Dr. Pierce has been board certified by the American Board of Plastic Surgery since 1999. (You can check any plastic surgeon’s board certification status at abplasticsurgery.org.)

Dr. Pierce is on staff at Honor Health Shea and Honor Health Osborn.

We use only board-certified anesthesiologists. Most cases are done under general anesthesia. Each anesthesiologist has their own technique so it is not possible to specify which drugs are used in each case. All our cases are covered by Valley Anesthesia. Dr. Pierce have been working with most of our anesthesiologists for many years. 

Most of our surgeries are performed at Scottsdale McCormick Ranch Surgicenter, which is licensed by the state of Arizona and accredited by the Accreditation Association for Ambulatory Health Care (AAAHC) and Medicare.

Dr. Pierce has had an active license in Arizona since 2001. You can check his license status by going to bomex.org and performing a Doctor Search.

We try to perform an en bloc capsulectomy — when the implant and capsule are both removed as a unit without any holes in the capsule — whenever possible.

If the capsule is thin or adherent to the ribs or muscles, it is often not possible to do an en bloc capsulectomy. In this case, the implant is removed and the capsule is then carefully dissected away from the surrounding structures under direct vision and completely removed. This is called a total precise capsulectomy. The outcome, removal of the implant and entire capsule, is the same. No plastic surgeon can guarantee an en bloc capsulectomy in every case and we believe that a precise total capsulectomy is often safer, removes less normal tissue, and, in most cases, requires a shorter incision. 

The only time we would not remove the entire capsule is if it would be a danger to your life.

We will repair or reposition the pectoralis major muscle if needed. Not all patients need muscle repair.

Surgery time is an estimate and may take more or less time. The average time for implant removal and capsulectomy is 2 hours. If a lift is done at the same time, the average time is 4 hours. If the surgery takes longer than anticipated, there is no additional surgeon fee but there might be additional operating room or anesthesia fees.

We have done thousands of explants — it is our most common surgical procedure.

Yes! Dr. Pierce does not use an assistant and has no residents or students working in the practice.

We typically use your previous scar if you have an inframammary (under breast) scar, but it will need to be longer to perform your capsulectomy. 

If you have an incision around your areola or armpit, we cannot use those incisions and will need to make a new scar on the lower portion of your breast. This area typically heals very nicely, but every patient scars differently.

We only use an intravenous dose of antibiotics right before surgery. You will not need antibiotics after surgery. We do not use antifungal medications unless specifically indicated.

No.

While many of our patients can take acetaminophen or ibuprofen for pain, we will prescribe a small amount of pain medication such as Percocet or Vicodin (unless you have problems with either of these medications). 

We encourage our patients to avoid taking opioid medications unless needed.

We will prescribe Zofran that you can take for any nausea that you might have after surgery. It dissolves under your tongue.

Yes, we use drains in all explant/capsulectomy cases, and they are typically in place for 1 week. We determine when your drain is ready for removal based on the amount of drainage.

We will wrap you in an Ace wrap after surgery. You can take the wrap off after 2 days, shower, and put on the surgical bra we provide. 

If you have a lift, we will take off your wrap the day after surgery and replace your dressing and put on your surgical bra.

We do not use any tape or glue. All your sutures will dissolve except the suture holding your drain in.

We can return your implants unless you have a ruptured gel implant. 

We are happy to send your capsules to pathology for an additional fee. 

Many patients leave it up to Dr. Pierce’s discretion (if the capsule looks abnormal or you have a textured implant, your capsules will go to pathology). Pathology only checks for malignancy

We do not routinely test for bacteria, biofilm, mold, or heavy metals unless specifically indicated.

We routinely take photos of your implants and capsules after surgery and we will send these photos to you. We do not video your surgery routinely or take photos inside your chest wall. 

BIA-ALCL is a rare lymphoma associated with textured implants. All capsules associated with textured implants, or history of previous textured implants, are sent to pathology.
 
The pathologist will determine if any additional studies are indicated.

No.

Every attempt will be made to remove as much of the silicone as possible. We also use a solution called Phase 1 to irrigate the pocket after your implant and capsule are removed. We will perform an en bloc capsulectomy if possible in cases of ruptured silicone implants.

Infection after explant surgery is very uncommon, but the signs to look for are redness, swelling, and fever. 

Please contact us if you have any questions after surgery.

We are always available for any problems after surgery. You can text Christina or call the office and be connected directly to Dr. Pierce’s cell phone for emergencies. 

Please reserve routine questions for regular office hours. If we are going to be out of town, there will be another plastic surgeon covering our practice. 

That will depend on whether you have a lift at the same time as your implant removal and capsulectomy. If you only have an explant and capsulectomy, your follow-up will take place after 1 week (to remove your drain), 6 weeks, and 6 months. 

If a lift is performed, we also see you one day after surgery. Of course, we are available to see you any time between visits. 

We do not accept insurance for explant surgery, and we are not contracted with most insurance companies. 

You will not be able to submit a claim to your insurance company after surgery.

If you only have implants removed with a capsulectomy, we have little control over what your breasts will look like after surgery. This will depend on how much breast tissue you already have, how large your implants are, your age and genetics. It will take 6 months or even up to one year to see your final result. 

If you are a candidate, a lift (mastopexy) or fat transfer may be an option to improve the size and shape of your breast after implant removal and capsulectomy.

It is difficult to answer this question without examining you. If your nipples are below your crease or you have excess skin after implant removal, a lift might be indicated. 

It is important to have adequate blood supply to your nipple/areola. In many women, it is not safe to perform a lift at the same time as an explant/capsulectomy.

We often perform fat transfer to restore some of the volume lost after implant removal/capsulectomy. We do not usually perform fat transfer at the same time as implant removal/capsulectomy and prefer to wait at least six months.

It is also important to have enough fat in other areas to use for fat transfer.

We are happy to provide you with any of your records upon request.