Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney
Breast implant removal decisions fall into two camps. The first is largely driven by the clinical picture: a ruptured implant, painful capsular contracture, an infection that won’t clear. The surgery is clinically indicated and the consultation mostly confirms what the patient already knew. The second is harder. Symptoms that don’t fit a clean diagnosis, imaging that’s clean but the unease remains, or implants that simply don’t feel right anymore. This article is for patients in the second camp, who are weighing up whether explant is the right decision.
This guide walks through when removal is typically indicated, when alternatives deserve consideration first, and what questions to work through before committing. I’m Dr Scott J Turner, a Specialist Plastic Surgeon (FRACS) consulting at our Bondi Junction and Manly clinics in Sydney.
Breast Implant Removal Consultations in Sydney
What does a breast implant removal consultation actually cover? In short: your implant history, your current concerns, and what’s realistic given your starting point. The longer version is more individual. Some patients come in with a single ultrasound showing silicone leak and a clear sense of what they want. Others bring years of symptoms, half a dozen specialists’ opinions, and no strong view on surgery one way or the other.
At the Bondi Junction and Manly clinics, what we work through at consultation includes your original augmentation (when, where, what implants, what happened after), any current symptoms or concerns, previous imaging or operation notes you’ve been able to track down, and whether there’s a complication suspected on examination. From there the conversation moves to options. Removal alone. Capsulectomy. Replacement. A lift if needed. And honest talk about what your breast tissue will look like afterward based on years of implant pressure, skin elasticity, and how the implants have been sitting.
Patients from Sydney’s Eastern Suburbs, Northern Beaches, Inner West, North Shore, and wider NSW make up most of the explant consultations at the practice. The point of the consultation isn’t to reach a decision on the spot. It’s to clarify whether explant is medically indicated, personally appropriate, or whether waiting or trying something else would be the better first move.
Why Patients Think About Breast Implant Removal
The reasons women come in asking about explant fall into a few groups, though most women’s stories sit across two or three categories rather than one clean bucket.
The first group comes in with a clear medical complication. Capsular contracture that’s become painful or started distorting the breast. Implant rupture confirmed on MRI. An infection that hasn’t settled. Extrusion. A BIA-ALCL concern. For this group, the “should I?” question has mostly been answered by the clinical situation. The consultation is more about how and when.
The second group comes in with systemic symptoms they suspect are linked to the implants. Fatigue that’s hung around for a couple of years. Joint aches. Brain fog. Rashes. A sense of being generally unwell that doesn’t have an obvious cause on standard blood work. These symptoms are often bundled under the term Breast Implant Illness (BII), and the evidence on what’s happening, and how often explant resolves it, is still developing. Several studies show a meaningful proportion of women notice improvement after implant removal, though not all do, which is why expectations matter. For more on the evidence, see the breast implant illness guide.
The third and fourth groups are often mixed together. Women whose implants suited them in their twenties or thirties but don’t feel right at forty or fifty. Women whose bodies have changed through pregnancies, weight shifts, or time, and whose implants now sit in a position or shape they’re unhappy with. Sometimes the concern is rippling or palpability becoming more obvious. Sometimes it’s asymmetry that wasn’t there before. Sometimes it’s simply “I’d prefer not to have these anymore.”
Then there’s the group that has no symptoms, no imaging findings, and no specific problem, but does have anxiety about the implants being there long-term. Worry about BIA-ALCL. Worry about silicone. A general preference not to have a medical device in their body anymore. This is a legitimate reason to consider explant, but the decision framework is different from the clinical-indication group.
Why this matters: the right answer for someone with confirmed rupture isn’t the right answer for someone with vague BII symptoms, and neither is the right answer for someone who’s simply changed her mind. Each scenario deserves its own conversation.
When Breast Implant Removal Is Usually Indicated
Some situations make the decision relatively straightforward. In these cases, the question is less “should I?” and more “when and how should I proceed?” Breast implant removal is generally appropriate when there is:
- Baker III or IV capsular contracture causing pain, visible distortion, or significant discomfort that hasn’t responded to conservative measures
- Confirmed implant rupture on MRI or ultrasound. Silicone gel rupture, even when silent, is usually addressed because leaked silicone can trigger inflammatory changes over time
- Implant extrusion where the implant is eroding through the skin (this is a surgical emergency)
- Confirmed or suspected BIA-ALCL, which triggers a specific oncological workup and pathway
- A mass within the capsule or surrounding tissue on imaging that needs further investigation
- Significant infection that hasn’t settled with appropriate antibiotics or other conservative treatment
In these circumstances, surgery is driven primarily by medical need rather than by aesthetics alone.
When to Consider Alternatives First
For many women in Sydney who come to discuss breast implant removal, there’s time and space to explore alternatives before committing to surgery.
If you’re worried about BII-type symptoms
Before assuming your implants are the cause, a thorough medical workup can be helpful. Many women with systemic symptoms turn out to have another underlying explanation that responds to targeted treatment. A typical workup might include blood tests (inflammatory markers, thyroid function, hormones, vitamin levels), screening for autoimmune conditions, and sometimes assessments with a rheumatologist, endocrinologist, or other specialists.
If a treatable alternative cause is found, addressing that first is often the better starting point. If your tests are reassuring but symptoms persist, breast implant removal becomes a more considered option, with realistic expectations around the likelihood and degree of symptom improvement.
If you have mild capsular contracture
Baker I or II capsular contracture (mild firmness without distortion or pain) isn’t always a surgical problem. Observation, massage, and monitoring may be appropriate. Surgery is more often reserved for Baker III or IV when the breast is painful, misshapen, or functionally bothersome.
If you are mostly unhappy with the look
When the core issue is position, size, or shape rather than wanting the implants gone entirely, a revision procedure may be worth discussing. If the concern is mainly shape, size, position, or asymmetry, it’s worth comparing breast implant removal with breast implant revision and, in some cases, breast lift surgery. These are different operations with different trade-offs. A patient who wants to be implant-free may be best suited to explant, while a patient who still wants breast volume but dislikes the current result may be better served by revision.
If you feel anxious but otherwise well
If you have no symptoms, normal imaging, and no specific medical indication for removal, but feel uneasy about your implants, this deserves an open discussion. The anxiety is valid and worth taking seriously, but so is the question of whether surgery is the best response. Some women in this situation proceed with explant as a personal preference. Others choose to monitor and revisit the decision later. Both can be reasonable responses.
Breast Implant Removal, Capsulectomy, or Breast Lift: What Is the Difference?
Breast implant removal isn’t always one single operation. Depending on the reason for surgery and the condition of the surrounding tissue, the plan may include one or more components.
Implant removal alone involves removing the implants while leaving some or all of the capsule in place where clinically appropriate. The remaining capsule gradually reabsorbs over time.
Capsulectomy involves removing part (partial capsulectomy) or all (total capsulectomy) of the scar tissue capsule around the implant. This may be discussed when there’s capsular contracture, rupture, calcification, concern about abnormal fluid, or other findings.
Breast lift with implant removal (mastopexy) may be considered when there’s significant skin laxity, nipple descent, or loss of breast shape after the implants are removed. It can be performed at the same time as explant or as a staged procedure later.
The right option depends on the implant history, symptoms, imaging, tissue quality, and what the patient is hoping to achieve. Not every patient needs a total capsulectomy, and not every patient needs a breast lift. These decisions are made case by case at consultation.
Questions to Ask Yourself Before Deciding
Many patients find it helpful to sit with a few clear questions before committing to surgery:
- What exactly am I hoping explant will change: symptoms, appearance, peace of mind, or all three?
- What do I realistically expect to look and feel like after surgery, knowing my breasts and skin have changed since my original augmentation?
- Have I had a proper medical workup for any systemic symptoms I’m attributing to the implants?
- Have I explored reasonable alternatives (revision, conservative management, or simply waiting) and discussed them with a Specialist Plastic Surgeon?
- Am I in a mental and emotional space where I can make a considered decision, rather than reacting in the middle of a crisis?
- What will my plan be if my results are good but not perfect, or if my symptoms improve but don’t completely disappear?
Bringing honest answers to these questions into your consultation often makes the discussion more focused and productive.
What Life After Explant May Actually Look Like
Explant isn’t just a procedure. It’s also an adjustment. The implants may be out, but the breast tissue, skin envelope, scar profile, and emotional expectations all have to settle. Honest conversation about this part of the process matters more than most clinics are willing to admit upfront.
If you’re having explant for a medical reason, the clinical outcome tends to be predictable. Capsular contracture pain usually settles once the capsule and implant are out. Infections controllable with antibiotics after the implant is removed. Silicone that’s leaked from a ruptured gel implant, cleaned up at surgery. These are the easier expectations to set: remove the problem, resolve the problem.
BII-related symptom outcomes are less predictable, and this is where honest counselling genuinely matters. Recent studies show a meaningful proportion of women with BII-type symptoms report substantial improvement after implant removal, sometimes within weeks, often sustained over months. But improvement isn’t universal. Some women see partial change. A smaller group see little or no symptom relief. The uncertainty should be part of the pre-operative conversation, not something that gets glossed over.
What your breasts look like after explant depends on a list of things: how long you’ve had the implants, what size they were, how your tissue has responded to years under pressure, and whether you’re having a lift at the same time. Expect smaller breasts than you had before augmentation. Expect some skin redundancy, more pronounced if the implants were large or long-standing. Expect the shape to shift over the first three to six months and settle closer to a year. For patients wanting a more lifted result, a breast lift at the time of explant (or as a staged second procedure) is often part of the conversation. For the practical recovery side of what the first weeks and months look like, see recovery after breast implant removal.
And then there’s the emotional side. Many patients describe a mix of relief and adjustment sitting side by side. Relief that the implants are out. Adjustment to a body that looks and feels different. Both are normal. Both can coexist for months. Patients who’ve done the mental prep for this tend to move through it more smoothly than patients who expect everything to feel settled by six weeks.
When to Wait and When to Proceed
Timing is individual. Not every explant decision has to happen this month, and not every situation can sit on the shelf indefinitely.
The situations that shouldn’t wait are mostly the obvious ones. Confirmed infection that isn’t responding to antibiotics. Implant extrusion through the skin. Suspected BIA-ALCL. A mass within the capsule that needs histology. Baker III or IV contracture with significant pain or functional impact. In these cases, the clinical picture drives the timeline. The question becomes how soon, not whether.
The situations where a slower pace makes sense are usually about the decision itself rather than the physical urgency. If your symptoms are vague and you haven’t completed a proper medical workup, getting that done first is worth the time. If you’re in the middle of an acute life crisis or a severe mental health episode, surgery decisions made during instability tend to be regretted more often than surgery decisions made from a steadier baseline. If you’ve only had one consultation, or if you’re still not sure what you’re hoping explant will actually resolve, more time and a second opinion aren’t going to hurt.
Then there’s the “perfectly fine to wait” category. No symptoms, no imaging findings, no specific complication, just a preference to have the implants out eventually. There’s no clinical imperative forcing the decision. If there’s a major life event coming (planned pregnancy, significant weight change, major surgery for something else), waiting until after often makes practical sense. If you want more time to sit with the decision, take the time. Explant isn’t going anywhere.
How the Decision Pathway Works in Australia
In Australia, breast implant removal may be considered for medical, reconstructive, or cosmetic reasons. The pathway depends on why you’re considering surgery.
For patients seeking cosmetic surgery, a GP referral is required before consultation under the Medical Board of Australia’s cosmetic surgery guidelines introduced on 1 July 2023. A GP referral is also important when there are medical concerns such as suspected rupture, capsular contracture, breast implant illness symptoms, infection, or pain, because it helps carry your medical history, investigations, and relevant health information into the specialist consultation.
The consultation pathway generally includes:
- A GP referral before your specialist consultation
- Review of your medical history, implant history, symptoms, imaging, and goals
- At least two consultations before cosmetic surgery proceeds
- Assessment of suitability, including psychological readiness where relevant
- A cooling-off period after informed consent before surgery can be booked
- Written financial consent including surgeon, anaesthetic, hospital, implant-related, and follow-up costs where applicable
These steps aren’t intended to slow patients down unnecessarily. They exist to support careful decision-making, especially when the reason for explant is personal preference, anxiety, or symptoms where the evidence is still developing.
Frequently Asked Questions
How do I know if I really need my breast implants removed? Honestly? Some signs are clear, others aren’t. The clear ones are the things your surgeon will pick up on examination or imaging: Baker III or IV contracture with pain or visible distortion, a confirmed rupture, suspected BIA-ALCL, a mass in the capsule, infection that isn’t settling, implant extrusion. These are clinically indicated, and the conversation is about how and when, not whether. The less clear situations are BII-type symptoms, aesthetic dissatisfaction, or general anxiety about having implants. For those, a consultation with a Specialist Plastic Surgeon helps you work out whether removal is clinically indicated, personally appropriate, or whether something else deserves consideration first.
Should I try anything else before deciding on explant? Sometimes, yes. If you have systemic symptoms you believe may be related to your implants, a medical workup is usually a sensible first step. This may include blood tests, autoimmune screening, thyroid testing, vitamin levels, or review by another specialist. For mild capsular contracture, monitoring may be appropriate. For aesthetic concerns, breast implant revision or breast lift surgery may be worth discussing before deciding on permanent removal.
Will my symptoms definitely go away after breast implant removal? No, and any surgeon who promises otherwise is overstating what the evidence supports. What the studies do show is that a meaningful proportion of women with BII-type symptoms report substantial improvement after explant. Some see it within weeks. Some see partial improvement over months. A smaller group see little or no change. The outcomes for clearly medical problems (painful contracture, rupture, infection) are more predictable because you’re removing a defined problem. For BII-type symptoms, uncertainty is honest pre-surgery messaging, not a scare tactic. If a clinic is making firm promises about symptom outcomes, that’s the red flag to notice.
What will my breasts look like after implant removal? After implant removal, the breasts are usually smaller and may have some loose skin, flattening, or change in shape. The final appearance depends on implant size, how long the implants have been in place, skin quality, breast tissue, pregnancy history, weight changes, and whether a breast lift is performed. Most early changes settle over 3 to 6 months, with final results continuing to mature over 12 months.
How long does the process take from consultation to surgery in Sydney? The timeline depends on whether the surgery is medically indicated, whether further imaging or medical workup is needed, and whether the procedure is cosmetic or reconstructive in nature. For cosmetic surgery in Australia, patients need a GP referral, appropriate consultations, informed consent, and a cooling-off period before surgery can proceed. Some patients move through the pathway over several weeks, while others take longer to complete investigations or consider their options.
Book a Breast Implant Removal Consultation in Sydney
If you’re considering breast implant removal, the first step is a careful consultation to understand why you’re thinking about explant, whether there’s a medical indication for surgery, and what outcome is realistic for your body.
Dr Scott J Turner consults with patients considering breast implant removal at our Bondi Junction and Manly clinics in Sydney, seeing patients from Sydney’s Eastern Suburbs, Northern Beaches, Inner West, North Shore, and wider NSW. Dr Turner also consults at Brisbane, Canberra, and Newcastle.
Before your appointment, please bring:
- Your GP referral
- Previous implant records if available
- Operation notes from your original breast augmentation if you have them
- Ultrasound, MRI, or mammogram reports
- A written list of symptoms or concerns
- Any relevant blood tests or specialist letters
Your consultation will cover your implant history, examination findings, imaging, surgical options, risks, recovery, expected appearance after explant, and whether Medicare or private health insurance may be relevant in your situation.
To arrange a consultation, contact the clinic on 1300 437 758 or email [email protected].
This article is general information only and isn’t a substitute for medical advice. Breast implant removal is surgery and carries risks. Suitability, surgical options, recovery, costs, and outcomes vary between patients. A consultation with a qualified health practitioner is required to assess your individual circumstances.
