Breast explant surgery is on the rise. But some women can be discouraged by the cost and cultural pressures

 

 

 

 

 

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A post shared by Katie Corio (@cutekatiebug)

“It was a shocking thing,” she said, on why she thinks there was so much interest in her choice. She thinks her posting sparked curiosity about what her breasts would look like post-removal — but it also prompted a number of women interested in the surgery to ask her questions, including who she saw and which procedure she chose. With explant surgery, there are different options: the more straightforward extraction; the option to remove the capsule, or surrounding scar tissue, if needed; or an additional breast lift, too. For each patient, results and healing time can vary and take several months to fully settle.

Corio hoped to help other women. Before her own removal, she had initially believed it would be straightforward to consult with her original surgeon, but she said she was appalled when he began to argue that she should change her mind about full explant surgery and switch to smaller implants instead.

“It was literally like he was trying to scare me into not removing my implants,” she said in a video posted to Instagram. “It was horrible.” According to Corio, the surgeon, who did not return CNN’s request for comment, showed her extreme pictures of deflated, scarred and uneven breasts, as she recounted on YouTube, and he asked her partner, who accompanied her, if he wanted her to look like that. She recalled her doctor saying: “You’re young and attractive and you should have attractive breasts.”

The right to remove

What happens when women want their implants out is far less discussed than the decision to go bigger. Women can be discouraged by the cost, cultural pressures or pressure within the plastic surgery industry itself.

“A number of patients have come to me and they’ve said: ‘I went back to my original surgeon, and he refused to do the explant.’” said Dr. Nina Naidu, a board-certified plastic surgeon based in New York City, in a phone call. “It’s your body. If you don’t want them anymore, isn’t it your choice to take them out?”

Despite those barriers, breast implant removal has been on the rise in recent years. A global survey by the International Society of Aesthetic Plastic Surgery (ISAPS) found a sharp increase between 2020 and 2024 as surgeons performed nearly two-thirds more procedures. In the U.S., the American Society of Plastic Surgeons (ASPS) data shows steady growth between 2020 and 2023, though numbers leveled off last year, a trend the group links to economic uncertainty. Even so, removals still represent a small share of total cosmetic surgeries — around 2% worldwide—compared with 9.5% for augmentations according to the ISAPS survey. Plastic surgery may often be a game of guesswork when it comes to celebrities, but several stars have gotten candid about the decision to remove their implants — most famously Pamela Anderson, and more recently, Ashley Tisdale, SZA and Chrissy Teigen.

“They’ve been great to me for many years but I’m just over it. I’d like to be able to zip a dress in my size, lay on my belly with pure comfort! No biggie!” Teigen announced on Instagram in 2020. She told Glamour UK that she had gotten her implants as a 20-year-old swimsuit model but her breasts had significantly changed with breastfeeding.

As with Teigen, the decision is often not just a matter of a change in beauty ideals, but can be because of lifestyle or age changes, such as menopause, which can further increase breast size.

 

 

April Ball, a 49-year-old dietician, like Corio, said she felt the pressure to have larger breasts. She also had a partner who encouraged the implant surgery.

“A lot of it was like being immature, not quite stepping into myself yet,” she said of her decision. “And just thinking that I needed to modify myself to be more attractive or to fit in.”

This past March, Ball, who also lives in Southern California, finally had her implants removed after 18 years. She had never gotten used to their size and struggled to find clothes that fit her well — her original surgeon had given her a larger size than she wanted, she explained, telling her post-surgery that most women wished they’d gone bigger. (Ball’s surgeon did not return CNN’s request for comment.) But she tolerated them until she went through a divorce and began changing her life. She went back to school for two master’s degrees, went to therapy, “and just got to know myself better,” she recalled.

Ball said the second surgery was about $10,000 more expensive, since she opted for a breast lift in addition to the explant, and the basic costs of surgery had gone up over time. She told herself: “’You worked really hard. You can afford it now and still take care of the kids and everything — this is something for you.’”

Elusive symptoms

While many patients simply “don’t want them anymore,” said Naidu, the New York City surgeon, a small percentage have health concerns. One of her patients, Karina Karapetyan, a 37-year-old singer-songwriter from Brooklyn, says she had never felt at ease with her implants, which were larger than what she’d initially wanted. She had the surgery in her mid-20s, and like Ball, she’d had a partner who pressured her and a surgeon who she felt didn’t listen to her. But Karapetyan had also begun to experience a host of other unsettling symptoms, including brain fog, chest tightness and depression, that she eventually attributed to her implants. She had always been active — weightlifting, rock climbing, dancing — but soon found herself struggling to do basic cardio. It was hard for her to take a full breath.

 

“It just felt like I could never completely wake up,” she explained over the phone. “It felt like I was slurring my words. I couldn’t connect my thoughts clearly. Critical thinking was very difficult for me.”

Over the past few years, a growing number of studies have examined the links between augmentation and Breast Implant Illness (BII), a cluster of systemic symptoms — including fatigue, brain fog, hair loss, joint pain and gastrological complaints — that are often self-reported by women but have not yet been recognized as a medical diagnosis. Some theories have posited that the silicone casing on implants can cause an inflammatory response, and last year, a comprehensive review of studies suggested a potential link to breast infections related to implants. Many of BII’s symptoms overlap with those of other chronic illnesses, making it difficult to pinpoint.

BII remains divisive within the field of plastic surgery, but the FDA has acknowledged it as a possibility. In 2021, the agency strengthened its safety requirements for the sale and distribution of breast implants and updated its guidance on safety risks, alongside known cancer risks, to include systemic symptoms associated with BII (though it noted that research is still ongoing).

Dr. Anthony Youn, a board-certified plastic surgeon in Troy, Michigan, whose candor around explants and other surgeries has earned him a significant following online, told CNN that he, like Naidu, believes the risk for BII is generally low. But he also believes there’s been a blind spot within the field, in part due to gender bias in medicine, and in part due to a lack of training.

“As surgeons, we’re very good at looking for surgical complications, bleeding, infection, rupture… (but) these types of symptoms that are vague, that could be due to other things… in our training, we’re not that focused on that,” Youn explained. “How much do plastic surgeons know about the causes of brain fog in women? Well, not a lot.”

On Facebook, support groups with tens or hundreds of thousands of members share their own experiences with illness and surgery, turning to each other for information. Shontia Marshall, a 40-year-old quality-assurance engineer from Grayson, Georgia, found one such group in 2018 after experiencing a debilitating, mysterious set of symptoms around nine years following her augmentation including intense nausea, brain fog and rapid weight loss that left her unable to do her job or care for her two young children.

 

 

 

Testing by hospitals and specialists couldn’t pinpoint the problem. “It was so weird, because with all my panels, it showed that I wasn’t sick… and I’m like, how? (They were) seeing between my visits how much weight I was losing. But they were very dismissive,” she said. “I even caught them laughing, like, ‘Okay, this girl is crazy.’”

A gastroenterologist found ulcers in her small intestine and suggested she may have an autoimmune disease. But the next diagnostic step was a spinal tap, she said. By that point, she had found women with symptoms like hers in one of the Facebook groups.

Removing implants can bring relief to patients who are suffering, whether or not a placebo effect could be at play, as Youn noted. The review of studies published last year showed support for significant improvement for patients who removed their implants.

Karapetyan initially treated her symptoms as a psychological condition with antidepressants, under the care of her primary doctor. But following her surgery in 2023, Karapetyan says her symptoms almost instantaneously resolved, and she now believes that they were at least partially caused or exacerbated by BII. Marshall, too, says she had nearly all of her symptoms resolve over the course of a few months following explant surgery. She never received acknowledgment from a medical professional that her symptoms may have been caused by BII, though when she fell ill in 2018, it was far less studied and discussed.

“I went through so much just trying to figure out the underlying issue,” she said.

A sense of mistrust

Across the board, the four women who spoke with CNN described frustrations in making decisions about their bodies — surgeons who they felt didn’t listen to them, or persuaded them against explant surgery, or who had broken their trust during the initial augmentation surgery.

In 2011, Naidu found in a survey of nearly 900 plastic surgeons that male surgeons were more likely to give their patients larger implants than female surgeons, though no cause was studied. Anecdotally, however, she often performs downsizes as well, and is aghast at how many testimonies she has heard of patients being upsold to larger sizes — and one case where she says he discovered a patient’s previous surgeon had outright lied to her about what size implant he gave her.

“It’s outrageous, and it’s such a disservice to our patients,” she said. “It’s not an occasional thing. Very often they come to me and say, ‘I’m not going to go back to my original surgeon because he didn’t listen to me.”

 

This distrust has also led to information-swapping across Facebook, Instagram, TikTok and YouTube, as women share what they wish they’d known before undergoing breast augmentation and aggregate surgeons to see or avoid.

And while Youn credits social media with bringing more attention to some of the issues his patients have faced — he cautions, too, against misinformation. As CNN has seen, the online communities can be insular, circulating anecdotal, non-professional advice, and potentially influencing patients towards more extreme explant surgeries than what they might need, like full capsulectomies, which removes surrounding scar tissue around the implants, too. It is often discussed on social media as the only way to cure BII, despite a lack of scientific evidence that the capsule is a factor at all.

Broadly, however, both Youn and Naidu expressed frustrations within their field over surgeons who dismiss the concerns of their patients.

“For some plastic surgeons, there is a financial incentive to potentially dismiss it because they don’t want it to be real, because that cuts into their profits,” Youn said, noting he’s performing fewer augmentations than he used to, and guides his patients through the possible risks. “I’m not going to gaslight them into trying to make them believe something that’s not true, just so that I can make more money off of it.”

Since recovering from her ordeal, Marshall says she has never sought out a cosmetic procedure again, saying she has done “a lot of meditation, a lot of prayer and just accepting myself and my body for what it is.”

In California, six months since her surgery, Corio is content with her results — she didn’t have the extreme sagging her doctor warned of, and in fact, she says her breasts appear the same as they did before her augmentation. As a fitness professional, she does notice a muscle deformity — called dynamic distortion — when she flexes, due to the augmentation surgery placing the implant under the muscle.

“Sometimes I regret getting them in the first place,” she said. “I’m so much weaker in my chest now, and I hate this weird deformity thing when I flex, but it’s fine, whatever…. but I don’t regret it, in the end, because I know that I’m actually able to help a lot of people through this experience.”

“I definitely don’t regret getting them out,” she added. “Best thing I ever did.”