The Top Five Reasons People Remove Their Breast Implants

Thousands of people are removing the breast implants they once loved. The reasons why might surprise you.

While numbers fluctuate from year to year, the breast implant trend appears to be deflating some.

According to data from the American Society of Plastic Surgeons (ASPS), from the years 2000 to 2020, breast augmentations decreased by 9%. Numbers for "explants" (removing the implants) also fluctuate, but in 2020, over 36,000 individuals had their implants removed, an 8% increase from the previous year.

Why are people having their breast implants removed? Let's look at a few top reasons.

Get in the Way

Excessively large implants can make activities like jogging uncomfortable. And research shows that people with larger breasts might be less likely to work out at all. A 2019 study published in the Journal of Science and Medicine in Sport showed that participants with hypertrophic (excessively large) breasts "participated in significantly less total physical activity per week, particularly less vigorous-intensity physical activity, compared to their counterparts with smaller breasts." Researchers also found that people with large breasts (slightly smaller than hypertrophic) also participated in less vigorous-intensity activity when compared to those with small and medium-sized breasts.

Hence the need for a good sports bra. Case in point: A 2021 study published in the International Journal of Environmental Research and Public Health determined that "suboptimal breast support likely negatively impacts the level of physical activity and exercise in a number of females, particularly those with larger breast size."

Are High Maintenance

No matter what size a person gets for implants, the longer they're inside the body, the higher the chance that one or both will deflate or rupture, according to 2022 research published in the journal Plastic and Reconstructive Surgery. "Implants are not lifetime devices—the longer a woman has them, the more likely it is that she will need additional surgery, which could include replacement or removal," explained Janette Alexander, MD, a plastic surgery medical officer in the FDA's division of surgical devices.

That's not exactly a fact you'll find splashed on the plastic surgery billboards around the country.

Michele Manahan, MD, professor of plastic and reconstructive surgery at Johns Hopkins University, added, "I see a significant number of women who've gone through one or two surgeries and just get tired of having to deal with implants."

Capsular contracture—stiffening of scar tissue that can lead to pain and rock-hard, misshapen breasts—is the most common complication with implants, according to a 2015 literature review published in the journal Archives of Plastic Surgery.

"Placing implants beneath the chest muscle, as most surgeons do today, versus on top—more common in past years—greatly lowers the risk of contracture," said Daniel Mills, MD, former president of the American Society for Aesthetic Plastic Surgery (ASAPS).

That same 2015 literature review also stated that the type of coating the implants have makes a difference. People with polyurethane-coated implants had a 6.3% chance of capsular contracture. In contrast, those who had expanded texture implants experienced capsular contracture at a rate of 21.7%.

Are Pricey

Because implants need to be replaced every so often, there is a cost for maintenance. And while some insurance policies will pay for revision or reduction surgeries for women who develop serious complications, others deem cosmetic breast implants elective and won't cover fixes—or screenings for ruptures. (Of note: Insurance companies and HMOs that cover mastectomies for breast cancer must, by law, also pay for reconstruction.)

Can Cause Neck, Shoulder, and Back Issues

Large augmented breasts can cause neck, shoulder, and back problems—challenges that naturally large-breasted people often have to contend with, too. "The bigger the breast implants are and the more they protrude from the body, the more they change the center of gravity, and the more force they exert on the spine," explained Theodore Shybut, MD, an orthopedic surgeon and assistant professor at Baylor College of Medicine in Houston.

A 2019 study published in the journal Plastic and Reconstructive Surgery supports this idea. In this study, participants who had hypertrophic breasts had significantly higher reported levels of pain in their necks, shoulders, and backs. Study authors suggested exercises to strengthen these areas or reducing the size of the breasts.

Don't Always Look Natural

Changing body ideals play a big part in why people are breaking up with their implants, as well. "Surgeons are seeing a definite shift in the look many women are asking for, away from the very round, prominent 'stripper boob' toward something more in keeping with their natural shape," said Dr. Mills.

People may also be responding to a new cultural norm. Being fit is "in," just as being waifish or having a pear shape once was, noted sociologist Victoria Pitts-Taylor, PhD, chair of the feminist, gender, and sexuality studies program at Wesleyan University in Middletown, Conn.

"Cultural preferences for body shapes move in and out of vogue," said Pitts-Taylor. "Renaissance painters showed women with the plump, round bodies and small breasts that were 'in' then. Pop art and fashion in the 1960s were all about thin, flat-chested Twiggy types." Then came the porn-influenced emphasis on big boobs and a tiny waist in the 1990s and early 2000s, "a tough look to achieve without plastic surgery," noted Pitts-Taylor.

While nobody is ready to declare victory in the body-acceptance battle, there has been a cultural shift toward celebrating a wider diversity of bodies, added Pitts-Taylor, the author of several books, including Surgery Junkies: Wellness and Pathology in Cosmetic Culture. "The idea of what 'beautiful' means has grown," said Pitts-Taylor.

Even more influential than pop culture trends are the forces within individuals themselves to redefine what's attractive—and appropriate—as they age. Nearly every person Health spoke with expressed, in various words, that the overtly sexy, oversized implants they once prized in their younger years no longer felt authentic.

Reversing a boob job can be the right decision for many individuals, but it's not for everyone. Plenty of people appreciate and adore their implants, and lots more continue to get them. It's simply important to educate yourself and understand the upkeep (and not delay mammograms—some people with implants skip their annual mammogram, fearing the mammography machine will squeeze too hard and cause their implants to rupture).

Ultimately, it's all about what makes you content. As Zen Buddhist monk, Thich Nhat Hanh put it, "To be beautiful means to be yourself. You don't need to be accepted by others. You need to accept yourself."

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