Secondary breast surgery · Dr. Jorge Aso
Breast Implant Removal in Madrid, Spain: breast explant surgery
Choosing to stop having implants is personal. We help you understand how your breasts may look and the options for reshaping them.
Ultrasound assessment · Fat transfer · Breast lift when appropriate
Understand the possible result before deciding
How will my breasts look after implant removal?
The breasts lose the volume supplied by the implants. Their shape depends on the remaining natural breast tissue, skin and how the tissues adapt.
A breast explant procedure removes implants without replacing them. It may be combined with fat transfer, a lift or both, but not every patient needs the same operation.
In some patients, a breast lift is clearly appropriate. In others, the decision is more difficult: there may be little remaining breast tissue, stretched skin or less upper-pole fullness. Neither removal without a lift nor adding a lift guarantees a satisfactory result on its own.
Before surgery, we discuss what you would like to retain, change or avoid: volume, sagging, natural appearance and scars. The plan is agreed with you, not based on a photograph alone.
Your starting point
Assessment begins with your breasts, not a technique
Dr. Jorge Aso personally performs breast ultrasound during the consultation. He assesses the implant, capsule, tissue coverage and any fluid, alongside examination and your medical history.
Bring your implant card, previous operation reports and imaging if you have them. These help us understand the earlier surgery and plan removal. Further tests may be needed depending on the findings.
- Your own tissue
- How much breast tissue remains and how it is distributed.
- Skin and position
- Elasticity, excess skin and areola position.
- Implants and capsule
- Their condition, position, previous surgery and any abnormalities.
- Your priorities
- The volume and degree of sagging you would accept, and the scars you would prefer to avoid.
There is no single answer
Implant removal: with or without a breast lift?
Mastopexy lifts and reshapes the breast. Fat transfer adds volume. These are separate decisions: fat grafting may accompany removal with or without a lift.
Dr. Jorge Aso’s approach
Sometimes, waiting is the better choice
“If very little breast tissue remains, a smaller breast with some sagging may be preferable to a flatter breast with an inverted-T scar. Patients weigh that balance differently.”
When we choose to observe skin contraction, we usually wait 9–12 months before deciding whether a lift is worthwhile. This interval is for considering aesthetic refinement, not for delaying investigation of a complication.
With some anatomies, both removal without a lift and mastopexy may leave an unsatisfactory result. Discussing this limitation before surgery is an essential part of the consultation.
Reshaping with your own tissue
Implant removal with fat transfer
In our practice, we combine fat grafting with the large majority of implant removals. It is not reserved only for small refinements.
The aim is to add volume and improve contour after removal. The amount we can transfer depends on available donor fat, the receiving tissues and the individual goal.
Our technique uses different tissue planes, including the subcutaneous and breast tissues—including the intraglandular plane—and the pectoralis major muscle, depending on the case. Not every patient needs the same distribution.
Fat does not necessarily reproduce an implant’s shape, projection or stable volume. The amount injected is different from the amount that remains; further treatment is considered after observing how it settles.
The implant and capsule are different
Does the capsule also need to be removed?
The body forms a capsule of tissue around an implant. In our practice, we preserve a healthy, thin capsule. Removing an implant does not always require removing the entire capsule.
The plan changes with established capsular contracture, capsule abnormalities or other findings. For repeated contracture or older implants, Dr. Aso often prefers complete capsulectomy when it can be performed safely.
Our approach also changes when systemic signs or symptoms raise concern about a possible association with implants, including cases investigated as suspected ASIA syndrome or breast implant illness. In that setting, we discuss capsule removal after individual assessment.
Suspicion does not establish that the implant caused the symptoms. Some patients improve after removal, but we cannot guarantee that symptoms will resolve or state that capsule removal is necessary for improvement. [1] [2]
What does “en bloc capsulectomy” mean?
Many patients use this phrase for removing the implant and capsule together without opening the capsule. The precise name for that procedure is total intact capsulectomy. The oncological term en bloc is reserved for removal with a margin when implant-associated cancer is suspected or confirmed. Not every implant removal requires this operation. [3]
Planning surgery and recovery
Operating time, anesthesia and recovery
Recovery depends on any procedures performed alongside removal: fat transfer, mastopexy or capsule surgery.
- Without a lift
- 1 hourRemoval with fat transfer
- With a lift
- 2–2.5 hoursRemoval, fat transfer and lift
- Combined procedures
- GeneralAnesthesia in a hospital setting
- Typical stay
- 1 nightSimple removal may be outpatient
Approximate operating times in our practice. Simple removal is assessed separately; “outpatient” means no overnight stay, not necessarily local anesthesia.
- First few days
Discomfort, a supportive bra and reviews
Tightness or discomfort may occur and is managed with prescribed medication. We recommend a postoperative bra suited to the procedure and monitor healing, swelling and the treated areas.
- 7–14 days
A guide to returning to office work
After combined procedures, some patients may resume work without physical exertion in this interval. This does not mean they are ready for a physically demanding job.
- From 4–6 weeks
Gradual return to exercise
Lifting and exercise are reintroduced according to the technique, recovery and your surgeon’s clearance. When a lift is included, high-impact exercise such as running is usually postponed until around the third month.
- Over the following months
The shape continues to change
Swelling subsides, skin adapts and graft volume changes. If a lift is deferred, we usually wait 9–12 months before deciding whether it is worthwhile.
Information for your decision
Risks and limitations to understand
Removal may involve hematoma, seroma, infection, changes in sensation, unfavorable scars, wound-healing problems, asymmetry or further surgery. Anesthetic and thromboembolic risks also need assessment. [4]
Fat transfer adds the possibility of reabsorption, cysts, fat necrosis or calcifications. Tell your radiologist about any fat grafting. A new lump should be assessed, not automatically attributed to the graft. [5]
Who will assess your case
I’m Dr. Jorge Aso
Secondary breast surgery requires understanding both the previous operation and what you want now. My priority is to help you decide what we can improve, which limitations to accept and when it may be better not to add another procedure.
I personally perform ultrasound during the consultation to assess your starting point and explain options for removal, reshaping and follow-up.
- Specialist in Plastic, Aesthetic and Reconstructive Surgery through Spain’s MIR residency pathway.
- Trained at Hospital Universitario 12 de Octubre, Madrid.
- Doctorate in Medicine, cum laude , from Universidad Complutense de Madrid.
- Extensive experience in secondary breast surgery.
Video consultation with Dr. Jorge Aso
Your first assessment, from home
If you live outside Madrid or prefer to avoid an initial trip, a video consultation lets you explain your concerns and discuss initial questions. The initial consultation costs 100 EUR.
A video consultation helps outline options and next steps. A subsequent in-person examination and ultrasound are needed to confirm suitability and the surgical plan.
From home · No travel for the initial consultation
An individual surgical quotation
How much does breast implant removal cost?
At our clinic, the indicative range is 5,000–10,000 EUR, depending on whether fat transfer or a lift is included and on the complexity of the procedure.
The plan and quotation are finalized after assessment. If further fat-transfer sessions or a delayed lift are anticipated, discuss those costs separately before deciding.
Depending on the procedures you need
Your consultation
Discuss implant removal with Dr. Aso
Tell us when you had surgery, what concerns you and whether your priority is to be implant-free. You do not need to decide about a lift or fat transfer before requesting an assessment.
Our team can assist you in English by email and WhatsApp. Initial video and in-person consultations cost 100 EUR. An in-person examination is required to confirm suitability and the surgical plan.
If you are traveling to Madrid, discuss the required stay, postoperative reviews and ongoing care before booking travel. Return-to-work estimates are not clearance to fly.
Frequently asked questions
Before removing your implants
Can I remove my implants without replacing them?
Yes. This is explant surgery without replacement. We first assess the natural breast tissue remaining and the result you would accept. Depending on the case, removal can be combined with fat transfer, a lift or both.
Is a breast lift always needed when implants are removed?
No. We can perform a lift in the same operation when it is clearly appropriate. In patients with little remaining breast tissue and no sagging with implants in place, I sometimes prefer to observe skin contraction and decide about a lift after 9–12 months. This is a shared decision that includes considering scars.
Can fat replace the entire implant volume?
We cannot promise that. The amount transferable varies, and some fat is reabsorbed. In our experience, at least 50% of the injected fat is commonly lost, so we explain that more than one session may be needed.
Will I have more scars after explant surgery?
It depends on the operation. Implant removal and reshaping with a lift require different approaches. If skin needs removing and the breast lifting, scars around the areola, vertically below it or in an inverted-T pattern may be required. We explain the proposed pattern during assessment.
Is the capsule always removed?
No. In our practice, we preserve a healthy, thin capsule. Capsule abnormalities or suspected implant-related systemic symptoms require an individual plan. Removing the capsule does not guarantee that symptoms will resolve.
How long does the operation take, and will I stay overnight?
Removal with fat transfer takes approximately 1 hour without a lift, or 2–2.5 hours with a lift. We perform these combined procedures under general anesthesia with one overnight stay. Simple removal may be an outpatient procedure, depending on the case.
How much does breast implant removal cost?
Our indicative range is 5,000–10,000 EUR, depending on fat transfer, a lift and the procedure’s complexity. A quotation follows assessment; possible later operations should be discussed separately.
What if I am not sure I want to stop having implants?
A consultation can help clarify this. If you want to maintain volume with another implant, replacement may be an option. If your priority is to be implant-free, we assess removal and reshaping with your own tissues.
Medical references
The timings, usual use of fat transfer and surgical criteria described as our own reflect Dr. Aso’s practice. The following sources provide context for risks and the limits of the evidence.
- FDA. Medical Device Reports of Systemic Symptoms in Women with Breast Implants.
- McGuire and colleagues, 2024. Symptom improvement after breast implant removal without capsulectomy: a prospective study.
- BSCC. Consensus on capsulectomy terminology and indications.
- ASPS. Breast implant removal safety and risks.
- ASPS. Fat transfer breast augmentation safety and risks.
About this guide
Based on the current Spanish guide by Dr. Jorge Aso. This information supports, but does not replace, an individual medical consultation.
Selected interviews, mentions and third-party articles. Coverage is in Spanish.
Medical authorship
Specialist in Plastic, Aesthetic and Reconstructive Surgery (Spanish MIR training)
Medical registration no. 2828/61062 · Madrid
About Breast Implant Removal in Madrid: clinical information, safety and expectations. Based on the original Spanish content.
Translation does not constitute a new medical review. This information does not replace an individual medical assessment.
View profile, training and credentialsMedical sources and editorial standards Selected references for this page 5 references
References support the general medical information. Suitability, alternatives, and risks are discussed individually during consultation.
- Medical Device Reports of Systemic Symptoms in Women with Breast Implants U.S. Food and Drug Administration
- Symptom Improvement After Explanation of Breast Implants Without Capsulectomy: A Prospective Study Aesthetic Surgery Journal
- Capsulectomy Terminology and Management Consensus Statement Breast Surgery Collaborative Community
- Breast Implant Removal Safety American Society of Plastic Surgeons
- Fat Transfer Breast Augmentation Safety American Society of Plastic Surgeons