What is Breast Explantation?

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Breast Explantation is the plastic surgery in which the implant is removed, along with all the tissue that the body formed around the implant, called the CAPSULE. Breast Explantation seeks to remove all of this Lymphatic tissue that forms the Capsule, since it has the potential to generate an autoimmune biological response, and worse yet can also produce a cancer called Anaplastic Large Cell Lymphoma.

 

The explantation must remove that lymphatic tissue called the Capsule to always send it to Pathology, along with some chemical tests to rule out that the implant has caused that type of tumor. Although the possibility is low, that is, one case per 20,000 patients, it cannot be ruled out with any other test than the analysis of a Pathologist.

 

It is called Total Explantation when the totality of the tissue is removed. And it is called En Bloc Explantation when it is removed without the capsule breaking, this being an Oncological term, that is, a term used in the treatment of cancer. That is why this term, which includes the removal of the capsule and even neighboring tissues, should not be used.

 

It is important that your surgeon be convinced that the explantation is done because the implant is producing damage to the patient. Not simply to perform a procedure that is in Fashion. That is why it is not very reasonable for a surgeon who is explanting to simultaneously be placing implants in other patients.

If the surgeon is convinced that the breast implant does cause harm, and for that reason performs explantations, this surgeon, as is the case of Dr. Pavajeau, does NOT place breast implants anymore.

 

It is as absurd as if a doctor knows that a medicine or a vaccine causes harm to his patients, and then publishes a photo the next day placing this medication...

Breast Explantation or the removal of Breast Implants is one of the surgeries most performed by Dr. Luis Pavajeau, for about 9 years now. With more than 1,200 patients on whom he has performed a Breast Explantation, Dr. Pavajeau considers that Explantation is not a surgery that became fashionable, as it is at this moment for many Plastic surgeons.

Patients seek Explantation for Health reasons. Explantation is a very important topic, as removing the prostheses brings many benefits for the patient with diseases related to the implant, or Breast Implant Illness.

 

The unaesthetic result due to reduction in breast size is what generates the most fear in patients who are considering a Breast Explantation. The fear is not unfounded and is so great that the recognized journalist and former queen Carolina Cruz stated that women end up flat and without their femininity. This can happen if an adequate immediate reconstruction is not performed.

 

Without a doubt a Breast Explantation should not be left to improvisation and chance. Experience counts a lot in this surgery which is much more complex than placing an implant.

One should always think of Breast Explantation as an immediate reconstructive topic in which the objective is to rescue the greatest amount of breast tissue and generate the best volume and the best possible shape, including with fat transplanted from other places.

Why do Patients want to undergo Breast Explantation

 

The most frequent consultation is because the patient has an Autoimmune disease, which appears after the placement of the implant. In second place because the patient has symptoms of the so-called Breast Implant Illness or the ASIA Syndrome which has more than 100 described symptoms and are real. Many patients, simply because due to their age they no longer want implants, to avoid submitting to another change in 10 years when due to age it could already be dangerous. And there are simply many patients who upon seeing the potential damage of implants, decide without having any symptoms, that they do NOT want implants for no more valid reason than simply not wanting to have them.

 

The so-called Breast Implant Illness is real and is part of the ASIA Syndrome which originates from substances that reached our body, and that stimulate the Immune System, generating a series of local changes in the breast, such as hardening, or encapsulation, with a lot of pain and changes in the shape and position of the prosthesis, and Systemic changes, that is, in other organs and that greatly affect the immune system and that are reflected as autoimmune diseases.

 

Although many doctors do NOT accept it as a disease developed by implants, the majority of symptoms can improve upon removing them.

 

It is important to know that the ASIA SYNDROME can only be confirmed when after a BREAST EXPLANTATION the Symptoms improve. So it is incorrect for a patient to arrive at surgery saying they are going to be explanted because they have ASIA syndrome.

So when scheduling a BREAST EXPLANTATION surgery, we assume that the patient COULD have an ASIA Syndrome, BUT IT IS ONLY CONFIRMED WITH THE IMPROVEMENT OF SYMPTOMS, SOME TIME AFTER THE EXPLANTATION.

 

Dr. Pavajeau is one of the most recognized specialists in implant removal or Explantation and is among the best Plastic surgeons in Colombia who have dedicated themselves fully to attending to Breast Explantation and no longer place implants.

This problem that affects the health of many women has been increasing, becoming at this moment one of the most frequent surgeries in Colombia.

 

What is Breast Implant Illness or BII

 

Many patients noticed changes since they had their implants placed. These changes, initially considered normal, were related by the patients to their prostheses. As groups of women formed sharing this information through networks, and then more and more groups appeared describing the symptoms, patients went to their surgeons, and the Medical term Breast Implant Illness appeared, in which all these symptoms described by patients were grouped. The described symptoms already number more than 100. Among them the ones that affect the most are those related to the immune system.

 

Many patients with rheumatological problems had already been removing their implants on the recommendation of their Rheumatologists, due to the association that has long been known between breast implants and autoimmune diseases such as arthritis, Lupus, or Sjögren's Syndrome. Many Rheumatologists who are the ones who see this type of Autoimmune diseases agree on the need to remove the implants. However, unfortunately some still consider it unnecessary.

 

Many patients who removed their implants, simply to reduce the risk of having an autoimmune disease, also improved from other nonspecific symptoms that were not related to their disease.

Initially the Plastic Surgeons of patients who did not have autoimmune diseases and who presented with these symptoms thought that the patients were faking and that their symptoms, as they are not easy to measure, were psychological or invented. It was even speculated that the symptoms would be "spread through networks," that is, patients upon reading them would be influenced and feel them. Even at the last MIAMI 2023 congress of the ASAPS American Society of Aesthetic Plastic Surgery, a NOCEBO effect was discussed. That is, the patients, according to these doctors, are so obsessed with Breast Explantation that upon being explanted they improve simply because their brain believes that the Explantation is going to improve them. I personally consider that the patients' Symptoms are real and DO improve when performing a Breast Explantation.

 

The reality is that in the majority of patients who decided to remove their breast implants, the symptoms disappeared or improved. All of this encouraged other women who sought help and also decided to remove their implants.

 

What are the described symptoms of Breast Implant Illness

Extreme fatigue/low energy, tiredness without reason Sudden palpitations at night and insomnia Dizziness, vertigo and feeling of being unbalanced Cognitive dysfunction (extreme lack of concentration and/or memory loss) Constant mild or very sharp headaches, migraines (as if you have a hangover) Joint, muscle and tendon pain Constant infections throughout the body Flu, colds without reason, a lot of coughing, respiratory problems and sudden fevers Rashes and skin irritations, sudden acne, aggravated or unprecedented skin allergies Swollen lymph nodes, thyroid problems and inflamed glands Unprecedented sensitivity to light and sound Worsening of sight and blurred vision shock syndrome

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What Surgical Alternatives exist for BREAST EXPLANTATION or the removal of breast implants

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There are three types of surgery performed by Dr. Pavajeau

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1. Periareolar Breast Explantation In this surgery Dr. Pavajeau only makes an incision around the areola. A good result can be achieved if the mammary gland or the breast with the implant does not look or is not sagging. Although the incision is made only around the areola, internally the breast explantation must always be performed removing the totality of the capsule or the tissue around the prosthesis. And the tissue must always be sent to pathology and to chemical tests to rule out tumor. The care and recovery time is 14 days. It almost always requires fat lipo-injection if the breast is small.

2. J-shaped Breast Explantation In cases in which the prosthesis is to be removed but the mammary gland is sagging, and has a lot of excess skin in the lower pole, or the base of the breast is very wide. The best incision for medium-sized and sagging breasts is the "J" incision. It is also a careful surgery and there are restrictions until day 14 for movements etc. in the arms. The tissue that is drooping in the lower part is used for breast reconstruction. In some cases it does not require fat injection, if the volume in the lower pole is large.

3. Anchor or Inverted T Breast Explantation This incision is reserved for Giant and very sagging breasts, where the excess of skin and/or breast Ptosis is so large that the explantation needs not only to remove the implant, but also a lot of excess skin and gland.

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IN ALL CASES, IF THE AREOLAS ARE LARGE, THE OPPORTUNITY IS TAKEN TO REDUCE THE SIZE OF THE AREOLA DURING THE BREAST EXPLANTATION.

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