Breast Implant Removal and Capsulectomy in Beverly Hills: Every Reason, Every Approach, and Why the Decision to Remove Is as Valid as the Decision to Augment
The decision to remove breast implants is one that patients arrive at from many different directions. Some arrive because something has gone wrong medically: a ruptured implant, capsular contracture that has hardened and distorted the breast, or an infection that has not resolved. Some arrive because they have been experiencing a constellation of systemic symptoms that they and their physicians have traced to their implants. Some arrive because their priorities, their body, or their relationship with their own appearance have changed over the years, and the implants they chose at thirty no longer feel right at forty-five. And some arrive because they simply want to exchange what they have for something different.
Every one of these reasons is legitimate. Every one of them deserves a surgical plan as precise and individualized as the reason that produced it.
Breast implant removal and capsulectomy in Beverly Hills with Dr. Daniel Golshani addresses the full spectrum of implant removal presentations, from the simplest elective explantation through the most complex en bloc capsulectomy for BIA-ALCL, ruptured silicone, or severe capsular contracture. Dr. Golshani’s approach in every case is the same: understand what the patient’s anatomy actually requires, explain the options and their trade-offs clearly, and execute the plan with the precision that both the medical and aesthetic components of the procedure demand.
Before
After
Why Patients Choose Breast Implant Removal: The Full Spectrum
Breast implant removal is not a single decision driven by a single concern. It is a category of decisions that encompasses medical necessity at one end and personal preference at the other, with a great deal of complexity in between.
Capsular contracture. Every breast implant is surrounded by a fibrous capsule of scar tissue that the body forms naturally as a response to the presence of a foreign device. In most patients, this capsule is thin, soft, and entirely asymptomatic. In some patients, the capsule thickens and contracts, squeezing the implant into an abnormal shape and producing the firmness, distortion, and sometimes significant pain of capsular contracture. Capsular contracture is graded on the Baker scale from Grade I, where the breast feels soft and appears normal, through Grade IV, where the breast is hard, painful, and significantly distorted. Grades III and IV typically require surgical correction.
Implant rupture. Saline implants that rupture deflate visibly and immediately as the saline is absorbed harmlessly by the body. The affected breast becomes noticeably smaller, making the rupture immediately apparent. Silicone implant rupture is a different scenario: modern cohesive gel implants are designed to hold their shape even when the shell is compromised, meaning the rupture can be clinically silent and detectable only on MRI. When silicone gel does migrate beyond the capsule into the surrounding tissue, the biological response requires both implant removal and removal of the affected tissue.
Breast implant illness. Breast implant illness is a term used to describe a range of systemic symptoms that some patients with breast implants attribute to their devices. Reported symptoms include chronic fatigue, cognitive difficulties sometimes described as brain fog, joint and muscle pain, hair loss, skin rashes, and a range of autoimmune-like presentations. The relationship between breast implants and these symptoms is the subject of ongoing research, and the medical community has not reached full consensus on the mechanisms involved. What is clear is that a meaningful number of patients report significant improvement in their symptoms following explantation, and this experience is taken seriously as a clinical reality in the consultation. Dr. Golshani approaches these patients with respect for their experience and provides a thorough surgical plan for safe, complete removal.
BIA-ALCL. Breast Implant-Associated Anaplastic Large Cell Lymphoma is a rare form of lymphoma that develops in the fluid or scar tissue surrounding breast implants, most commonly textured implants. It is not a breast cancer but a cancer of the immune system cells within the peri-implant tissue. When detected, BIA-ALCL is in most cases treated successfully by complete removal of the implant and the surrounding capsule, without the need for chemotherapy or radiation. This is one of the clearest medical indications for en bloc capsulectomy.
Implant malposition. An implant that has shifted from its intended position, whether superiorly, inferiorly, or laterally, produces a visually asymmetric result that may worsen over time. Malposition correction requires removal of the original implant, correction of the implant pocket, and replacement with a correctly sized and positioned device.
Personal preference and lifestyle change. Some patients simply no longer want breast implants. Their aesthetic priorities have changed. Their body has changed. Their relationship with their own appearance has shifted in the years since the original augmentation, and the implants that once felt right no longer do. This is a completely valid reason for removal, and it does not require a medical diagnosis to justify.
The Four Approaches to Breast Implant Removal
Dr. Golshani determines the correct approach for each patient based on the reason for removal, the condition of the existing capsule and surrounding tissue, whether the implants will be replaced, and the patient’s aesthetic goals following the procedure.
Simple explantation. The implants are removed and not replaced. The capsule is left in place. This approach is appropriate for elective removal in patients whose capsule is thin, soft, and asymptomatic, and who are not experiencing symptoms attributable to the capsule. It is the least extensive approach and carries the quickest recovery.
Partial capsulectomy. Portions of the capsule are removed where they are thickened, calcified, or clinically relevant, while thinner, healthier portions are left in place. This approach is appropriate for patients with localized capsular thickening or mild to moderate contracture where complete capsule removal is not required.
Total capsulectomy. The entire capsule is removed from around the implant. This approach is appropriate for patients with significant capsular contracture, patients with ruptured silicone implants where gel has been contained within the capsule, and patients who want the most complete removal of all foreign material and reactive scar tissue.
En bloc capsulectomy. The implant and the surrounding capsule are removed together as a single, intact unit without opening the capsule during the procedure. This is the most technically demanding approach and is specifically indicated when the capsule contains ruptured silicone gel that could contaminate the surrounding tissue if the capsule were breached, when BIA-ALCL is present or suspected, and for patients with severe capsular contracture where complete intact removal is the safest and most complete option. En bloc capsulectomy requires precise surgical planning and experience in the approach, as the capsule must be dissected away from the chest wall and surrounding structures without disruption.
What Happens to the Breast After Implant Removal
This is the question most patients ask most anxiously in the consultation, and it deserves a direct and honest answer.
The breast that was augmented and then has its implants removed does not return to exactly what it was before the augmentation. The skin and breast tissue have stretched and accommodated the implant volume for months or years. When the implant is removed, there is a gap in the breast where the implant was, and the breast tissue must shift to fill it. This process takes several months and produces different results depending on the patient’s skin quality and elasticity, the size of the implant that was removed, the duration it was in place, and how the breast tissue has changed in the intervening years through pregnancy, breastfeeding, or weight fluctuation.
In patients with good skin elasticity and modest implants, the breast often recovers a natural, proportionate shape over several months without additional surgery. In patients with significant skin laxity, larger implants, or longer implant duration, the breast may appear deflated, ptotic, or hollow after removal without additional reshaping.
This is why implant removal is frequently combined with a breast lift or the Multiplanar Mastopexy, which reshapes and elevates the breast tissue that remains after the implant has been taken out, and with autologous fat grafting using the G-Stem technique to restore modest volume and improve the softness and contour of the breast without returning to an implant.
Dr. Golshani discusses the realistic post-removal appearance for each patient’s specific anatomy honestly during consultation, including whether and what additional procedures are indicated to achieve the result the patient is hoping for.
Breast Implant Removal and Insurance Coverage: What Qualifies
Breast implant removal is one of the most significant areas where insurance coverage can meaningfully apply to a procedure that might otherwise be perceived as cosmetic, and understanding the qualifying criteria is one of the most practically important parts of the consultation for many patients.
The distinction insurers draw is between elective removal for personal preference and removal that is medically necessary due to a documentable implant-related complication or health condition. The following presentations commonly qualify for full or partial insurance coverage:
Implant rupture. A documented ruptured or deflated implant, supported by clinical examination, imaging, or manufacturer documentation, is one of the most straightforward qualifying conditions for insurance coverage of removal.
Capsular contracture grades III and IV. Clinically documented significant capsular contracture producing pain, breast distortion, and functional limitation is a medically recognized complication that frequently qualifies for coverage. Documentation should include clinical photographs, a grading assessment, and a record of any conservative treatments attempted.
BIA-ALCL. Confirmed or clinically suspected BIA-ALCL is a medical diagnosis that qualifies for insurance coverage of implant removal and en bloc capsulectomy. In these cases, coverage is typically more straightforward to obtain than in other presentations.
Implant-related infection. A documented infection of the breast pocket or implant surface that has not resolved with antibiotic treatment and requires surgical management qualifies for coverage of the removal as a medically necessary procedure.
Implant malposition with documented functional symptoms. Significant implant malposition causing pain, functional limitation, or skin compromise, supported by clinical documentation, may qualify for partial coverage of the revision and correction components of the procedure.
Breast implant illness with documented systemic symptoms. Coverage for explantation on the basis of breast implant illness varies significantly by insurer and is an evolving area of insurance policy. Some insurers now recognize a documented clinical presentation of systemic symptoms attributed to breast implants as qualifying for coverage of removal. Dr. Golshani’s team supports patients in compiling the documentation required to make the strongest possible case for authorization.
Reconstruction-related removal. Patients who originally received implants as part of breast reconstruction following mastectomy and who require removal due to implant-related complications are typically covered for the removal under their reconstructive surgery coverage.
What to expect from the insurance process: Dr. Golshani’s practice assists qualifying patients through the pre-authorization process, including the preparation of clinical documentation, letters of medical necessity, coordination with relevant specialists, and support through the appeals process when initial authorization is denied. Coverage varies significantly between policies even within the same insurer, and patients are advised to confirm their specific policy’s criteria, exclusions, deductibles, and out-of-pocket requirements before proceeding.
Implant Removal With Replacement: Breast Revision
Not every patient presenting for implant removal wants to be without implants entirely. Many patients want to exchange what they have for a different size, a different type, or a corrected position. This is addressed through breast revision surgery, which can include any combination of implant exchange, pocket correction, capsule management, and additional reshaping procedures, planned specifically for each patient’s existing anatomy and new goals.
When Breast Implant Removal Is Part of a Larger Plan
Implant removal most commonly leads naturally to a discussion of the breast that remains and what can be done with it:
- Breast Lift and Multiplanar Mastopexy to reshape, lift, and support the breast tissue after the implant has been removed, addressing the ptosis and skin laxity that frequently develops over the implant during its time in place
- Fat Transfer to Breast with G-Stem to restore modest volume, improve breast softness and contour, and address upper pole or medial hollowing without returning to an implant
- Breast Revision for patients who want to replace rather than remove their implants, addressing the implant type, size, pocket position, and any capsule management required
- Breast Reconstruction for patients whose original augmentation was part of a reconstructive plan and whose removal creates a need for further reconstructive options
Why Beverly Hills Patients Choose Dr. Golshani for Breast Implant Removal and Capsulectomy
The patients who come to Dr. Golshani for implant removal arrive with a range of concerns, but they share a common need: a surgeon who will listen to their specific situation, evaluate their anatomy precisely, and give them an honest plan rather than a generic one.
Dr. Daniel Golshani, MD, FACS is a double-board-certified plastic and reconstructive surgeon with extensive experience in the full spectrum of breast implant removal procedures, from simple elective explantation through the most technically demanding en bloc capsulectomy. His practice works directly with insurance providers to support the documentation and authorization process for patients whose removal qualifies for coverage, and his approach to every removal case reflects the same surgical precision and patient-centered planning that defines every other procedure at this practice.
His practice at 9301 Wilshire Blvd., Suite 410 in Beverly Hills serves patients from Beverly Hills, Bel Air, Brentwood, West Hollywood, Pacific Palisades, Santa Monica, and internationally.
Your Breast Implant Removal Journey: Step-by-Step
Step 1 — The Consultation
Your consultation begins with a detailed conversation about your reason for removal, the history of your implants, any symptoms you have been experiencing, your goals for the breast following removal, and whether you want to replace the implants or proceed without them. Dr. Golshani performs a thorough physical examination and reviews any imaging. He determines which removal approach is indicated, whether capsulectomy is necessary and to what extent, and what additional procedures are appropriate to achieve the result you are looking for. If your presentation may qualify for insurance coverage, that conversation begins here as well. A patient coordinator attends every consultation, recording everything discussed so that nothing is lost between your visit and your surgery date.
Step 2 — Insurance Pre-Authorization
For patients whose removal may qualify for coverage, Dr. Golshani’s team begins the documentation process: preparing the clinical letter of medical necessity, compiling supporting medical records and imaging, coordinating with relevant specialists, and submitting the pre-authorization request. This process typically takes several weeks and may require appeal. Dr. Golshani’s team supports you through every stage.
Step 3— Preparation
Stopping smoking for at least six weeks before and after surgery, discontinuing blood-thinning medications and supplements, and arranging your recovery environment at home. His team ensures you have everything you need before you arrive.
Step 4 — The Procedure
Breast implant removal is performed under general anesthesia on an outpatient basis at the Rexford Surgical Institute, an accredited surgical center on the same floor as Dr. Golshani’s Beverly Hills office. Incisions are typically made along the original incision lines to minimize additional scarring. The approach, simple removal, partial or total capsulectomy, or en bloc removal, follows the plan established during consultation. If a breast lift or fat grafting is being performed simultaneously, these are integrated into the same surgical session. Procedure time ranges from one to three hours depending on scope.
Step 5 — Recovery
Plan to rest at home for the first several days. A compression bra is worn to support healing and minimize swelling. Most patients experience less discomfort than they anticipated, particularly when the implants being removed were causing capsular contracture pain that resolves immediately with their removal. Most patients are socially presentable within ten to fourteen days. Light activity resumes at approximately two weeks. Strenuous exercise is restricted for four to six weeks. The breast settles and recontours progressively over the first three to six months.
FAQs about Breast Implant Removal
What is breast implant removal and capsulectomy in Beverly Hills?
Breast implant removal is surgery to take out breast implants, with or without replacement. Capsulectomy is the removal of the fibrous scar tissue capsule that forms around an implant. Dr. Daniel Golshani performs the full range of removal approaches in Beverly Hills, from simple elective explantation through en bloc capsulectomy for implant rupture, capsular contracture, BIA-ALCL, and breast implant illness, with comprehensive options for natural breast restoration following removal.
What is en bloc capsulectomy?
En bloc capsulectomy is the removal of the implant and its surrounding capsule as a single, intact unit without opening or breaching the capsule during the procedure. It is the most complete form of capsule removal and is specifically indicated when the capsule contains ruptured silicone gel, when BIA-ALCL is present or suspected, or when the most thorough removal of all implant-associated tissue is the clinical priority.
What is capsular contracture and when does it require surgery?
Capsular contracture occurs when the scar tissue capsule that naturally forms around a breast implant tightens and hardens, causing firmness, breast distortion, and sometimes significant pain. It is graded on the Baker scale from Grade I through Grade IV. Grades III and IV, characterized by visible distortion and pain, typically require surgical correction through implant removal and capsulectomy.
Is breast implant removal covered by insurance?
Breast implant removal may be covered by health insurance when the removal is medically necessary due to a documentable complication or health condition. Qualifying presentations include implant rupture, capsular contracture grades III and IV causing pain and functional limitation, BIA-ALCL, implant-related infection, significant malposition with documented symptoms, breast implant illness with documented systemic symptoms, and reconstruction-related complications. Dr. Golshani’s team assists qualifying patients through the pre-authorization and appeals process.
What will my breasts look like after implant removal?
The result depends on your skin elasticity, the size of the implant removed, how long the implant was in place, and how your breast tissue has changed over time. In patients with good elasticity and smaller implants, the breast often recovers a natural shape without additional surgery over several months. In patients with significant skin laxity or larger implants, additional procedures including a breast lift or fat grafting are frequently needed to achieve a satisfying result. Dr. Golshani discusses the realistic post-removal appearance for your specific anatomy honestly during consultation.
Do I need to replace my implants after removal?
No. Implant removal without replacement, called explantation, is a complete and appropriate surgical outcome for patients who no longer want implants. Many patients combine explantation with a breast lift or fat grafting to reshape and restore the breast without returning to a device.
Do breast implants need to be replaced after ten years?
Not automatically. Modern implants do not have a fixed expiration date. If an implant is intact, correctly positioned, and not causing symptoms, there is no automatic requirement to replace it. However, Dr. Golshani recommends evaluation around the ten to fifteen year mark, as the risk of implant failure increases with age. Regular monitoring and, for silicone implants, periodic MRI screening are the best approach to staying informed about implant integrity over time.
What is breast implant illness?
Breast implant illness refers to a range of systemic symptoms including chronic fatigue, joint and muscle pain, cognitive difficulties, hair loss, and autoimmune-like presentations that some patients attribute to their breast implants. The medical community continues to research the mechanisms involved. Many patients report significant symptom improvement following explantation, and Dr. Golshani approaches these patients with respect for their experience and provides a thorough plan for safe, complete removal.
What is the recovery time for breast implant removal?
Most patients rest at home for the first several days and are socially presentable within ten to fourteen days. Light activity resumes at approximately two weeks. Strenuous exercise is restricted for four to six weeks. The breast settles and recontours over three to six months.
How much does breast implant removal cost in Beverly Hills?
For patients whose removal is covered by insurance, out-of-pocket costs are limited to deductibles and co-pays. For elective removals without insurance coverage, cost varies depending on the approach, whether capsulectomy is performed, whether additional procedures are combined, anesthesia, and facility fees. Dr. Golshani’s team provides personalized estimates during consultation.
