Q. I had a breast augmentation about 10 years ago. I am older now and having large breasts is not that important to me. I am a long-distance runner and the implants just seem to get in the way when I run. I would like to have them removed, but I have read online that removing without putting another implant back in will cause distortion of the breasts. Is this true, and is it possible to take my implants out?

A. Yes, your implants can be removed and in most instances distortion of the breasts does not occur after removal. If you have saline implants, then removal is typically performed in the office under local anesthesia with some oral anesthesia (Valium), with only minimal downtime. You can expect to return to work the next day, but I ask patients not to jog for at least one to two weeks after explantation. If you have silicone gel implants and it has been less than 10 years since your surgery, and there is no evidence that they have leaked, removal can typically be done in the office as well, under local anesthesia with oral sedation. If your silicone implants are more than 10 years old, I typically perform the surgery under general anesthesia just in case the implants have leaked. Broken silicone gel implants are a bit more challenging to remove so that is why I prefer to do this surgery at the outpatient center, under general anesthesia. Your concern about distortion of the breasts after implant removal is an important point to be aware of. Every patient that I have removed implants from, has been more concerned about potential distortion of the breast than anything else about the surgery. Let me be clear, in most patients, there will not be distortion of the breasts. Of course, you can expect to be smaller and maybe a little saggy, depending on what has happened since having the breast augmentation, i.e. children, nursing, weight gain or loss, etc. Before the implants are removed, I am generally able to give the patient some idea about whether the breasts are at risk of distortion after removal of the implants. My rule of thumb is that as long as there is about one to one and a half inches of natural breast tissue behind the nipple area, distortion usually does not occur with removal. In my practice, I have removed implants in many hundreds of patients over the years and the satisfaction rate in these patients is in the high 90%. Very few patients ever request replacing the implant at a later date due to dissatisfaction with the appearance of the breasts. So, if you want to have your implants removed, then I recommend you see a board certified plastic surgeon who is an experienced breast surgeon.