Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney
Two recoveries that share the same surgical pocket but feel completely different. After breast augmentation, the breasts are bigger, swollen, sitting high. After explant, they’re smaller, deflated-looking, sometimes wrinkled. Same surgical site, opposite physical experience. Patients who arrive expecting explant recovery to be a mirror image of their original augmentation recovery are usually surprised by how different the early weeks feel, particularly visually.
What follows is a guide to the practical bits. Wound care. Sleeping. Compression garments. The visual changes that happen in the first weeks and months. When to think about a breast lift if you need one. When to ring the clinic. The framework here applies whether the explant is for breast implant illness concerns, capsular contracture, rupture, or simply because the implants are no longer wanted. I’m Dr Scott J Turner, a Specialist Plastic Surgeon (FRACS) at our Bondi Junction and Manly clinics.
What Explant Surgery Actually Involves
Explant is the removal of breast implants under general anaesthesia, usually as a day procedure or short overnight stay. What the procedure actually involves varies a fair bit between patients. The variables: whether the surgical plan includes capsulectomy and what type, whether the implants are silicone or saline, whether they’re intact or ruptured, and whether a breast lift is being done at the same time. Each combination changes the operating time, the recovery profile, and what you’ll feel in the first weeks.
The four main surgical scenarios:
Implant removal alone is the simplest version: the implants are removed through the original incision (usually the inframammary fold), the pocket is washed out, and the incisions are closed. Recovery is typically the most straightforward.
Implant removal with partial capsulectomy removes the implants plus a portion of the surrounding capsule. This adds some additional surgical work and slightly extends recovery, but is generally well tolerated.
Implant removal with en-bloc capsulectomy aims to remove the implants and the entire capsule as a single intact specimen. Some patients prefer en-bloc, particularly in the context of BII concerns or when there’s a known silicone implant rupture and they want maximum reassurance about silicone containment. While every effort is made to remove the entire capsule when en-bloc is the surgical plan, it’s important to understand that this isn’t always possible. The capsule is sometimes adherent to underlying structures (the ribs, the chest muscle, the lung lining), and forcing complete removal in those areas can create unnecessary risk. Patient safety takes priority over technique purity. Patients should go into the conversation knowing that “en-bloc attempted” is a more accurate description than “en-bloc guaranteed.”
For most explant indications, including symptomatic implants, capsular contracture, rupture, and BII concerns, partial capsulectomy is clinically sufficient. The current evidence does not clearly establish en-bloc as superior to less extensive capsulectomy for BII symptom improvement. The choice between approaches is individualised, taking into account capsule thickness, implant integrity, patient preference, and the technical feasibility of complete capsule removal in your specific anatomy.
Combined explant and breast lift (mastopexy) is performed when the patient has significant skin redundancy after implant removal. This is a longer procedure with additional incisions and a longer recovery timeline. Whether to combine or stage these procedures is a clinical decision based on tissue characteristics and patient preference.
What Your Breasts Will Look Like Early On
This is the part that surprises some patients. Right after explant, your breasts will look smaller than your pre-augmentation breasts, often with visible skin redundancy where the implants used to be. There’s typically wrinkling, a deflated appearance, and sometimes asymmetry that wasn’t there before.
This is normal and expected. Skin that has been stretched around an implant for years takes months to retract, and tissue that was thinned by the pressure of the implant takes time to thicken back up. Most of the early appearance settles substantially over 3-6 months. Final results may take up to 12 months to be apparent.
Patients who’d had implants for many years, or who had larger implants relative to their natural breast tissue, tend to have more pronounced changes after removal. The conversation about expected appearance is part of the consultation before surgery so there are no surprises.
For patients with significant skin redundancy or who don’t want to wait for natural skin retraction, a breast lift performed at the same time or as a staged procedure later may produce a tighter, more elevated result. This is discussed individually based on your tissue characteristics.
Before You Come Home from Hospital
Most patients are discharged the same day or after one overnight stay. Before you leave, the nursing team will run through what to expect: how to manage your compression garment, what your incisions look like under the dressings, when to take which medication, and the warning signs to watch for.
Worth organising before surgery day: a driver to take you home (you won’t be driving for at least 10-14 days), someone to stay with you for the first 24-48 hours, prescription medication picked up from the pharmacy in advance, your bed set up with extra pillows for elevated sleeping, loose button-front clothing that doesn’t require pulling over your head, easy meals prepared or in the fridge, and someone to handle children, pets, or other regular responsibilities for the first week or so.
Patients who underestimate how much help they’ll need at home are the ones who tend to struggle most in the first week. Plan generously.
The First 72 Hours
The first three days after explant are typically the most demanding. You’ll likely be sore, tired, and moving slowly. The intensity of pain varies depending on what was done at surgery: implant removal alone is generally less painful than removal with capsulectomy, and combined explant with breast lift is the most involved.
Pain Management
Most patients describe the first 48-72 hours as more uncomfortable than severely painful. The sensation is typically a tightness or ache across the chest with some sharpness around the incision sites. Prescribed pain medication manages this for most patients. Take the medication on schedule for the first 48 hours rather than waiting for pain to escalate.
What to Expect Physically
Swelling, bruising, and tightness are all expected. Some patients experience a “drained” sensation in the breast tissue as the implants are no longer there. Numbness around the nipples or incision lines is common and typically resolves over weeks to months. Occasional sharp shooting sensations as nerves recover are normal.
Incision Care
Your incisions will be covered with surgical tape or dressings for the first week. Keep them dry. Don’t remove or adjust the dressings yourself unless specifically instructed. Showering is usually permitted 24-48 hours after surgery, though dressings should stay intact. If a dressing comes loose or gets wet, contact the clinic for guidance rather than trying to replace it yourself.
Sleeping After Explant
Sleep on your back with your upper body elevated for at least 4-6 weeks. The reasoning is similar to breast augmentation recovery: avoid pressure on the chest while incisions heal and tissue settles, keep the compression garment in position, and reduce morning swelling.
Practical setups for back-sleeping: a recliner chair for the first week, a wedge pillow or bed wedge, or multiple stacked pillows supporting from lower back to shoulders. A pillow under the knees takes strain off the lower back. Most patients return to side-sleeping around 6 weeks.
The Compression Garment
A surgical compression garment is part of standard explant recovery. Wear it day and night for the first 4-6 weeks, including for sleep and gentle walking. After this period, transition to a supportive sports bra during the day. Continue with night-time compression for several more weeks if recommended.
Compression supports the healing tissue, helps reduce swelling, and may aid in skin retraction by providing gentle inward pressure as the tissue settles. The garment should feel firm but not painful. If it’s cutting in, digging, or causing skin damage, contact the clinic for a different size or style.
Nutrition and Hydration
Sensible eating supports healing without needing to be elaborate. Include a protein source at each meal (lean meat, fish, eggs, dairy, legumes), eat a normal range of fruit and vegetables, and stay well hydrated. Most Australian diets meet the basic nutritional needs for recovery without supplementation.
What to avoid: alcohol for at least 2 weeks after surgery and longer if you’re on pain medication; smoking and vaping, which constrict blood flow and impair wound healing significantly (ideally stopped 6 weeks before surgery and continued off for at least 6 weeks after); high-sodium foods which can worsen swelling in the first week or two.
Scar Care
Explant scars are typically in the inframammary fold (under the breast), where they sit hidden in the natural crease. If a breast lift is performed at the same time, additional scars around the areola and vertically down to the fold (the lollipop or anchor pattern) are present.
In the first 2 weeks: keep incisions clean and dry, don’t pick at scabs or dissolving stitches, don’t apply anything to the incision unless directed.
From around 2-6 weeks: once incisions are fully closed and dressings off, scar care can begin. Silicone gel or silicone sheets daily, sun protection on the scars for at least 12 months (UV darkens healing scars), and gentle scar massage from around week 6 once cleared by the clinic.
Scars typically mature over 12-18 months, fading from red or pink to a pale line. Scar quality varies between individuals based on skin type, genetics, and how closely scar care is followed.
Follow-Up Appointments
The standard follow-up schedule for explant patients includes a first review around day 5-7 (dressings checked, healing assessed, any early concerns addressed), a second review at 3-4 weeks (compression garment transition discussed, scar care reviewed), a 3-month review (tissue settling progressing), and a 12-month review (final result and scar maturation assessed).
For patients who had explant for BII concerns, follow-up appointments also include discussion of whether systemic symptoms have improved, partially improved, or persisted. This is part of the conversation in the months following surgery and informs whether any additional intervention may be considered.
When to Call the Clinic
A quick word on the next bit. Some of these warning signs sound dramatic, and they’re listed because we’d rather you call about something minor than wait at home worrying about something serious. Pick up the phone if any of the following come up during your recovery:
- Sudden change in breast shape, size, or symmetry
- Pain that’s getting worse rather than better, or pain not controlled by your prescribed medication
- Fever above 38°C
- Redness, heat, or fluid leaking from an incision
- A wound separation or gap opening in an incision line
- Calf pain or swelling on one side (this can signal a blood clot and needs prompt attention)
- Shortness of breath or chest pain (this is urgent, call 000)
- Significant new bruising appearing after the first week
- Persistent or worsening psychological distress (explant can be an emotional process)
Returning to Normal Life
Most patients take 1-2 weeks off work after explant, depending on what was done at surgery and the physical demands of the role. Desk-based work can usually resume earlier than physical work.
Driving typically resumes around day 10-14, once you’re off opioid pain medication and can comfortably perform an emergency stop.
Exercise comes back gradually. Light walking is encouraged from day one for circulation. Light cardio such as stationary cycling can typically return around week 2. Lower body strength work from week 4. Upper body work, including chest exercises, from around week 6 onwards. The progression is similar to recovery after breast augmentation but the considerations are different because there’s no implant pocket to protect.
The emotional side of recovery deserves a mention. Patients undergoing explant often have complex feelings about the procedure, including relief, grief, anxiety about appearance, and sometimes regret about the original augmentation. These feelings are normal and worth talking about with someone you trust. If they become persistent or affect daily functioning, your GP can connect you with appropriate support.
Frequently Asked Questions
How long does recovery after breast implant removal take? For implant removal alone, most patients are back to normal daily activities within 2 to 3 weeks. Adding capsulectomy or a breast lift to the procedure stretches that timeline out. Light exercise comes back around weeks 2 to 3, full exercise around the 6-week mark. The longer-term piece is tissue settling and scar maturation, which continues quietly in the background for around 12 months. So “recovered” depends on what you mean. Back to normal life: weeks. Final visual result: months.
Will my breasts look very different after explant? Yes, immediately after surgery. Expect smaller breasts than before, some skin redundancy or wrinkling, and possibly asymmetry that wasn’t there before. Most of this settles substantially over 3-6 months as the skin retracts and tissue thickens back up. Patients who had implants for many years, or who had larger implants, tend to have more pronounced changes.
Will I need a breast lift after explant? Not all patients do. Whether you’d benefit from a breast lift depends on the amount of skin redundancy after implant removal, your tissue characteristics, and what you want the final appearance to be. The decision is typically made either at the time of explant (combined procedure) or after waiting 3-6 months to see how the skin retracts naturally. This is discussed individually at consultation.
Will my BII symptoms improve after explant? Honestly, we can’t predict this with certainty for any individual patient. What the evidence shows is that a substantial proportion of women experience meaningful symptom improvement after explant. Some see significant improvement within weeks. Others see partial improvement that builds over months. A smaller proportion don’t see meaningful change. This uncertainty is part of the conversation we have before surgery. If a clinic is promising guaranteed BII resolution, that’s a red flag rather than a reassurance. For more on what’s currently understood about BII, see the breast implant illness guide.
Do I need en-bloc capsulectomy or is partial capsulectomy enough? For most explant indications including symptomatic implants, rupture, and BII concerns, partial capsulectomy is clinically sufficient. The evidence doesn’t establish en-bloc as superior for BII symptom improvement. Some patients still prefer en-bloc, and where it’s the surgical plan, every effort is made to remove the entire capsule. However, due to anatomical and safety limitations, complete en-bloc removal isn’t always possible. Patient safety takes priority over technique purity. The right choice for you is a clinical decision discussed with your surgeon based on your specific anatomy and preferences.
When can I drive after breast implant removal? Most patients are back behind the wheel around day 10 to 14, provided you’re off opioid pain medication and can comfortably perform an emergency stop without flinching. This applies to all motor vehicles, not just cars.
Book a Consultation
Explant decisions are individual. The right surgical plan depends on why you’re considering removal, what your tissue is doing after years of implant pressure, whether a lift makes sense for you, and whether capsulectomy is part of the plan. None of this gets resolved properly online. It gets worked through in consultation.
Consultations run at our Bondi Junction and Manly clinics in Sydney. Dr Turner also sees patients at Brisbane, Canberra, and Newcastle.
Process notes for new patients. A GP referral is recommended for explant being considered for medical reasons (BII concerns, capsular contracture, rupture) because it carries your medical history forward. The standard surgical consultation framework still applies: at least two consultations with the surgeon, a psychological evaluation, and a cooling-off period before surgery is scheduled. These steps support careful decision-making rather than slowing things down.
To book, contact our clinic or call 1300 437 758.
