explant options.

Fat Transfer Reconstruction

Fat transfer, also known as autologous fat grafting, involves removing fat from areas like the abdomen or thighs via liposuction, purifying it, and injecting it into the chest to create a soft, natural breast shape. Benefits include:

• Uses the body’s natural tissue
• Subtle, natural-looking results
• No foreign materials

Some women may require multiple sessions to achieve optimal volume. Dr. Schwartz’s refined technique ensures symmetrical, lasting results with minimal risk. Only women with enough donor fat can be good candidates.

The Goldilocks Technique

The Goldilocks procedure is a specialized reconstructive technique ideal for women who prefer a small breast mound made from their own remaining tissues. Dr. Schwartz has perfected this technique and published extensively on this topic, in a nutshell: remaining breast skin and soft tissue after explant are reshaped and repositioned to form a small, modest breast mound. In some cases, Dr. Schwartz can also include a reverse tummy tuck in some cases to add volume.

Women looking for an in-between option: not flat, not full-volume, but a natural breast contour using what’s already there are choosing this option.

Mastopexy (Breast Lift) After Explant

Implant removal often leaves excess skin or asymmetry. A mastopexy, or breast lift, repositions the remaining tissue and skin by lifting and tightening the loose skin, for a youthful, balanced appearance.

Dr. Schwartz frequently combines mastopexy with other reconstructive options to refine the breast shape following explant surgery, enhancing both form and function.

Latissimus Dorsi Flap Reconstruction

For women desiring more volume or coverage than fat transfer or Goldilocks alone can provide, Dr. Schwartz offers latissimus dorsi flap reconstruction. This sophisticated technique uses muscle and skin from the upper back to reconstruct the breast mound.

Benefits include durable, natural-feeling results without implants, especially for women lacking sufficient local breast tissue.  This surgery is more involved with a longer recovery time, but highly rewarding for the right candidate.

Choosing Aesthetic Flat Closure

Some women prefer to forgo reconstruction altogether, opting for a smooth, aesthetic flat closure. This procedure involves carefully removing extra skin and contouring the chest wall for a dignified, comfortable, and symmetrical appearance.

Dr. Schwartz honors each woman’s autonomy in choosing flat closure, ensuring meticulous surgical technique and compassionate postoperative care.

Why Choose Dr. Schwartz for Your Explant and Reconstruction

Dr. Schwartz is a board-certified, fellowship-trained breast and reconstructive surgeon with extensive experience in implant removal, en-bloc capsulectomy, and advanced reconstructive techniques. His practice is dedicated strictly to breast surgery only and women can expect:

• Patient-centered, compassionate care
• Safety-focused, evidence-based surgical techniques
• Comprehensive post-explant reconstructive options tailored to each individual’s needs

Women trust Dr. Schwartz to guide them through their explant and reconstruction decisions with empathy and expertise.

Conclusion

Breast implant removal after mastectomy is a personal, powerful decision. Whether prompted by physical discomfort, health concerns, or changing body image, women deserve safe, supportive, and effective care.

Dr. Schwartz offers a full spectrum of post-explant options, ensuring every woman’s unique needs are honored and addressed. Survivors can reclaim both physical well-being and peace of mind under his expert care.

FAQs

1. What is the difference between en-bloc and total capsulectomy?
   • En-bloc removes the implant and capsule together; total capsulectomy removes the entire capsule, possibly in pieces.
2. Is en-block capsulectomy always possible?
   • Not always. In the cases where the capsule is too thin or attached to vital structures, Dr. Schwartz will use the safest method to remove as much capsule as possible.
3. Will insurance cover explain surgery?
   • In most cases, yes – especially if medically indicated (pain, contracture, BII, rupture). Reconstruction procedures, including aesthetic flat closure, are also typically covered by insurance.
4. How long does recovery from explant surgery typically take?
   • Most women can return to light activity within 1-2 weeks, with full recovery in 4-6 weeks but this can vary based on the type of reconstructions chosen.

Whether you want to return to your natural body, ease chronic discomfort, or simply take back your power, explant surgery can be a life-changing step toward self-love and well-being. You have the right to feel healthy, whole and empowered after breast cancer treatment.

You are not alone. You are not broken. You are choosing you. With Dr. Schwartz, you are not just choosing a surgeon – you are choosing a compassionate partner in your healing – on your terms.

Ready to Take the Next Step?

Schedule a confidential consultation with Dr. Schwartz to explore your explant reconstruction options. Dr. Schwartz offers in-person consultations at this clinic, while out-of-town patients can connect with Dr. Schwartz via a secure video teleconference.

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