Robert Whitfield MDAmerica's Breast Implant Illness Expert™

Breast Implant Concerns: Explant Options & Autologous Reconstruction

19 Jun 2025 · 2 min

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1:38

Dr. Robert Whitfield (MD) describes his clinical approach to long-term follow-up of breast implant patients, emphasizing that he often performs explantation with total capsulectomy and reconstruction using deep flaps when patients present with ruptures, recalled textured implants, symptomatic contractures, or systemic complaints. He states a strong preference for autologous reconstruction—primarily autologous fat transfer/fat grafting—for both reconstructive and cosmetic patients (young women with asymmetry or post-pregnancy volume loss) and highlights the importance of listening to patients and offering both diagnosis/treatment and aesthetic refinement after explant.

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When it comes to the long term follow up of my reconstructive breast implant patients, there have been so many instances of patient symptoms related to implant ruptures and textured implants that have been recalled from the marketplace, symptomatic contractures and systemic symptoms from their implants that I frequently explant those patients with total capsulectomies and restore them with usually deep flaps. And this was as recently as yesterday. And in practice, when patients come in seeking augmentation, my preference is autologous tissue, meaning autologous fat transfers, fat grafting. And I see that commonly in young girls that have asymmetry or women who've had pregnancies deflated. They want a breast lift, they need some volume, they don't want an implant. I'd rather not put an implant in either. I show them the results of fat transfer and they're happy. And because of the reconstructive and cosmetic backgrounds, I've seemed to have attracted patients that seek explants and they want doctors that are willing to listen to their symptoms and their concerns and not have them minimized. And being able to offer them diagnosis and treatment and aesthetic refinement of their breast after the explant has really solved problems for many women.