Breast Implant Removal and its Influence on Future Pregnancy

by Dr. Alan Gonzalez
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Many women who opted to get breast implants in their 20s and 30s are now deciding to have them removed. The trend is real – in 2021, 47% more women underwent implant removal procedures. At the same time, the number of women still getting breast implants has been on a steady decline.

As many women who have had their implants removed are now looking forward to family planning, the effect of implant removal on future pregnancies has become a hot topic. The good news for women in this situation is that there are a few downsides to implant removal and numerous benefits of experiencing pregnancy and breastfeeding without the worry of implants.

woman holding breast implant photo credit: Alexander's Images via Canva.com
Photo credit: Alexander’s Images via Canva.com

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Reasons Behind the Removal Trend

It is not unusual for a woman who was very excited to get implants to discover that these devices aren’t always everything they were cracked up to be. Some of the reasons women choose to undergo implant removal (also known as explantation) include:

  • Unhappiness with the way the implants look or feel
  • Persistent discomfort associated with the implants
  • Inability to participate in some activities because the implants are too large and heavy
  • Complications, such as rippling, capsular contracture, or implant rupture
  • Worries that the implants could make mammogram results less accurate
  • Fear of a rare cancer associated with implant known as BIA-ALCL
  • Symptoms that appear after the implants are placed
  • Concerns over how implants could impact motherhood, specifically pregnancy and breastfeeding

In recent years, there has been much concern regarding a condition known as breast implant illness or BII. This condition occurs after women get the implants and includes various symptoms, including joint pain, fatigue, headaches, and dry mouth. While there has not been conclusive evidence supporting BII, anecdotal evidence shows that many women see these symptoms clear once the implants are removed.

As women consider raising a family, health concerns they hadn’t felt in their youth may become more pressing. Some women decide that risks associated with breast implants are no longer acceptable when children enter the family plan. Others choose to experience pregnancy and breastfeeding without worrying about how their implants might affect their motherhood journey.

Breast Changes During Pregnancy (And the Effect of Implants)

While many women go through pregnancy with their implants intact, those who choose to remove them before becoming pregnant see definite advantages with their choice. While the implants may not impact the safety of pregnancy, they can exacerbate changes occurring naturally to the breasts throughout those nine months.

The breasts tend to fluctuate throughout pregnancy due to hormonal shifts and the biological preparation for breastfeeding that is to come. Breasts tend to get larger to accommodate milk supply. After breastfeeding, the breasts typically get smaller again. This process can lead to loose skin that cannot support the breasts, leading to sagging and drooping breasts.

Implants in the breast tissue create additional size and weight to the breasts, which may make sagging even worse. While breast lift surgery can often restore the breasts after pregnancy, women often find changes are not as pronounced when implants are not involved.

The Breastfeeding Question

The ability to breastfeed is another concern women with implants often share. Many women successfully breastfeed with their implants. However, in some cases implants can change nipple sensation, which may make breastfeeding uncomfortable if nipples are more sensitive or reduce milk supply if sensation declines after the surgery. Larger implants may also make a woman feel engorged, which can also impact milk supply.

Women tend to think they could have a better chance of breastfeeding if the implants are placed underneath the chest muscle (known as submuscular placement) than if they are placed on top of the muscle and behind the breast tissue (subglandular placement). This is only a suspicion, because the feeding possibility has multifactorial causes which can interfere with milk flow in some women.

The final breastfeeding factor is incision placement. Some surgeons use an incision around the areola to place an implant. To place an implant, some surgeons make an incision around the aerola, while others make an incision beneath the breast base or in the armpit. In all of these cases, it is necessary to find a surgeon who has experience, who will always make breastfeeding more possible.

The good news is that women who remove their implants before pregnancy can often breastfeed their babies without the additional concerns listed above. The likelihood does depend on how the implants were placed and whether the procedure affected the nipple or milk ducts at all. When you schedule your implant removal, tell your surgeon that you are planning to have children so our surgical plan takes breastfeeding into account.

Some women have difficulty breastfeeding even if they never had implants. Many factors go into a woman’s ability to nurse effectively. If you still have concerns about your ability to breastfeed your infant, please talk to your doctor.

Options for Breast Enhancement After Pregnancy and Breastfeeding

Some women may hesitate to remove their implants because they fear their breasts might sag or look deflated after the procedure. The good news is there are techniques to enhance the breasts while removing the implants to ensure an optimal aesthetic result.

In my practice, I use a proprietary implant removal technique with immediate breast reconstruction called BRALAN, or breast reconstruction anatomical lift augmentation. This surgery uses an L-shaped scar that minimizes visible scarring and preserves cleavage between the breasts. Through the incision, I remove both the implant and the capsule surrounding the implant. I can then rearrange the remaining tissue to create a beautiful, natural breast mound and reposition a drooping breast to create a youthful appearance.

Women can also undergo breast enhancement after their pregnancy and breastfeeding experience. I offer a BRA LIFT (breast reconstruction anatomical lift), which raises drooping breasts to improve projection and create a more youthful contour. BRAR (breast reconstruction anatomical reduction) effectively reduces the size of breasts that become heavy or pendulous after pregnancy. I can combine reduction with a lift if a patient needs both types of correction.

If you decide to experience pregnancy and breastfeeding without the burden of implants, you will join other women doing the same. Select your plastic surgeon carefully to ensure your breast implant removal is safe and you achieve the best possible aesthetic result.

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