Awake breast surgery
Awake Breast Implant Removal (Explant) in Ottawa
Breast implant removal, or explantation, takes out your implants and can include removal of the surrounding capsule. For selected patients it can be performed awake, with local anesthesia and sedation.
Breast Implant Removal (Explant) at a glance
| Typical operating time | About 1 to 3 hours |
|---|---|
| Awake suitability | Often suitable in selected patients |
| Typical return to desk work | Desk work often within about a week |
| Anesthesia | Local anesthesia with or without sedation. General anesthesia arranged if needed |
| Setting | Outpatient, with an anesthesiologist present throughout |
Times are typical ranges for planning, not promises. Your plan is individualized.
What is breast implant removal (explant)?
Implants are removed through an incision, and the capsule, the scar tissue around the implant, may be left, partly removed or removed in one piece, depending on the situation. Many patients combine removal with a lift or with fat transfer to restore shape.
Who may be a good candidate
- People who want implants removed for comfort, change in preference, age of implants, or complications
- Patients with capsular contracture, rupture or other implant problems
- Those who want to restore shape afterward with a lift or fat transfer
- Patients with concerns about implant illness, who understand that the evidence on symptom improvement is still debated
Why awake breast implant removal (explant) may work
Removal does not require creating a new pocket or placing a new device, so it can be a more limited operation than placement, which can make an awake plan feasible. Smaller procedures of this type are well suited to local anesthesia with light sedation, particularly when only the implants are removed. Combining removal with a lift can be done awake in some patients, as published work describes simultaneous mastopexy and volume restoration.
When awake may not be the right choice
More extensive capsule removal, large or very scarred capsules, or a combined lift and fat transfer may be best done with deeper sedation or general anesthesia. We recommend the safest plan for you.
Your awake breast implant removal (explant) journey
1. Before surgery (pre-op)
We review your implant history, imaging, and any symptoms. We discuss capsule options and what your breasts may look like without implants.
- A consultation to review your goals, health history, medications and previous surgeries, and a physical examination
- An anesthesia assessment to decide whether an awake plan is appropriate and safe for you
- Photographs, with your consent, and a written plan, quote and consent form
- Medication guidance, including when to stop blood thinners, certain supplements, and smoking or vaping
- Fasting instructions from the anesthesia team. Follow them exactly
- A ride home and an adult to stay with you after surgery
2. Day of surgery (intra-op)
Local anesthetic is infiltrated, sedation is added as needed, implants are removed with or without capsule management, and a lift or fat transfer is added if planned.
- You arrive, change, and meet the surgeon and anesthesiologist, and your markings and plan are confirmed
- An IV and monitors are placed. The anesthesiologist stays with you from start to finish
- Local anesthetic is given. Expect brief stinging, then numbness, and light sedation if planned
- You can listen to music, talk with the team, and tell us at any time if you feel discomfort
- Afterward you rest in recovery, receive written instructions and go home with your driver
3. Recovery (post-op)
You are observed in recovery, given written instructions and pain-control guidance, and scheduled for follow-up. Call us or seek urgent care for fever, spreading redness, severe or worsening pain, heavy bleeding, chest pain, shortness of breath, or leg pain or swelling.
| When | What is typical |
|---|---|
| Days 1 to 3 | Soreness and tightness. A supportive bra is worn. |
| Week 1 | Many return to desk work in a few days to a week. A drain may be used in some cases. |
| Weeks 2 to 6 | Return to exercise as advised. Swelling settles. |
| 3 to 6 months | Breast shape settles. Skin retraction continues over time. |
Timelines are general and vary. Your surgeon gives you instructions specific to you.
Anesthesia options
Anesthesia options range from local anesthesia, with or without sedation, to general anesthesia. An anesthesiologist is present throughout your procedure and recommends an approach after reviewing your health, the extent of surgery and your preferences. If an awake approach is not suitable, general anesthesia is arranged. Plans can change during surgery if comfort or safety requires it, including deepening sedation or converting to general anesthesia.
Learn more: anesthesia options, levels of anesthesia, fear of intubation, and pain perception and music.
Alternatives
Replacement with new implants, removal with lift, removal with fat transfer, or monitoring.
Risks
Residual skin looseness, asymmetry, change in breast volume and shape, seroma, bleeding, infection, scarring, need for a later lift, and anesthesia-related risks. Reviews describe systemic symptoms attributed to implants as a controversial condition, and the benefits of removal for symptoms are not guaranteed.
Anesthetic risks include reactions to medications, breathing or airway events, the need to deepen sedation or convert to general anesthesia, and, rarely, transfer for further care. All surgery carries risk, and results are not guaranteed.
Frequently asked questions about awake breast implant removal (explant)
Will my breasts look flat after removal?
Appearance depends on your tissue and skin. A lift or fat transfer can improve shape.
Should the capsule be removed?
It depends on the situation. We discuss options such as no capsulectomy, partial, or total removal.
Will removal help symptoms I attribute to my implants?
Some patients report improvement, but the evidence is mixed and we cannot promise it.
Can this be done awake?
In selected patients, particularly when the plan is limited. We confirm at consultation.
Related procedures
- Awake Combined Breast Procedures (Mix and Match)
- Awake Breast Fat Transfer
- Awake Breast Lift (Mastopexy)
Starting from $2,000 for implant removal without capsulectomy, or $8,000 with capsulectomy (CAD, before 13% HST). Your personalized written quote follows consultation. See pricing and financing.
Explore your options at a consultation
References
- Haws M, Lawrence M. Explantation: techniques and outcomes. Clin Plast Surg. 2026;53(2):329-339. PMID 41826053
- Messa CA, et al. Breast explantation with simultaneous mastopexy and volume restoration: an analysis of clinical outcomes and prospective quality of life. Aesthet Surg J. 2023;43(8):840-852. PMID 36911998
- Ferreira S, et al. Breast implant illness: symptoms and outcomes with explantation (systematic review and meta-analysis). Aesthetic Plast Surg. 2025;49(23):6600-6620. PMID 40788544