BII patients must undergo implant removal and total capsulectomy to achieve BII symptom improvement. Total capsulectomy involves removing the entire scar sac formed around the implant by the body(capsule). This requires separating the capsule from the pectoralis muscle and in the case of under the muscle implant(submuscular), from the underlying rib cage. This is a precise dissection requiring finesse and experience. Dr. Chun has safely performed close to five thousand explant surgeries since 1995 without any rib cage complications.
The implant removal surgery reduces the breast size/volume with resulting loose skin. Some patients, such as younger patients with tight skin and smaller implant size are able to shrink enough skin on their own to end up with a reasonable outcome with the removal-only options.
For those unable to do so, performing a simultaneous mastopexy/reconstruction avoids cosmetic deformity and improves the overall shape by removing excess skin, elevating/reducing areola, and internally stacking breast tissues. This involves the "anchor" scar which represents the location of the excess skin removal.