Breast surgery · London
Breast implant removal, by a specialist explant surgeon.
Simple explant, total and en-bloc capsulectomy, and concurrent mastopexy uplift, done by consultant BAAPS or BAPRAS surgeons with high explant volumes in CQC-registered London units, with sarcoma-centre pathways when BIA-ALCL is suspected.
Why patients choose us
- 01
A specialist breast or plastic surgeon, on the BAAPS or BAPRAS register
Not a general cosmetic list. A named consultant with high explant and capsulectomy volumes, in a CQC-registered unit with overnight cover.
- 02
En-bloc capsulectomy done properly, when it is indicated
For BIA-ALCL and for symptomatic breast implant illness we favour en-bloc capsulectomy where technically feasible, with the capsule and implant removed intact.
- 03
Independent, and free
We are paid by no clinic, so the recommendation on technique and whether to combine with mastopexy is impartial and costs you nothing.
Indicative pricing
What private breast implant removal costs in London.
Indicative ranges across our partner units. Send the history and any imaging and we quote firm figures across two or three options.
In short
Explant with en-bloc capsulectomy in our London network: £8,500–£14,000, plus mastopexy where indicated.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Consultation, imaging review and surgical plan | £250–£450 | 45–60 min | Same visit |
| Simple implant removal, both sides (capsule left in situ) | £5,500–£8,500 | 60–90 min | Day case |
| Total or en-bloc capsulectomy, both sides | £8,500–£14,000 | 2–3 hours | Day case / 1 night |
| Explant with concurrent mastopexy uplift | £12,500–£22,000 | 3–4 hours | 1 night |
| Explant with mastopexy and fat transfer | £14,500–£24,000 | 3.5–4.5 hours | 1 night |
| BIA-ALCL suspected: NHS sarcoma-centre referral | NHS-funded | MDT pathway | 2 weeks |
Prices vary by unit, by which consultant does the case, and by whether a concurrent mastopexy or fat transfer is added. BIA-ALCL is managed on an NHS sarcoma-centre pathway and is not billed privately.
The journey
From first message to histology what happens, in order.
One team from consultation through surgery to the capsule histology and follow-up review.
- 01
Before
You send us the history and any imaging
A short, confidential form. Implant type if known (silicone, saline, textured Allergan Biocell), year placed, symptoms, and any prior mammogram, ultrasound or MRI.
- 02
Before
We come back with a recommendation
Within one working day: whether simple removal, partial capsulectomy or total en-bloc capsulectomy fits, and whether a concurrent mastopexy is worth planning. Indicative price. An honest read either way.
- 03
Before
Imaging and consent
Mammography, ultrasound and often MRI to characterise silicone rupture (intact, intracapsular or extracapsular) and to look for fluid collection. Anticoagulants are reviewed. A frank discussion about realistic cosmetic outcome.
- 04
On the day
Arrival at the unit
Arrival, consent and a chat with your surgeon and anaesthetist. Marking of the inframammary fold and, where planned, the mastopexy pattern.
- 05
On the day
The explant itself
2 to 3 hours under general anaesthetic. IMF or peri-areolar approach, capsulectomy as planned, closed-suction drains, and a concurrent mastopexy if agreed.
- 06
On the day
Day case or one night
Most patients go home the same day or after a single overnight stay. Drains stay in 24 to 48 hours. A surgical bra and written aftercare go home with you.
- 07
After
Histology and review
Capsule histology in 7 to 14 days. Sutures at 10 to 14 days. Compression bra for 4 to 6 weeks. Scars mature over 12 to 18 months.
When it helps
When explant is the right step.
The indications we see most, plus the red flag that changes the whole pathway.
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Implant rupture, silicone or saline
Silicone rupture is graded intact, intracapsular or extracapsular on MRI and each drives a different plan. Saline rupture is usually obvious clinically as the breast deflates over days.
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Capsular contracture, Baker 3 or 4
A firm, distorted or painful breast from a thickened, contracted capsule. Total capsulectomy with implant removal is the reliable answer.
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BIA-ALCL suspected or confirmed
Breast implant associated anaplastic large cell lymphoma, tied to textured Allergan Biocell implants recalled in 2019. Requires en-bloc capsulectomy at a sarcoma centre on an NHS pathway.
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Breast implant illness (BII)
A patient-reported syndrome of fatigue, brain fog, joint pain and rash. No proven biological mechanism, but many patients report real symptom relief after total or en-bloc capsulectomy.
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Patient choice, change of appearance
A wish to return to a natural shape, or to move on from implants that no longer fit your life. A valid reason for explant, with a frank pre-op conversation about cosmetic outcome.
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Ageing patient wanting removal
Older implants, thinning tissues and rippling. Removal, capsule assessment and often a mastopexy sit better than swapping like for like.
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Asymmetry or malposition
Bottoming out, lateral displacement or a double-bubble deformity. Removal, capsulectomy or capsulorrhaphy and revision as a single planned operation.
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Red flag: new seroma years after surgery
A late seroma, especially around textured implants, needs urgent ultrasound with cytology to exclude BIA-ALCL before any planned explant. Do not ignore it.
Technique options
Explant is a family of techniques.
What each option involves, and which fits which indication. Concurrent mastopexy is planned in most cases for the best cosmetic result.
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Simple implant removal
Implant taken out through the IMF or peri-areolar scar, with a healthy capsule left in situ. Shortest operation, lowest risk profile, best for straightforward saline deflation or elective removal.
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Partial capsulectomy
Diseased or thickened capsule tissue removed alongside the implant, healthy areas left. A middle path for mixed capsular findings where full capsulectomy adds risk without benefit.
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Total capsulectomy
The entire capsule is removed, in pieces if needed. Standard for Baker 3 or 4 contracture and for symptomatic BII where the capsule is thick enough to peel cleanly.
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En-bloc capsulectomy
The gold standard for BIA-ALCL and preferred for symptomatic BII. Capsule and implant removed as one intact specimen, preserving oncological principles. The most demanding technique, and thin capsules around textured Allergan implants may not come out intact.
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Concurrent mastopexy uplift
Essential in most post-explant patients. Stretched skin and ptosis after implant removal is unavoidable, so a same-sitting uplift gives the best cosmetic result and avoids a second general anaesthetic.
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Explant with fat transfer
Autologous fat grafted to the upper pole after removal restores a little volume without a new implant. Suits patients who accept a smaller but natural shape.
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Revision for malposition
Capsulorrhaphy stitches to reshape the pocket, or dermal-matrix reinforcement, at the same operation as removal or exchange.
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Second-opinion review
A specialist review of your imaging, symptoms and prior operative notes. Sometimes the answer is watchful waiting, an MDT referral or a different technique to the one you were quoted.
Our vetted London network
A small panel of explant specialists, we picked them.
Consultant BAAPS or BAPRAS surgeons with high explant volumes at Cadogan Clinic, London Bridge Cosmetic Surgery, HCA The Wellington Cosmetic and Reconstructive and King Edward VII's Hospital, with sarcoma-centre pathways for BIA-ALCL. Introductions made privately, once we understand your case.
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Consultant breast or plastic surgeons on the BAAPS or BAPRAS register with high explant volumes
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CQC-registered units with overnight cover and 24/7 surgical contact
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Access to breast MRI, and to sarcoma-centre pathways for suspected BIA-ALCL
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Anaesthetist-delivered general anaesthesia with enhanced-recovery aftercare
Safety and recovery
What to expect afterwards, honestly.
Explant is a well-established operation. The things worth planning are the anaesthetic, drains, the compression bra and realistic cosmetic outcome.
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General anaesthetic, 2 to 3 hours
Longer if a concurrent mastopexy or fat transfer is planned. Fitness for anaesthesia is assessed by the anaesthetist before the day.
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Haematoma and seroma
The commonest early complications. Drains reduce seroma risk. A rapidly expanding, painful breast in the first 24 hours needs to go back to theatre.
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Wound problems and delayed healing
Smoking, diabetes and steroids all raise the risk. Wound breakdown is uncommon but can expose the nipple pedicle when a mastopexy is combined.
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Sensation change
Numbness or altered sensation of the nipple and lower pole is common and usually settles over 6 to 12 months. A minority is permanent.
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Remaining capsule if partial
If a partial capsulectomy is chosen, tissue left behind may thicken again or produce late seroma. Discussed and consented before surgery.
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Contour deformity and skin laxity
Skin stretched by years of implant volume rarely re-drapes tightly. Without a concurrent mastopexy, expect visible ptosis and folds.
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Revision surgery
A minority of patients need a second procedure for asymmetry, scar revision or residual laxity. Quoted honestly at consent.
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DVT and pulmonary embolism
Mechanical calf pumps intra-operatively and early mobilisation reduce the risk. Chemical prophylaxis is used selectively.
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Red flags after discharge
A rapidly swelling breast, severe unilateral pain, calf swelling, breathlessness, fever or wound discharge: call the unit or attend A&E the same day.
Considering explant?
Tell us about your implants. We come back within a working day.
Send the implant type and year, your symptoms and any prior imaging. We match you with the right BAAPS or BAPRAS explant surgeon, quote two or three options and confirm whether a concurrent mastopexy makes sense for you.
Recognised by major UK insurers
Cover for explant varies. Rupture, Baker 3 or 4 contracture and confirmed BIA-ALCL are usually funded when medically indicated. Breast implant illness and elective removal are usually self-pay.
Frequently asked
Everything we get asked about explant.
Quick answers on BII, en-bloc capsulectomy, BIA-ALCL, mastopexy, insurance and cosmetic outcome.
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Will explant surgery fix my breast implant illness (BII) symptoms?
Patient series report symptom relief of fatigue, brain fog, joint pain and rash in roughly 60 to 80 per cent of BII patients after total or en-bloc capsulectomy. There is no proven biological mechanism and no rigorous randomised trial, so results cannot be guaranteed. We will discuss realistic expectations at consultation and only offer surgery when we think it is the right step.
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What is en-bloc capsulectomy, and do I need it?
En-bloc capsulectomy removes the implant and its surrounding capsule as one intact specimen, preserving oncological principles. It is the gold standard for confirmed or suspected BIA-ALCL and is preferred for symptomatic BII where technically feasible. It is a longer, more demanding operation than simple removal, and thin capsules, particularly around textured Allergan Biocell implants, may not come out intact even in expert hands.
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I have Allergan Biocell textured implants recalled in 2019. What should I do?
The Allergan Biocell recall in 2019 followed cases of BIA-ALCL. Current UK guidance is against prophylactic removal in the absence of symptoms, but any new late seroma, breast swelling, lump or skin change needs urgent ultrasound with cytology. Confirmed or suspected BIA-ALCL is managed on an NHS sarcoma-centre pathway with en-bloc capsulectomy, not privately.
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Do I need a mastopexy at the same time as explant?
Most patients do, for the best cosmetic result. Years of implant volume stretch the skin and lower the breast, and simple removal alone leaves significant ptosis and laxity. A concurrent mastopexy adds scars but avoids a second general anaesthetic and gives a much better shape. We will show you the trade-off honestly at consultation.
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Will my insurance cover breast implant removal?
Cover varies by insurer and by indication. Rupture, Baker 3 or 4 capsular contracture and confirmed BIA-ALCL are usually funded when medically indicated. Breast implant illness and cosmetic or elective removal are usually self-pay. We confirm cover with your insurer before booking.
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What will my breasts look like after explant?
Expect a smaller, softer, more ptotic breast than you had with implants. With a concurrent mastopexy the shape is uplifted and firmer, with new scars around the areola and often a vertical or anchor scar to the fold. Scars fade over 12 to 18 months. Realistic photographs of comparable patients are shown at consultation.
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