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Breast Explant Surgery, La Jolla and San Diego
Breast implant removal in La Jolla with Tim Sayed MD, a double board-certified plastic surgeon who has made explant surgery the center of his practice for two decades. Implant and capsule come out together, in one careful en bloc operation, with the shape of the breast afterward planned before you ever reach the operating room.
En bloc
Implant and capsule out as one
2
Board certifications
20+
Years in practice
4.6
Google rating
At a glance
What it is
Outpatient surgery that removes your breast implants and, in most cases, the scar-tissue capsule around them, with the option of a lift or fat transfer in the same operation.
Who it suits
Women with capsular contracture, a ruptured or aging implant, symptoms they attribute to their implants, a textured-implant concern, or simply a decision that they are done with implants.
San Diego cost
Explant with en bloc capsulectomy commonly runs about $9,000 to $14,000 all in; adding a lift commonly brings the total to about $14,000 to $19,000. Financing is available.
Time in surgery
Roughly two to three hours for en bloc removal, longer when a lift or fat transfer is added. Home the same day.
Back to normal
Light desk work in about a week, drains out within the first week or two, full exercise around six weeks, final shape settling over three to six months.
Your surgeon
Tim Sayed MD, MBA, FACS, double board-certified, operating from his University City office at 4510 Executive Drive, minutes from La Jolla Village.
Explant is not a reversal of your augmentation. It is its own operation, with its own technique and its own planning. Done well, it removes everything that was placed and leaves a breast that looks natural and settled, with results that vary from patient to patient.
Why women explant
Most patients who come to Dr. Sayed for explant fall into one of five groups: a capsule that has tightened and hardened, an implant that has ruptured or is simply past its useful life, a cluster of symptoms they believe their implants are causing, a textured implant they no longer want to carry, or a change of mind about having implants at all. None of these needs to be justified to anyone. Your reason is enough, and the consultation is where it becomes a plan. You can also explore the full breast implant removal and BII overview for the complete range of explant options.
The capsule your body formed around the implant has thickened and squeezed it, so the breast feels firm, sits high, aches, or looks distorted. Removing the implant and the whole capsule is the most definitive way to treat it.
Implants are not lifetime devices. A silent silicone rupture found on MRI, a deflated saline implant, or an implant that is 15 or 20 years old are all common reasons to remove rather than replace.
Fatigue, joint pain, brain fog, hair loss, rashes, and other symptoms that patients attribute to their implants. Many report feeling better after complete removal, and Dr. Sayed has cared for a large number of these patients.
Certain textured implants, including recalled Allergan Biocell devices, carry a small but real association with BIA-ALCL. Some women choose to remove them and the capsule rather than live with the question.
Children are grown, a body has changed, a lifestyle has shifted, or the implants never felt right. Wanting your natural breasts back is one of the most common and most valid reasons of all.
Large or heavy implants that strain the neck and shoulders, implants that have dropped, drifted outward, or joined in the middle, and rippling that shows through thin tissue.
These symptoms overlap with many other conditions, and having them does not prove your implants are the cause. They are, however, a legitimate reason to sit down with an experienced explant surgeon, review your implant history, and decide together whether removal makes sense for you.
The technique
The single most important question to ask any surgeon you consult about breast implant removal is what happens to the capsule. Dr. Sayed's default is en bloc removal: the capsule is dissected free from your tissue with the implant still sealed inside it, and the two come out as one closed unit. If en bloc cannot be completed safely, he converts to a complete total capsulectomy and still removes every piece of capsule.
| Comparison | En bloc capsulectomy | Total capsulectomy | Partial capsulectomy |
|---|---|---|---|
| What is removed | Implant and entire capsule together, capsule unopened | Entire capsule, but opened and removed around or after the implant | Only part of the capsule; the rest is left on the chest wall |
| Best suited to | Ruptured silicone, breast implant illness concerns, textured implants, capsular contracture | Thin or adherent capsules where en bloc is not safe, most routine removals | Thin, healthy capsules when a new implant is going straight back in |
| Contents stay sealed | Yes. The capsule stays closed, so silicone, fluid, and biofilm are far less likely to contact your tissue | Partly. The capsule is opened, so contents may be exposed | No |
| Capsule to pathology | Yes, as one intact specimen | Yes | Sometimes |
| Dr. Sayed's approach | His default whenever the capsule can be freed safely | His fallback if en bloc would risk the chest wall | Rarely, and only when the capsule is thin and a new implant is planned |
Why does the sealed capsule matter so much? An older silicone implant may have ruptured without you knowing. A capsule may contain biofilm, calcification, or gel fragments. Taking it out closed keeps whatever is inside from spreading into the breast, which matters for your comfort, for a clean pocket if you ever choose implants again, and for the peace of mind that brought many patients to explant in the first place. Dr. Sayed describes the operation in more detail on his en bloc breast implant removal page.
En bloc means the capsule comes out with the implant still inside it. Total capsulectomy means all of the capsule comes out, in one piece or several. Partial means some stays behind. Ask your surgeon which one is planned for you and why, so you know what to expect.
Compare en bloc removal with other techniques in Dr. Sayed's detailed guide
Breast implant illness and BIA-ALCL
Breast implant illness (BII) is the name patients and physicians use for a wide set of symptoms, fatigue, joint pain, cognitive fog, hair loss, rashes, and more, that some women develop after augmentation and attribute to their implants. It is not yet a formal diagnosis with a test that confirms it, and research into the mechanism continues. What is well documented is that many women report meaningful improvement after complete removal of the implants and capsules, and that is why Dr. Sayed takes these symptoms seriously rather than dismissing them.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is different. It is a rare but real cancer of the immune system that develops in the capsule around certain textured implants, and the FDA has issued safety communications and a recall of specific textured devices because of it. The FDA has also described rare cases of squamous cell carcinoma in the capsule. BIA-ALCL most often presents as sudden swelling or a fluid collection years after surgery, and when it is caught early, removing the implant and the entire capsule en bloc is the recommended treatment. The FDA keeps a public summary of BIA-ALCL medical device reports and a plain-language guide to breast implant risks and complications.
For both concerns, Dr. Sayed's protocol is the same: remove the implant and the complete capsule as one sealed unit whenever it is safe, send the capsule and any fluid for pathology, and review the report with you in person. He also moderates a private BII explant support community where patients compare notes before and after surgery, so you are not navigating this alone.
How Dr. Sayed performs explant
Explant surgery with Dr. Sayed is performed under general anesthesia in an accredited surgical facility and takes about two to three hours for en bloc removal, longer when a lift or fat transfer is added. You go home the same day. Every step below is done by Dr. Sayed himself.
01
Dr. Sayed reviews your implant records, any imaging, your symptoms, and your goals for the breast afterward. He examines your tissue and tells you plainly what to expect from removal alone, with a lift, or with fat transfer.
02
Whenever possible he reuses your original inframammary scar. If a lift is planned, the capsule comes out through the lift incisions so no extra scar is added.
03
With the implant still sealed inside, the capsule is freed from the breast tissue, the muscle, and the chest wall. Dr. Sayed stops short of the chest cavity if the capsule is fused to the ribs and converts to a total capsulectomy rather than take an unsafe risk.
04
The intact specimen is photographed for your records and sent to pathology. You receive the report about a week later.
05
If planned, Dr. Sayed repairs the pectoralis muscle where helpful, performs the lift, or grafts fat from the abdomen or flanks into the upper breast to restore softness and shape.
06
Small drains are placed to prevent fluid buildup and usually come out within the first week or two. You leave in a surgical bra with a written recovery plan and Dr. Sayed's direct follow-up schedule.
Explant is surgery under general anesthesia, and it carries the risks any breast operation does: bleeding, infection, a fluid collection (seroma or hematoma), changes in nipple or breast sensation, visible scarring, asymmetry or contour irregularity, and the risks of anesthesia itself. Entering the chest cavity during capsule removal is rare, which is exactly why Dr. Sayed converts to a total capsulectomy rather than force an en bloc dissection off the ribs.
Most of these are uncommon and manageable, and your consultation covers each one in plain language along with how your own health history changes the picture. Results, and the degree to which any symptoms improve, vary from patient to patient.
Explant surgery is usually postponed if you are pregnant or breastfeeding, still in the middle of significant weight loss, using nicotine and not able to stop for several weeks on either side of surgery, or managing an uncontrolled medical condition that raises surgical risk. An active infection or an unexplained breast mass is evaluated first, not operated on.
Women who want to keep implants but fix a problem such as capsular contracture or malposition are often better served by breast augmentation revision. Dr. Sayed will tell you which path fits, even when it is not the one you came in asking about.
Your options after removal
The explant itself is only half the plan. The other half is what the breast looks like once the volume is gone, and that depends on how much of your own tissue you have, how much the implant stretched your skin, and where your nipple sits. Dr. Sayed walks through all three paths at your consultation and shows you results from each.
You do not have to decide this alone, and you do not have to decide it before you walk in. Bring your questions. Dr. Sayed will show you what each path has looked like on women with tissue like yours.
Read Dr. Sayed's guide to breast lift and fat grafting with explant
The simplest path, and the right one more often than women expect. It works when your implants were modest for your frame, your skin still snaps back when pinched, and your nipple sits at or above the fold beneath the breast. Dr. Sayed checks all three at your consultation.
With nothing added you keep your original scar, recovery is the shortest of the three, and the breast settles over three to six months toward its pre-augmentation size.
The trade-off is patience. The first few weeks look deflated, and some women with larger implants decide later that they want a lift. That can be done as a second stage once the tissue has settled, which many patients prefer to committing to a lift up front.
When an implant has stretched the skin envelope or the nipple has dropped below the fold, removing the volume alone leaves loose skin with nowhere to go. A breast lift at the same time removes that excess, raises the nipple, and reshapes your own tissue into a smaller but firmer breast.
Dr. Sayed takes the capsule out through the lift incisions, so no extra scar is added, and he chooses the lightest lift that will do the job: a periareolar lift for modest repositioning, a lollipop or anchor pattern when more skin has to come out.
It adds about an hour of surgery, a slightly longer recovery, and scars that fade over 12 to 18 months. For most women with larger or long-standing implants, it is the difference between a result they tolerate and one they are happy with.
Fat grafting is for women who are done with implants but miss the softness at the top of the breast. Dr. Sayed harvests fat from the abdomen, flanks, or thighs with gentle liposuction, purifies it, and places it in fine layers into the breast tissue, never into the old capsule space.
A portion of the grafted fat takes and stays, usually enough for a modest, natural gain in volume, and the donor area gets a contour improvement in the process.
It cannot replace a large implant one for one, it needs enough donor fat to work with, and it is sometimes staged a few months after the explant so the graft goes into healed, well-perfused tissue. Combined with a lift, it is the closest thing to an implant-free rebuild of the breast.
Nipple position. At or above the fold beneath the breast points to explant alone; below it points to a lift. This single measurement decides more than anything else.
Skin quality. A pinch test and a look at stretch marks tell him how much the envelope will shrink back on its own over six months.
Your own tissue versus the implant. A 200 cc implant on a woman with a full B cup of her own tissue behaves very differently from a 500 cc implant on a small frame.
Capsule and implant condition. A thick, calcified capsule or a ruptured implant can leave contour dips that fat grafting smooths better than a lift alone.
Your priorities. How you feel about scars, a second stage, donor-site liposuction, and the budget all shape the plan. Nothing is decided for you.
Case studies
Dr. Sayed photographs and documents his explant cases so that you can see what removal looks like on real bodies, not illustrations. The galleries below are organized by the plan each patient chose. Every case was performed by Dr. Sayed, and every capsule came out intact or was removed completely.
Case study 01
The largest group in the gallery. Women whose implants had stretched the skin or dropped the nipple, treated with en bloc removal and a mastopexy through the same incisions. Note how the lifted breast reads as natural rather than deflated.
Case study 02
Smaller implants and good elasticity, with nothing added. These cases show the honest answer to the most common question Dr. Sayed hears: what will I look like with just the implants out?
Case study 03
Women who wanted to stay implant-free but keep some softness up top. Fat grafted from the abdomen or flanks fills the upper pole and smooths the contour where the implant used to sit.
Case study 04
A gentler lift for women who need modest nipple repositioning and prefer to keep scarring to the areola border. Capsule removal and lift in one operation.
Results vary from patient to patient, and photographs are shared with consent. Ask at your consultation to see cases that match your implant size, tissue, and goals.
Cost
Breast implant removal with en bloc capsulectomy in San Diego commonly costs about $9,000 to $14,000 all in, covering the surgeon, anesthesia, the accredited facility, pathology, and follow-up. Adding a breast lift commonly brings the total to about $14,000 to $19,000, and fat transfer adds to that depending on how many areas are harvested. Your written quote comes after your consultation, once Dr. Sayed knows exactly what your plan involves.
Capsule work. En bloc or total capsulectomy takes longer and demands more than simply pulling an implant out, which is reflected in surgeon and facility time.
Adding a lift or fat transfer. Each adds operating time and technical work, and each is quoted as part of a single combined fee rather than as a separate surgery.
Implant history. Older ruptured silicone, heavily calcified capsules, and prior revisions take more time to remove cleanly.
Insurance. Removal for a documented rupture, severe contracture, or BIA-ALCL may be partly covered. Removal for breast implant illness or a change of mind generally is not. Dr. Sayed's team can help you request a predetermination.
Financing. Monthly payment plans through third-party medical lenders are available to qualified patients.
When you compare quotes, ask whether the capsule is included, whether it goes to pathology, and whether the lift, if you need one, is in the number. Those three questions tell you what a price actually covers.
See Dr. Sayed's pricing overview | Explore financing options
Recovery
Most explant patients are up and walking the day of surgery, back at a desk in about a week, and cleared for full exercise around six weeks. Drains typically come out in the first week or two. The breast continues to soften and settle for three to six months, and that is when you see your result. Dr. Sayed sends you home with a written plan and sees you himself at every follow-up.
Surgery day
Outpatient, home within a few hours. Expect tightness and soreness managed with prescribed medication. Someone drives you home and stays the first night.
Days 2 to 7
Swelling and bruising peak and start to ease. Short walks several times a day. Drains are usually removed at your first visit. Many patients are at a desk by the end of the week.
Weeks 2 to 3
Daily routines return. Driving once you are off prescription pain medication. Surgical bra continues. No lifting, pushing, or chest exercise.
Weeks 4 to 6
Light cardio resumes, then full activity and upper-body training once Dr. Sayed confirms healing.
Months 3 to 6
Swelling resolves, the breast softens, and any lift or fat transfer settles into its final shape. This is your result.
Sleeping. On your back, upper body raised, for about three to four weeks. Side sleeping once Dr. Sayed clears it.
Drains. Small tubes that keep fluid from collecting where the implant sat. Most patients find them more awkward than uncomfortable, and the team shows you how to empty them before you leave.
Scars. Dr. Sayed reuses your original incision whenever he can. Scars fade over 12 to 18 months, and he will guide you on tape, silicone, and sun protection.
Working out. Walking from day one. Lower-body work at about three weeks, full training including chest and shoulders at about six.
How the breast looks early on. Flat or deflated in the first weeks is normal. Fullness and shape return as swelling fades and tissue relaxes.
Symptom changes. Many patients who explanted for BII describe improvement over weeks to months. Results vary, and Dr. Sayed will not promise what he cannot predict.
Your surgeon
Tim Sayed MD, MBA, FACS is a double board-certified plastic surgeon, certified by both the American Board of Plastic Surgery and the American Board of Surgery, and recertified in both. He trained at UC Berkeley, the UCSF School of Medicine, and Massachusetts General Hospital at Harvard before completing his plastic surgery fellowship at UCSF, and he later earned an executive MBA from Northwestern's Kellogg School of Management.
Over more than 20 years in practice, breast implant removal has become the heart of his work. He performs en bloc capsulectomy as his default technique, sends every capsule to pathology, documents his cases in a public gallery, and moderates a BII explant support community so his patients can learn from one another. He performs every explant himself, from the first incision to the last suture, and he is the one you see at each follow-up.
American Board of Plastic Surgery
Board certified and recertified
American Board of Surgery
Board certified and recertified
UCSF School of Medicine
MD and plastic surgery fellowship
Harvard, Mass General
General surgery training
Kellogg School of Management
Executive MBA, Northwestern
Alpha Omega Alpha
National medical honor society
Aesthetics Done Right is not a slogan. It means doing the full operation, telling you the truth about what to expect, and being there for every visit afterward. This page was medically reviewed by Tim Sayed MD, MBA, FACS. Last updated October 2026.
Serving La Jolla and San Diego
Dr. Sayed's San Diego office sits in University City at 4510 Executive Drive, Suite 210, just off Genesee Avenue near Westfield UTC and a few minutes from La Jolla Village, La Jolla Shores, Torrey Pines, and Bird Rock. Patients also come from Pacific Beach, Del Mar, Carmel Valley, Rancho Santa Fe, Encinitas, Carlsbad, and Coronado, and from across Southern California and out of state for his explant work. Orange County patients can see him at his Newport Beach office.
Explant recovery and coastal living fit together well. Walking is the best early activity, and La Jolla's flat shoreline paths and year-round mild weather make it easy to do daily. The one caution is sun: fresh scars darken with UV exposure, so plan on a rash guard or high-coverage swimsuit and mineral sunscreen at the beach for the first year. Swimming in the ocean or a pool waits until incisions are fully sealed, usually about four weeks.
Tim Sayed MD, San Diego office
Address
4510 Executive Drive, Suite 210, San Diego, CA 92121
Phone
(858) 247-2933
Nearby
University City, UTC, La Jolla Village, La Jolla Shores, Torrey Pines, Bird Rock, Pacific Beach
Also serving
Del Mar, Carmel Valley, Rancho Santa Fe, Encinitas, Carlsbad, Coronado, and Newport Beach
Drive times to the office
La Jolla Village
5 min
University City / UTC
4 min
Del Mar
12 min
Carmel Valley
13 min
Carlsbad
35 min
Encinitas
25 min
Bring your implant records, your questions, and whatever is on your mind. Dr. Sayed will examine you, explain en bloc removal, show you results from women with tissue like yours, and give you a written plan and quote, with no pressure to decide on the spot.
Questions
Breast implant removal with en bloc capsulectomy in San Diego commonly costs about $9,000 to $14,000 all in, including the surgeon, anesthesia, facility, and pathology. Adding a breast lift commonly brings the total to about $14,000 to $19,000, and fat transfer adds to that. Insurance may contribute for a documented rupture, severe capsular contracture, or BIA-ALCL. Your exact price comes from a consultation and written quote, and financing is available.
In en bloc removal the capsule is freed from your tissue with the implant still sealed inside, and both come out as one closed unit. In a total capsulectomy the entire capsule is still removed, but it is opened, either to take the implant out first or because it is removed in pieces. En bloc keeps the contents sealed, which matters most for ruptured silicone, textured implants, and breast implant illness concerns. Dr. Sayed attempts en bloc whenever it is safe and converts to total capsulectomy only to protect the chest wall.
Not always. When the back wall of the capsule is thin and fused to the ribs, peeling it off intact can risk entering the chest cavity. In those cases Dr. Sayed removes as much as possible en bloc, then completes a total capsulectomy, cauterizes any fragment that cannot be safely lifted, and documents everything. He tells you beforehand that this is a possibility and tells you afterward exactly what was done.
Many women do, but not all. If your implants were modest, your skin has good elasticity, and your nipple still sits at or above the breast fold, explant alone often gives a good result. If the skin has stretched or the nipple has dropped, a lift at the same time removes the excess skin and reshapes the breast through the same incisions. Dr. Sayed shows you results from both paths at your consultation.
In the first few weeks they will look flatter and smaller than they will eventually be. Over three to six months the tissue relaxes, swelling resolves, and most women settle near their pre-augmentation size, adjusted for any changes from pregnancy, weight, or age. A lift or fat transfer, when planned, shapes that final result. Dr. Sayed's gallery shows real examples of each option.
The symptoms are real, and so is the pattern of many women reporting improvement after complete removal of implants and capsules. What research has not yet established is the exact mechanism or a test to confirm it, so breast implant illness is not currently a formal diagnosis. Dr. Sayed takes these symptoms seriously, performs en bloc removal for patients who have them, and is honest that he cannot promise which symptoms will improve.
BIA-ALCL is a rare lymphoma that forms in the capsule around certain textured implants, most notably recalled Allergan Biocell devices. The FDA does not recommend removing textured implants in women with no symptoms, but it does recommend evaluation for new swelling, fluid, or a mass. Some women choose removal and en bloc capsulectomy for peace of mind. Dr. Sayed reviews your implant records and helps you weigh that choice.
Most patients return to desk work in about a week, have drains removed within the first week or two, resume light cardio at about four weeks, and are cleared for full exercise around six weeks. Swelling and shape continue to settle for three to six months. Explant with en bloc capsulectomy takes a little longer to recover from than a simple augmentation because more surgery is done inside the breast.
Sometimes. Removal for a documented rupture, severe capsular contracture with pain, or BIA-ALCL may qualify for partial coverage, and some plans cover removal of implants placed for reconstruction. Removal for breast implant illness or a change of mind is usually considered cosmetic and not covered. Dr. Sayed's team can help you request a predetermination from your insurer.
Yes, every time. The capsule and any fluid are sent to a pathologist, who examines the tissue and reports back in about a week. Most reports describe ordinary scar tissue. If anything unexpected is found, Dr. Sayed reviews it with you and arranges whatever follow-up is appropriate.
Yes. Dr. Sayed routinely places small drains to remove fluid from the space where the implant and capsule sat, which helps the tissue heal back together and lowers the risk of a fluid collection. They are usually removed within the first week or two at a follow-up visit.
Fat transfer can restore some softness and upper fullness after explant, but it is not a one-for-one replacement for implant volume. Fat is harvested from the abdomen or flanks, purified, and grafted into the breast, and a portion of it takes and stays over the long term. It suits women who want to stay implant-free and have enough donor fat. Dr. Sayed will tell you plainly what it can and cannot do for your frame.
He is double board-certified in plastic surgery and general surgery, trained at UCSF and Harvard's Massachusetts General Hospital, and has more than 20 years in practice with explant as the center of his work. He performs en bloc capsulectomy as his default, sends every capsule to pathology, publishes his results in a case gallery, and does every operation and follow-up himself. His San Diego office in University City is minutes from La Jolla, and he also sees patients in Newport Beach.
Gather your implant card or operative report, the year and surgeon of your augmentation, any imaging you have had, and a list of your symptoms and goals. Think about whether you want to stay implant-free, and look through Dr. Sayed's gallery so you can point to results you like. The consultation itself is unhurried, and a virtual visit is available if you are traveling from outside San Diego.
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