Breast Implant Removal

Dr. Khouri has a natural, and innovative solution to common breast implant problems.

His breakthrough Fat Transfer procedure is a comfort to patients who had breast implants in the past and are now experiencing problems. It is true that a percentage of patients with implants, experience problems at some point in their lives.

We offer the least invasive method of breast reconstruction & augmentation to remedy implant problems. We will remove the implant completely and replace it with your own fat to create a natural feeling breast, with the benefit of liposuction. At times, we might replace your implant with another implant and then add fat to enhance the appearance.

His large experience with this procedure has shown that he can provide, in one grafting session, about half the volume of the implant as a permanent augmentation with your own fat. The results are soft, natural looking and feeling breasts, smaller than the implanted breasts, but still much larger than your original breasts by about half the size of the implant.

If you still desire larger breasts it is certainly possible to get further augmentation with your own fat with another Fat Transfer session a couple of months later. It is a natural breast enhancement procedure that has resulted in many satisfied patients at the Miami Breast Center.

Reoperation & Removal of Implants

Breast implants require maintenance and there is a high percentage of patients that will likely need a re-operation or removal of the implants due to breast implant complications. Removal of breast implants may result from severe complications where the only choice is removal. A re-operation with placement of another implant in a different pocket will be a temporary fix and the problem very often recurs.

With Dr. Khouri’s BRAVA + AFT (autologous fat ransfer technique), the patient will never have to worry about needing a re-operation or removal again because her new breast(s) will be created from her own fat. No foreign objects will be implanted into her body.

Why Implant Removal with Immediate Fat Transfer Works

Breast augmentation with implants stretches out the breast tissue in front of the implant. (A two-dimensional flattening stretch, not quite as useful as the 3D volume expansion of the BRAVA). Nonetheless, immediately after the implant is removed there is loose breast tissue that Dr. Khouri can fill up with the micro-Fat Transfer technique. The grafts are not placed in the implant cavity because it cannot survive there. Instead, the grafts are diffusely weaved one micro-droplet at a time in the breast tissue to fill it again.

total tissue area = 30cm2

1. Implant Augmented Breast

After longstanding augmentation, the original tissue area has been stretched from the original 10 cm2 to 30 cm2.

total tissue area = 10cm2

2. Removing Implant

After Removal of the implant the breast collapses. The tissue area returns to 10 cm2, but has the potential to be back to 30 cm2. The horizontal fibers (and the skin) that were stretched by the implant are now loose but the tissue is still held at 10cm2 because of the vertical fibers.

total tissue area = 30cm2

3. Immediate Fat Grafting

By releasing the vertical fibers while keeping the horizontal fibers intact we can deliver micro fat grafts to restore the 30 cm2 potential.

The resultant 30 cm2 is a breast that is not much smaller than the implant augmented breast but it is entirely your natural fat and is more nicely shaped. It also releases restricting fibers and micro fat graft.

Patient Example


Thirty-nine-year-old woman who had cosmetic breast augmentation with silicone implants 10 years prior to her presentation. Plastic surgeons insert implants either under the muscle or over the muscle. In her case, she had the right implant over the muscle that developed a deforming and painful capsular contracture and the left implant under the muscle that migrated inferiorly resulting in loss of the normal breast fold.

We removed her implants and restored breast volume with microfat grafts meticulously placed in the tissue plane between the implant capsule and the skin. The capsule was treated with PALF and the breast fold was restored with a RAFT.

She is shown 1-year post-grafting implant free with satisfactory breast shape and volume. Note that even in the skinniest of patients we can always harvest enough fat from the “love handles” and give the patient an improved waistline contour (far right).

See More Photos

Commom Problems That Occur with Breast Implants

  • Asymmetry
  • Breast pain
  • Breast tissue atrophy
  • Calcification deposits
  • Capsular contracture
  • Chest wall deformity
  • Delayed wound healing
  • Extrusion
  • Asymmetry
  • Granuloma
  • Hematoma
  • Iatrogenic injury/damage
  • Infection
  • Inflammation/irritation
  • Malposition/displacement
  • Nipple/breast changes
  • Ptosis
  • Redness/bruising
  • Rupture/deflation
  • Iatrogenic injury/damage
  • Scarring
  • Seroma
  • Unsatisfactory style/size
  • Wrinkling/rippling

The most common problems that can occur with both silicone gel-filled and saline-filled breast implants are Capsule Contracture which are sometimes painful and Rupture/Deflation which can lead to silicone granulomas. Both of these will lead the patient to another major surgery for either a re-operation and/or a removal of her implants.

Capsule Contracture

Capsule contracture, the most common complication of breast implant augmentation surgery, can happen at any time. It occurs when the scar tissue or capsule that normally forms around the implant tightens and squeezes the implant. It can happen to one or both of the implants.

The body naturally shrinks scar tissue somewhat. In some cases, the capsule will tighten, and squeeze the implant. This makes the breast implant feel hard, and distorts the appearance of the breast. Causes of capsular contracture are implants placed above the muscle, infections, seroma, hematoma, and smoking. There are four grades of capsular contracture known as Baker grades. The Baker grading is as follows:

  • Grade I breast is normally soft and looks natural
  • Grade II breast is a little firm but looks normal
  • Grade III breast is firm and looks abnormal
  • Grade IV breast is hard, painful, and looks abnormal


Breast implant manufacturers acknowledge and warn that breast implants are not lifetime products, they have a “shelf life”. Some implants may rupture or deflate within a few months or take several years. This is why Dr. Khouri’s natural fat-transfer technique is such a breakthrough for women. Ruptured saline implants will usually deflate quickly.

Silicone gel leak or rupture can sometimes go unnoticed, even for a period of years. Symptoms may include: decreased breast size, uneven size of breasts, pain or tenderness, tingling, swelling, numbness, burning, changes in sensation or lumps. The longer an implant has been placed the higher the risk. Some of the causes are:

  • Normal aging of the implant
  • Too much handling during surgery
  • Compression during a mammogram
  • Capsular contracture
  • Overfilling or underfilling of saline-filled implants
  • Placement through a belly button
  • Damage by surgical instruments
  • Damage during procedures to the breast
  • Stresses like trauma or intense physical pressure

These ruptured implants should be removed as soon as possible, especially if it is a silicone gel implant. Silicone gel can leak from the implant into healthy breast tissue and go to other parts of your body, such as the lungs and lymph nodes, where it could be impossible to remove.

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Miami Breast Center | 580 Crandon Blvd, Suite 102, Key Biscayne, FL 33149

EVEBRA: Non-Surgical Natural Breast Enlargement

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