People frequently change their minds on various matters, and for women, this sometimes involves the decision to remove their breast implants. It’s a topical subject: Chrissy Teigen recently disclosed that she had her breast implants removed after 14 years, and other celebrities like Ayesha Curry have also spoken about reversing their decisions. “They’ve been wonderful to me for many years but I’m simply done with them,” Teigen wrote on Instagram. “I want to be able to zip up a dress of my size and lie on my belly with total ease!”
Naturally, for implants to be taken out, they first need to be put in, and the surgery to increase breast size remains highly popular: breast augmentation has been the top cosmetic surgical procedure for 14 years. However, the number of removals is also increasing: breast implant removal has been the eighth most popular cosmetic surgical procedure for the past two years, moving up from the 10th place in 2015, as per The Aesthetic Society. “I removed more implants than I inserted last year,” says Dr. Patricia McGuire, a board-certified plastic surgeon in St. Louis. “Breast aesthetics are evolving, and large breasts and obvious implants are becoming less favored, at least in the Midwest.”
Dr. Melinda Haws, a board-certified plastic surgeon in Nashville, reports a similar trend. “I’m undoubtedly observing an increase in breast implant removals for a variety of reasons.” This includes breast implant–associated anaplastic large-cell lymphoma (BIA-ALCL), a rare form of cancer of the immune system that can develop around textured breast implants, and breast implant illness (BII), which refers to a collection of symptoms that numerous women attribute to their breast implants.
But while patients with BIA-ALCL and BII contribute to this trend, they are by no means all of it. “Just because someone loves their implants at 30, doesn’t mean they will at 50,” says Dr. Haws. As she explains, women’s breasts change as they age – they might gain weight and their breasts grow larger, eliminating the need for implants. Or their lifestyle could shift. “More and more women get into shape later in life and prefer a more athletic breast profile over a curvaceous one,” says Dr. Haws. (If size is the main concern, your implants can also be replaced with larger or smaller ones, a procedure known as an exchange.)
Whether women have health concerns or have “outgrown” their implants, it’s understandable that they are worried about how their breasts will appear once the implants are removed. The straightforward answer is that everyone is different. Key factors include skin laxity, the extent of augmentation, your age, the duration the implants were in place, and whether you’ve gained or lost weight. In many women, the breast tissue will recover to some extent and the skin can contract. “If a woman didn’t require a breast lift initially and only had implants, I’m constantly astonished by how much her breasts will fluff up and the skin will shrink just with implant removal,” says Dr. Haws. “Most women’s breasts return quite close to their pre-implant state, unless there’s been significant weight gain or loss.”
If your breasts sag after explantation, a breast lift can be performed. But unless it’s blatantly obvious that you need a lift (one sign is if your nipples fall below the bottom part of your breast), don’t rush to have the surgery concurrently with the explantation, advises Dr. Allen Gabriel, a board-certified plastic surgeon in Vancouver, Washington. “Take a few months to get accustomed to the new you and then decide,” he says. “You can have had a primary augmentation and not much will have changed with your breasts once the implants are removed.”
Though Teigen expressed interest in following up her explantation with a breast lift, plastic surgeons say that many women choose to remain as they are afterwards. “Many patients go through an adjustment period after implant removal, initially concerned about the size and shape, but within a few days of surgery, most are content and comfortable with their smaller breasts,” says Dr. McGuire.
To obtain detailed information on downsizing, we spoke with three women* who recently had their implants removed. Continue reading to learn why they did it, how the surgery went, and how they feel about their breasts without implants. Spoiler alert: Along with 98% of RealSelf members who have had their implants removed, all of them believe the procedure was “Worth It.”
Related: Breast Implant Illness Patients Are Demanding a Say in How Their Implants Are Removed – But Is Their Technique of Choice Too Risky?
“I’m certain I made the correct choice”
Last summer, Julie Lowe decided to have her breast implants removed, with the sole aim of seeing if it would alleviate the persistent and excruciating pain she was experiencing in her shoulder. “The pain just emerged. I didn’t injure myself – it simply occurred,” says Lowe, who underwent breast augmentation 14 years ago when she was 33. “I’ve always struggled with a negative perception of my body, and after having my daughters, I felt deflated and dissatisfied with my breasts,” she remarks. Her right breast was also smaller than her left breast, a difference that became more apparent after having children.
With the augmentation, she went slightly larger than she was before having kids. “I was a full B cup before having children and a small B afterwards, and I became a small C with the surgery.” She states that her plastic surgeon did an excellent job. “He truly listened to me, and the result looked very natural.”
Although Lowe never had any issues with her implants, she has Hashimoto’s disease, an autoimmune disorder that leads to low thyroid function. After getting the implants, she struggled to stabilize her thyroid levels. Approximately four years ago, the disease – and its symptoms, including hair loss, constant fatigue, weight gain, and skin sensitivity – became more severe and difficult to manage. Whether her implants were related is unknown, but around the same time, Lowe began experiencing pain in her right shoulder. “I’m right-handed, and I couldn’t do anything with my right arm,” she says.
After exhausting all other possible explanations for the shoulder pain, Lowe’s doctor suggested that it might be attributed to her breast implants. “I was gaining some weight at this time, and my breasts were also larger,” says Lowe. “My doctor wondered if my attempts to cope with this might be causing the pain.” With her life disrupted by the pain – she couldn’t sleep, exercise, or even open a sliding door – she chose to have her implants removed.
The surgery was successful in multiple ways, Lowe says. Her plastic surgeon removed her implants and the surrounding capsule through the same incisions used for insertion, she recovered very well, and her breasts “healed beautifully,” Lowe says. “I have an extremely high pain tolerance, so I didn’t take any pain medication – not even a Tylenol,” she says. “It might sound odd since I opted for implants, but I prefer a more natural approach. I wanted to see if I could endure the pain without taking anything.” That’s not to say it wasn’t painful: “It was, but as long as I didn’t move, it was manageable,” Lowe says. Two days after the surgery, she returned to work.
Most importantly, her thyroid issue stabilized within a few months and her shoulder pain has almost vanished. “It’s not 100%, but I can carry boxes and reach above my head. I don’t even think about it now,” she says. For her peace of mind, she paid extra to have the capsule sent for pathology testing to look for leaked silicone and any cancerous cells (the tests came back negative).
She was determined that she neither wanted nor needed a breast lift. “My breasts didn’t look bad before the implants; they were just too small in my opinion – and I wanted to see how they would look once the implants were removed,” she says. “I also wanted to give my body a chance to heal, so I didn’t want to undergo anything traumatic.” Plus, her nipples are still “quite perky,” which is a good indication that she didn’t require a breast lift. Surprisingly, the asymmetry that bothered her before getting implants is gone. “They’re both the same size now,” reports Lowe, who is also thrilled to be able to wear small bralettes or go without a bra. “It’s wonderful.”
Another unexpected advantage: the feeling of lightness on the chest after the removal. Breast implants, which typically add about two pounds of weight to the chest, can feel very heavy, says Lowe. “I remember coming out of anesthesia when I had the implants inserted, and I felt very heavy on my chest – like I couldn’t breathe. I was scared I’d have the same feeling with the explantation, but not at all. I can inhale much deeper than before, and my breathing is much better. It’s extremely liberating.”
“I’m glad to be back to my original self”
When Leslie Audino had a breast augmentation a year after breastfeeding her second son, “it was the best decision I ever made for myself,” says the 33-year-old. “Before having kids, I was a full C. After nursing my two boys, I didn’t even fill an A cup, and it was all just loose skin.” The surgery, which restored her bustline to a 36C or 34D depending on the bra, looked very natural, so most people didn’t even realize she had implants. But it made a significant difference to Audino: “I was self-conscious about being so small, and I felt much better about myself with the implants.”
For eight years, she was entirely satisfied with her choice. “I had no concerns about my implants at all.” Then, in July 2019, the type of implants she had, Allergan’s Natrelle textured silicone implants, was recalled by the FDA due to the risk of BIA-ALCL. It was classified as a Class I recall, the most serious type of recall. According to the FDA, “using these devices may cause serious injuries or death.”
Following the instructions in the letter she received informing her of the recall, Audino saw her primary care provider, who conducted a breast examination and blood work. Since BIA-ALCL is a type of lymphoma (cancer of the immune system), all her lymph nodes were also checked. That’s when they discovered a lump in her groin. “It’s a very frightening experience because your mind immediately jumps to the worst-case scenario,” she says. Although her blood work came back negative for cancer, she met with a general surgeon, who removed two lymph nodes from her groin for biopsies. They too came back negative.
Audino was relieved, but then she had to decide how to proceed. One option was to leave the implants in and monitor them – this is in line with the FDA’s recommendation not to remove implants in patients who weren’t experiencing symptoms of BIA-ALCL. That would mean having regular breast exams, MRIs, and blood work for the remainder of the time she had them.
The other option was to have them removed at her own expense, as Allergan doesn’t provide surgical fee assistance for asymptomatic patients. She could then have the implants replaced (Allergan would provide a smooth implant as a replacement) or not. “The choices were to live with fear or pay yourself to have them removed,” says Audino.
The recall, however, indicated that the majority of women having problems were at the 8- to 12-year mark of having their implants. “I was right at eight years, and I didn’t want to wait until I had an issue, especially after the initial scare, so I decided to have them out,” Audino says. “I’m the type of person who would have been stressed about having them in.”
She returned to her original plastic surgeon for the explantation, which included her implants and the surrounding scar tissue capsule, and decided to have a breast lift at the same time. “Otherwise, I would have been back to square one, and I didn’t want all the loose skin,” she says.
Her breast lift experience was very different from her breast augmentation. “Getting the implants inserted was no big deal – I recovered quickly,” Audino says. “But getting them removed and having the lift was probably the most painful thing I’ve ever endured.” While the implants were placed through small incisions beneath her breasts, the breast lift required nearly two feet of incisions in total, including an incision around the areola and then down the middle to the base of the breast. The nipple was repositioned higher and the areola was reduced to better match her new breast shape and size.
“To put it in perspective, when I had the implants inserted, I only took Tylenol one or two times and it was fine,” Audino says. “With this surgery, I was on prescribed pain medication around the clock.” She hardly got out of bed for the first five days and needed assistance from her husband and sister. After that, she gradually resumed normal activities until returning to work after 10 days. “It was definitely a couple of very tough weeks,” she says.
In the end, it was all worth it. “I wouldn’t change anything either way,” she says. “If you asked me if I’d have implants again, I would. But now, given the circumstances – I’m older and don’t care as much about the size of my breasts – it’s less important to me.” Although she once again doesn’t quite fill an A cup, “I’m 100% okay with that,” she says. Nine months after her surgery, the scars beneath her breasts are still very visible – her surgeon says they will take the longest to fade – but those around her nipple disappeared very quickly and the ones up the center are now quite faded.
In hindsight, Audino wishes she had given more consideration to the idea of having a breast lift initially. “I would encourage women to explore their options,” she says. “I was 24 when I did this, and I had no idea about getting a breast lift – I had no concept of what that would be like.” She sometimes thinks that if she had taken that route from the beginning, she could have avoided the situation with the implants, but she doubts she would have chosen to do so. “Back then, if I was going to pay for surgery, I probably would have wanted to be restored to my pre-kid state. I cared about that a lot more then,” she says. “Now I don’t mind. I actually feel really good. I’m happy with what I did. Even though the breast lift was extremely painful, it was completely worth it. I literally feel a weight lifted off my chest.”
Related: 6 Plastic Surgery Procedures Insurance Might Cover
“I’ll be 69 soon, and I didn’t want to deal with a rupture or other issue in my 70s or later”
Carol Harper had a breast augmentation in 1984 when she was 33. All her sisters have small breasts, and when her older sister’s initial experience with implants was positive, Harper decided to increase her size as well. The main reason behind her decision was how she appeared in a swimsuit. “It’s difficult to find a suitable swimsuit when you have a very small chest,” she says. “I vividly remember going to the pool when I was young. At that time, swimsuits had bra-like cups, and they would indent when I lay down on my stomach. I had to do this movement when I got up where I’d squeeze the cups with my arms and they’d pop out. I was always afraid someone would notice.” So, after having two kids, Harper had her breasts enlarged from “two peanuts on a board” to a B cup.
“I was quite happy with my breast implants when I first got them,” she recalls. “It was the only time I had cleavage, apart from when I was breastfeeding, and I enjoyed that.” But in the ‘90s, when breast implants were linked to breast cancer, autoimmune diseases, and neurological problems, Harper became worried and consulted several plastic surgeons about having her implants removed. “It came in waves – implants were in the news frequently, then out of the news, then back in the news, and that’s when I’d start worrying again and visit someone,” she says.
The first time (and the second, 10 years later), all she heard from plastic surgeons was how disappointed she would be if she removed her implants. “Everyone said, ‘It will be a disaster; you’ll be so dissatisfied with wrinkled skin and saggy boobs.’” One surgeon suggested removing her double-lumen silicone implants, which had an outer layer of saline (saltwater) that was wrongly thought to control rupture and capsular contracture, and replacing them with saline implants because, at that point, silicone implants had largely been removed from the market for augmentation purposes. “I thought that was crazy – I just wanted them out,” says Harper. “I knew women whose implants had ruptured, and my sister’s implants became encapsulated. She hates hugging people because they feel so uncomfortable and hard.”
Because the surgeons she consulted were quite certain her implants hadn’t ruptured, Harper didn’t feel an urgent need for the surgery. “It wasn’t a major concern, but it was always in the back of my mind,” she says. Then last September, 30 years after she first considered having her implants removed, Harper decided to go ahead with it. “This time, I was really determined,” she says. “I was concerned about the age of my implants – having them for over 30 years is a long time – and my age as well. I’m almost 69, and I just didn’t want to deal with a problem and a surgery in my 70s or beyond.”
This time, the plastic surgeons she saw were much more receptive to the idea of explantation, although two of them thought she might need a lift and
