- Oberhöchstadter Str. 8, 61440 Oberursel
- 06171 591 91
- Am Salzhaus 6, 60311 Frankfurt am Main
- 069 920 380 90
Guide · Implant removal
If you suspect that your breast implants are the cause of your symptoms, removal is a realistic option: In studies, most women with Breast Implant Illness (BII) felt better afterward, regardless of whether the capsule was removed en bloc, partially, or not at all. There is no guarantee, because to this day BII is not a recognized diagnosis and cannot be detected by any test. That is why, before any decision is made, we work out with you what condition your implants are in and whether something else might be causing your symptoms.
Perhaps you’ve already been through quite a bit: tests with no findings, explanations such as stress or menopause, and eventually the suspicion that your implants might be involved. Exhaustion, joint and muscle pain, difficulty concentrating, skin rashes, or heart palpitations are among the symptoms that women describe under the term “Breast Implant Illness” (DGPRÄC, FDA).
Women come to our consultation hours with this suspicion, and we take it seriously. Even though medicine still cannot prove a connection, your symptoms are real, and the question of whether removing your implants could help you deserves an honest answer.
“Many women expect us to turn them away. First, we listen. Then, together, we look at what we know, what we can examine, and what surgery can realistically achieve.”
– Dr. med. Zeynep Potente
This was the case for most women with BII symptoms who took part in studies. In the ASERF study by the US-based Aesthetic Society, six months after removal, 94% of the 50 women with BII symptoms reported feeling at least partially better, and the number of their symptoms had decreased by an average of 68% (Glicksman et al. 2022). One year after surgery, this was still true for 88% (Glicksman et al. 2023). Another study involving 38 women found a 74% reduction in symptoms after six months, even though the capsule remained in the body (McGuire et al. 2024).
What these numbers don’t tell us: The studies are small, and the women knew that their implants were being removed. It’s impossible to determine from this data how much of the improvement is due to the implant and how much is due to relief. Some women also don’t notice any change. That is why we’ll tell you upfront what we expect in your case and won’t promise anything that medicine cannot deliver.
It’s also important for your decision to note that the improvement refers specifically to removal without new implants. There is no evidence that a different model with a different surface or filling prevents these symptoms.
A case from our practice
One patient attributed her fatigue, brain fog, and aching limbs to her silicone implants and had both of them removed, together with the capsules, by Dr. med. Zeynep Potente. The right implant was defective; the left one was intact. Whether her symptoms were related to the defect, the implants, or something else cannot be determined from a single case. Six years after the procedure, she explains why she had her implants removed.
Not for you to feel better. Anyone who has read up on BII will quickly come across “en bloc”, meaning the removal of the implant and capsule in one intact piece, and this is sometimes presented as the only correct approach. The studies do not support this: In the ASERF study, symptoms improved equally after en bloc, complete, and partial capsule removal (Glicksman et al. 2022), and even without capsule removal, the improvement was comparable (McGuire et al. 2024). The Aesthetic Society expressly warns against presenting en bloc as a prerequisite for becoming symptom-free.
Removing the capsule as well may still be advisable or even necessary: in cases of a hardened capsule (capsular contracture), if silicone has leaked following a rupture, and mandatory in the case of a tumor of the capsule. In our practice, we generally remove the implant and the capsule together. We decide which approach is right for you based on your findings and discuss it with you beforehand, including whether a smaller procedure would suffice.
Before we discuss surgery, we want to know two things: the condition of your implants and whether something else could explain your symptoms. This has nothing to do with mistrust. It’s about ensuring that you don’t miss anything that can be specifically treated.
Your implants. Using high-resolution ultrasound in our practice, supplemented by an MRI if necessary, we look for changes that can be clearly identified:
You can find more information about capsular contracture on our page about Implant Replacement.
Other causes. Fatigue, joint pain, and difficulty concentrating can also stem from thyroid problems, iron deficiency, a rheumatic disease, or a long period of excessive strain. Together with your primary care physician or specialists, we check whether your blood count, thyroid levels, inflammatory markers, or rheumatology markers provide an explanation, and we take into account any findings you already have. Tests for heavy metals or silicone in the blood that supposedly detect BII are not validated for this purpose and do not help with the decision.
The decision. In the end, we tell you openly what we see and what, in our view, removal can achieve. You decide, without pressure in either direction.
Your consultation takes place at our private practice in Frankfurt at Goetheplatz (Am Salzhaus 6, private patients only) or in Oberursel (Oberhöchstadter Str. 8, patients with statutory or private insurance). Surgery is performed at our own clinic in Oberursel, where you will be cared for exclusively by our team, and general anesthesia is administered by our specialist in anesthesiology. We operate through your existing scar, usually in the inframammary fold. The procedure takes 2 to 3 hours, after which you’ll stay with us for 2 to 3 nights.
Here’s how you can plan the weeks afterward:
| Timeframe | What happens |
|---|---|
| Days 0–3 | You are at our clinic, wearing a support bra, and keeping your upper body elevated |
| Days 3–7 | Showering is allowed; at home, you can resume light physical activity |
| Days 10–14 | We remove the stitches |
| Starting in week 4 | You can wear a regular bra |
| Starting in week 6 | You can exercise |
| Months 6–12 | The final result is visible |
You can find full details about the procedure on our page on Implant Removal; for anesthesia, see Anesthesia.
Your breasts will be smaller than they were with implants and may look softer or droopier. How noticeable this is depends on how large the implants were, how long you’ve had them, how elastic your skin is, and how much of your own breast tissue remains. If you would not be happy with the result of removal alone, there are two options: a breast lift in the same operation, or more volume later using fat from your own body, as a second procedure once you have healed. We’ll discuss which option suits you during the consultation, based on your findings and your wishes.
| Performance | Price |
|---|---|
| Implant removal with total capsulectomy | Starting at 6,000 € |
| Implant removal with breast lift | starting at 7,000 € |
| Later autologous fat grafting | starting at 5,500 € |
| General anesthesia | 1.000 € |
| Hospital Stay | 500 € per night |
You will receive your binding price after the consultation in the form of a written cost estimate.
Because BII is not a recognized diagnosis, statutory health insurance generally covers removal only if it is medically necessary, such as in cases of capsular contracture, a rupture, or chronic inflammation, and even then it covers only the removal, not the cosmetic reconstruction. In the event of complications arising from a purely cosmetic surgery, your health insurance provider may also require you to contribute to the costs under Section 52 of the German Social Code, Book V (SGB V). The safest approach is to clarify coverage in writing with your health insurance provider or private insurer before the procedure. We will provide you with the necessary medical reports.
Perhaps you’ve found that your concerns were dismissed. This is partly because BII does not have an ICD code, is not recognized as a disease by the WHO, and cannot be detected by any laboratory test (DGPRÄC). Even the U.S. Food and Drug Administration (FDA) states that the symptoms and their causes are still poorly understood. Some doctors refer to ASIA syndrome, a related concept according to which foreign materials such as silicone can irritate the immune system.
Several possible explanations are being discussed: an immune system reaction to silicone, the minute amounts of silicone released even by intact implants, bacteria on the implant surface, and the role of worries and expectations. The ASERF study found no consistent differences in blood and tissue samples from 150 women, neither in heavy metals nor in bacteria or inflammation markers, and considers it possible that expectations play a role (Glicksman et al. 2023). That does not mean the symptoms are imaginary. How strongly we feel physical symptoms always depends in part on how we are doing overall.
Nevertheless, the issue is taken seriously: In 2021, the FDA introduced a boxed warning for breast implants that also mentions such symptoms, and in Germany, breast implant surgeries have been recorded in the implant registry since 2024 so that problems can be detected earlier.
In that case, you won’t need to have your implants removed as a precaution. The DGPRÄC also sees no need for action if you have no symptoms. Regular checkups are advisable: an annual ultrasound of the breasts and implants (DGPRÄC) and, for silicone implants, an ultrasound or MRI five to six years after surgery, followed by imaging every two to three years (FDA). This way, even an implant that has ruptured unnoticed will be detected. Your implant ID card, which lists the manufacturer, model, surface type, and filling material, is helpful for this.
If you notice any changes in your breast, such as new swelling, fluid, a lump, a hard area, or pain, you should have it examined promptly, even many years after surgery.
We are an all-female team of specialists in plastic and aesthetic surgery and have been practicing in Frankfurt and Oberursel since 2015. If you have any questions about breast implants, these two doctors in particular are here to help you:
We offer consultations in German, English, French, Italian, Romanian, or Turkish.
The more we know about your medical history, the better we can assess your situation right from the first appointment. The following information is helpful:
You can find more questions to ask during your appointment in our guide The consultation: What questions should you ask?
During the consultation, we’ll listen to you, examine your implants, and give you an honest assessment of what we see, even if our evaluation is that surgery is unlikely to help you.
Frankfurt 069 920 380 90 · Oberursel 06171 591 91
Breast Implant Illness (BII) is a collective term for systemic symptoms that women with breast implants attribute to their implants, such as fatigue, joint pain, or difficulty concentrating. BII is not a recognized diagnosis, and a causal link to the implant has not been scientifically proven.
Common symptoms include chronic fatigue, joint and muscle pain, problems with concentration and memory (“brain fog”), headaches, skin rashes, heart palpitations, numbness, and depressive mood. None of these symptoms is specific to BII; all may also have other causes.
Your symptoms are real, even though BII is not recognized as a disease. There is no WHO recognition, no ICD-10 code, and no specific laboratory markers. The FDA also describes the symptoms and their causes as poorly understood to date.
No. BII cannot be detected through blood tests or imaging. Tests for heavy metals or silicone in the blood are not validated for BII. During the evaluation, we therefore rule out other causes and examine your implants via ultrasound and, if necessary, via MRI.
This has not been clarified. The FDA lists systemic symptoms as a general potential risk of breast implants, without distinguishing between silicone-filled and saline-filled implants. Whether the filling material or the surface plays a role remains scientifically unclear.
ASIA (Autoimmune/Inflammatory Syndrome Induced by Adjuvants) is a medical concept according to which foreign substances such as silicone can trigger immune reactions. BII is the term used from the patient’s perspective. The clinical presentations overlap significantly; neither has been conclusively proven scientifically.
BIA-ALCL is a very rare, detectable lymphoma in the capsule surrounding the implant, occurring predominantly with textured implants. A typical symptom is late-onset fluid accumulation or swelling of the breast. BII, on the other hand, describes systemic symptoms without any detectable findings.
In studies, the symptoms improved in most women. In the ASERF study, 94% of women with BII symptoms reported at least partial improvement six months after explantation, and 88% after one year. Not everyone becomes symptom-free. That is why we talk honestly with you beforehand about what removal can achieve.
In the ASERF study, the number of symptoms decreased by 55% just three to six weeks after surgery and by 68% after six months. The improvement persisted after one year. It is impossible to predict how things will go for you.
According to current studies, no. Symptoms improved similarly after en bloc, total, and partial capsule removal, as well as after removal without the capsule. Medically, capsule removal is primarily indicated in cases of capsular contracture, silicone leakage, or a tumor of the capsule.
There is no evidence that a different implant prevents these symptoms. The reported improvements refer to removal without a new implant. If you would like to keep some volume, you can discuss later autologous fat grafting.
No. According to the DGPRÄC, there is no need for action if there are no symptoms. Regular checkups are recommended: an annual ultrasound and, for silicone implants, imaging five to six years after surgery, followed by imaging every two to three years.
It is smaller and may look softer or droopier. The result depends on implant size, how long the implants were in place, skin elasticity, and your own breast tissue. Options include a breast lift during the same operation or later autologous fat grafting.
After 2 to 3 nights in the clinic, you may shower starting on day 3. The stitches are removed after 10 to 14 days; you can wear a regular bra starting in week 4 and resume exercise starting in week 6. The final result will be visible after 6 to 12 months.
At Plastische Chirurgie Frankfurt, implant removal with total capsulectomy starts at €6,000, and with a breast lift at €7,000. General anesthesia (€1,000) and the hospital stay (€500 per night) are charged in addition. You will receive a binding price after your consultation.
Generally not, because BII is not a recognized diagnosis. Statutory health insurance usually covers removal only when it is medically necessary, such as in cases of capsular contracture, rupture, or chronic inflammation, and even then only the removal itself. Clarify cost coverage in writing in advance.
Please bring your implant ID card, the operative report from your breast augmentation, any existing findings (ultrasound, MRI, mammogram, lab results), and a symptom diary. This allows us to assess your situation thoroughly at your first appointment.
Consultations take place in Frankfurt am Main (Am Salzhaus 6) or in Oberursel. Surgery is performed at the practice’s own clinic in Oberursel (Oberhöchstadter Str. 8), which has two operating rooms of its own and inpatient care provided by its own team.
Medically reviewed by Dr. med. Zeynep Potente, specialist in plastic and aesthetic surgery · Updated on October 1, 2026
