Breast implant removal and exchange in Valencia: explant, capsule and what is done afterwards

Removing breast implants is not one operation: it is four different ways out. They can be taken out with nothing put in; taken out with the breast lifted in the same procedure; taken out and filled with your own fat; or exchanged for new ones. Which one applies depends on what lies beneath the implant after years of carrying it, and that is seen by examining.

At the ICPM all four are assessed in the same consultation, with the capsule as part of the decision and not as an afterthought. This page explains what each one involves, what is done with the capsule, how the breast ends up and how the decision is made.

Why women get to this point

The reasons fall into three groups, and it is worth separating them because they lead to different decisions.

Reasons to do with the implant itself. Rupture, capsular contracture, displacement, visible rippling. Here there is a specific mechanical problem and surgery solves it. How they are recognised is on the page about the symptoms of rupture and contracture.

Reasons to do with shape and size. The breast has changed —weight, pregnancies, years— and the implant no longer fits the body of today. In the most recent twenty-year series, with 77 explantations out of 4,909 augmentations, that was precisely the commonest reason: weight gain and the feeling of having breasts that are too large, in 35% of cases, ahead of loss of implant volume, in 31% (Aesthetic Plastic Surgery, 2026).

Reasons to do with perceived health. General symptoms —tiredness, joint pain, brain fog— that the patient relates to the implants. It is the most delicate ground and the one this page treats most cautiously; the page on BIA-ALCL lymphoma and implant illness sets it out in full.

⚠️ Demand has grown a great deal and that does not mean there are more problems. In that same series, explantations rose by 383% between 2016 and 2024. It is a change in expectations, not a safety figure.

The four ways out

This is the part almost nobody explains before the consultation, and it is the one that decides the result.

🔑 The middle two can be combined, and it is a described combination: removal, breast lift and lipofilling in a single procedure. In the published series of 14 patients, all of them went down a cup size and satisfaction with the breast measured with the BREAST-Q questionnaire rose by 19 points (Aesthetic Plastic Surgery, 2022). It is a small series with no control group: it serves to describe the technique, not to promise a result.

How each one ends up and what determines it is set out in full on the page about how the breast looks after implants are removed.

What is done with the capsule

Around every implant the body forms a capsule of tissue. It is not a complication: it is the normal response. What varies between patients is its thickness, its firmness and whether there is fluid inside.

There are four ways of dealing with it, with names that get confused a great deal —and that an international consensus in 2024 pinned down precisely because they were being used as synonyms:

• Intact total capsulectomy: it is removed whole, in a single piece.
• Precise total capsulectomy: it is removed whole, not necessarily in one piece.
• Partial capsulectomy: part of it is removed and the rest left.
• En bloc removal: the capsule is removed with the implant inside it and with a margin of healthy tissue around it.

🚨 The last one has a narrow indication, and this matters because it gets asked for a great deal by name. That same consensus —signed by the Breast Surgery Collaborative Community together with the ASPS and The Aesthetic Society, on 12 June 2024— establishes that en bloc removal is only indicated where there is an implant-associated cancer, confirmed or suspected after the appropriate work-up. Not for general symptoms, not for patients without symptoms and not as a preventive measure. And it adds the reason: it is a long, complex operation, it can leave the breast deformed and it adds complications of its own.

The page on capsulectomy and en bloc explantation sets it out in full.

How the decision is made

It is decided by examining, not from a photograph. What is measured in consultation is what is left underneath: how much of your own gland there is, where the nipple sits relative to the fold, how the skin responds to a pinch and which plane the implant is in.

And there is a prior question that orders everything else: is there a problem with the implant, or is there a change in the body? If there is rupture or contracture, the surgery has a clear medical indication. If the implant is fine and what has changed is the breast or the expectation, the conversation is a different one and there is no hurry.

⚠️ None of these operations is arranged on the day of the first consultation. Spanish Law 41/2002 sets no compulsory minimum interval between signing the consent form and having surgery, but it does establish that the more uncertain the result of an operation, the more necessary prior written consent becomes — which describes this situation exactly.

The tests before surgery

If rupture is suspected, imaging rules. Magnetic resonance imaging has an accuracy of 94% for detecting the rupture of a silicone gel implant, against 72% for ultrasound; the negative predictive value of ultrasound is 85%, which means that a normal ultrasound scan makes it possible, in many cases, not to need the MRI (Plastic and Reconstructive Surgery, 2014).

In addition: preoperative blood tests, a pre-anaesthetic assessment and whichever mammogram or ultrasound is due by age within the screening programme.

🔑 And one that gets forgotten: the implant card. Knowing which implants you carry changes the conversation —and if you do not have it, there are ways of finding out.

Risks

Those of any properly conducted breast operation, and they vary a great deal depending on which of the four ways out is taken:

• Seroma, a collection of fluid in the space the implant leaves. It is the one most closely related to the size of the cavity.
• Haematoma and infection, uncommon but possible in any operation.
• Healing problems, more likely in smokers. 🚨 Smoking is stopped a month before and a month after, which is the clinic’s rule for all its surgery.
• Altered sensation of the nipple and the skin, usually temporary.
• An unwanted aesthetic result. The FDA says it plainly: some women who do not replace their implants may develop dimpling, chest wall concavity, folds or drooping of their own breasts, and the risk of a significant deformity is greater with large implants placed in front of the muscle.
• The need for a second operation, particularly if lipofilling has been done and another session is required.

⚠️ And a risk specific to the capsule: the more completely it is removed, the more raw surface is left and the more likely bleeding and seroma become. It is the medical reason why it is not done beyond what is needed.

The price

Between €5,900 and €7,900, as a guide and subject to assessment, with a written quotation after the consultation. The range is wide because four different operations fit inside it.

What moves the price within that range, and what it includes, is what makes it possible to compare two quotations:

• Which of the four ways out is taken. Removal on its own and removal with a lift and lipofilling are not the same operation or the same time in theatre.
• How the capsule is dealt with. A total capsulectomy lengthens the operation considerably.
• Whether a new implant is placed, the cost of which is separate.
• What it includes: VAT, theatre, the fees of the team and the anaesthetist, the overnight stay if there is one, the post-operative bra, the removal of the stitches and the first year’s check-ups.

The quotation is given in writing after the assessment, and it is what is worth insisting on at any centre. A figure is never settled over the phone or from a photograph.

Where the operation takes place

In hospital, with an anaesthetist and with the possibility of admission. It is a checkable fact and not a claim about the safety of other centres: centres authorised for day surgery are authorised too, and what changes is the resource available if something departs from what was expected.

And a check anyone can make before having surgery anywhere: that whoever is going to operate is a specialist in Plastic, Aesthetic and Reconstructive Surgery, with a registration number that can be looked up in the Medical Council’s search tool. How to do it is on the page about who is allowed to perform aesthetic surgery in Spain.

Frequently asked questions

How much does it cost to have breast implants removed in Valencia?

Between €5,900 and €7,900, as a guide. What places a case at one point or another of that range is which of the four ways out is taken, how the capsule is dealt with and whether a new implant is placed. The quotation is given in writing after the assessment and includes theatre, team, anaesthesia, bra, removal of the stitches and the first year’s check-ups.

Can the implants be taken out and nothing put in?

Yes, and it is one of the four ways out. The result depends on the volume of the implant removed, on the plane it was in and on how much of your own gland is left. The FDA warns that with large subglandular implants the result can be a significant aesthetic deformity; that is why the conversation in consultation starts there and not the other way round.

Will my symptoms improve if I have the implants taken out?

It is the hardest question to answer honestly. The most recent meta-analysis bringing together the studies on explantation in symptomatic patients concludes that most did not achieve complete improvement and that the degree of improvement was moderate (JPRAS Open, 2026). There are series describing large improvements, but they are small, without a control group and with patients who come forward on their own initiative. The prudent course is to rule out other causes of those symptoms first and to decide knowing that the improvement is variable and cannot be guaranteed.

Does the capsule always have to be removed?

No. It is removed when there is a reason —a thick or calcified capsule, a symptomatic contracture, suspected rupture with silicone outside the implant— and as much is removed as is needed. En bloc removal has a much narrower indication: implant-associated cancer, confirmed or suspected.

Should I have them taken out if I have textured implants?

The health authorities do not recommend preventive removal in women without symptoms. In Spain, up to 2025 the AEMPS had received 146 notifications of suspected implant-associated anaplastic large cell lymphoma, of which 111 have been confirmed, in its sixth follow-up report published on 3 June 2026. What is called for if the breast increases in size late on is to seek advice so that it can be investigated.

How long does the breast take to settle afterwards?

Weeks to months. In the first month the breast is swollen and takes up more space than it is going to; from then on the skin retracts gradually and the result is judged at six months or a year, not before. If lipofilling has been done, you also have to wait to find out how much fat has survived.

Is recovery from an explantation easier than from an augmentation?

It usually is when the implants are simply removed: there is no new implant stretching the tissue. It stops being so when a lift is done in the same procedure, because then the recovery is that of a breast lift.

Can I change my mind and have implants again later on?

It can be considered, and it is not a decision that has to be taken on the same day. The sensible thing is to let some months pass to see how the breast ends up on its own, because most patients who have their implants removed do not have them put back.

Sources

• Breast Surgery Collaborative Community. Consensus statement on breast implant capsulectomy definitions and management, released by the American Society of Plastic Surgeons on 12 June 2024. plasticsurgery.org — It defines the four types of capsulectomy and establishes that en bloc removal is only indicated where there is a confirmed or suspected implant-associated cancer, not for systemic symptoms or for asymptomatic patients. Checked on 05-09-2026.
• Cuenca-Pardo J, Ramos-Gallardo GO, Lira-Álvarez M, et al. Breast implant explantation and capsulectomy in symptomatic patients. Is there any improvement with the procedure? Systematic review and meta-analysis. JPRAS Open. 2026;50:152-164. PMID 42099752 — Systematic review and meta-analysis. In the group with symptoms attributed to the implant, most did not achieve complete improvement and the degree was moderate; the authors themselves warn of considerable heterogeneity and ask for caution in interpreting it. Checked on 05-09-2026.
• Follow-up of the protocol for the detection in Spain of anaplastic large cell lymphoma (ALCL) associated with breast implants. Sixth report. Spanish Agency of Medicines and Medical Devices (AEMPS), 3 June 2026. aemps.gob.es — 146 suspected notifications and 111 confirmed cases up to 2025. Checked on 05-09-2026.
• Risks and Complications of Breast Implants. U.S. Food and Drug Administration, updated 14 December 2023. fda.gov — Description of the aesthetic result after removal without replacement and of the greater risk of deformity with large subglandular implants. Checked on 05-09-2026.
• Eisenberg TS, Pilla J, Chapa G. A 20-Year Experience with Round Smooth Saline Breast Implant Explantation: Reasons, Trends, and Management. Aesthetic Plastic Surgery. 2026;50(3):1073-1081. PMID 41023230 — 77 bilateral explantations out of 4,909 augmentations (1.57%), a mean of 12 years to explantation and a mean age of 43. Reasons: weight gain and breasts perceived as too large in 35.06%, and loss of implant volume in 31.17%. A 382.9% increase in explantations between 2016 and 2024. Level of evidence III. Checked on 05-09-2026.
• Mangialardi ML, Ozil C, Lepage C. One-Stage Mastopexy-Lipofilling after Implant Removal in Cosmetic Breast Surgery. Aesthetic Plastic Surgery. 2022;46(4):1542-1550. PMID 35064339 — 14 patients (28 breasts), mean follow-up of 11.3 months, mean volumes of 980 mL of liposuction and 295 mL of grafted fat. A reduction of one cup size in 100% and an improvement of 19 points in the BREAST-Q breast satisfaction domain; one patient (7.69%) needed a second session. Level of evidence IV. Checked on 05-09-2026.
• Rietjens M, Villa G, Toesca A, et al. Appropriate use of magnetic resonance imaging and ultrasound to detect early silicone gel breast implant rupture in postmastectomy reconstruction. Plastic and Reconstructive Surgery. 2014;134(1):13e-20e. PMID 25028829 — Overall accuracy of 94% for MRI and 72% for ultrasound, with a negative predictive value of 85% for ultrasound. Level of evidence II. The study population is one of reconstruction after mastectomy, not of aesthetic augmentation, and this page does not carry over the screening strategy they propose. Checked on 05-09-2026.
• Spanish Law 41/2002, of 14 November, the basic law regulating patient autonomy and rights and obligations regarding clinical information and documentation, article 10. BOE-A-2002-22188 — “The more uncertain the result of an operation, the more necessary prior written consent becomes”. Checked on 05-09-2026.

Book your consultation

If you are thinking of having your implants taken out and do not know how your breasts would look, that is exactly what an assessment settles: what lies underneath is examined and from that comes which of the four ways out applies —or whether, for now, none of them does.

Clinical confirmation by the surgeon

Dr Enrique Salmerón González

Specialist in Plastic, Aesthetic and Reconstructive Surgery
Registration no. 46/4624077

Dr Elena García Vilariño

Specialist in Plastic, Aesthetic and Reconstructive Surgery
Registration no. 46/4624503