What Can We Learn from Breast Implant Explantation: a 28-Year, Multicenter Retrospective Study of 1004 Explantation Cases

BACKGROUND: Implant-based breast augmentation remains popular, but the controversy over the safety and longevity of implants has continued. An event-based analysis of reasons for implant explantation may provide us with some insight into the controversy. METHODS: Data from May 1994 to October 2022 of explantation cases from aesthetic breast augmentation in three medical centers were retrospectively reviewed. Patient characteristics, time to explantation, reasons for visit, the major reason for explantation and intraoperative findings were analyzed. RESULTS: A total of 522 patients with 1004 breasts were included in our study. Objective explantation reasons accounted for 34.0% in primary augmentation breasts and 47.6% in revision augmentation breasts, which were significantly different (p = 0.006). The most common complaint was dissatisfaction with breast appearance, followed by concerns about implant safety, poor hand feeling and pain. 43.5% of the implants worn for more than 10 years were removed for objective reasons, which was found significantly different with the proportion of objective reasons in implants removed within 1 year and 1–5 years postoperatively (p < 0.008). CONCLUSION: The proportion of different reasons for implant explantation varies across the times of surgeries and the years that the implant had been worn. As the years of implant wearing increase, the proportion of subjective reasons decreases in implant removal cases and objective reasons increase among them. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.