Data story · ASPS 2007–2024
The Explant
Revolution
From 2009 through 2024, breast implant removals increased every single year. Not most years. Every year. Fifteen consecutive years of growth, through a recession recovery, a boom, a pandemic, and a demographic transformation.
15 yrs
Consecutive
growth streak
20K→41K
Removals
2009 → 2024
+108%
Total growth
over 15 years
+8%
Grew during
COVID (2020)
No other cosmetic procedure in the ASPS dataset has a streak like this. Not augmentation (down in multiple years). Not lifts (down in 2020). Nothing. The explant trend doesn't care about economic cycles, pandemic shutdowns, or shifting demographics. It just goes up.
Implant removals Augmentation (for scale)
In 2007, for every 100 women getting implants, about 8 were having them taken out. By 2024, that ratio was 13.5 — a 75% increase. The augmentation market is like a bathtub: new augmentations fill it, removals drain it. The faucet runs at the same rate, but the drain is open twice as wide.
7.7 → 13.5 removals per 100
augmentations
~4%/yr
Phase 1: Slow Build
2009–2015
Implant lifecycle replacements
+37%
Phase 2: Acceleration
2016–2019
BII social media explosion
+8%
Phase 3: COVID Resilience
2020
Grew while everything else fell
The pandemic test was the most telling. In 2020, augmentation dropped 33%, lifts dropped 21%, reductions dropped 23%. Implant removals grew 8%. Removal felt urgent — even medically necessary — making it resistant to forces that suppress elective procedures.
Implant lifecycle
Implants last 10–15 years. The augmentation boom of 2005–2010 (~300K/year) created millions of women now in their replacement window. Many choose removal over replacement.
The BII movement
Facebook groups with hundreds of thousands of members. Common reported symptoms: chronic fatigue, joint pain, brain fog. The FDA issued updated warnings in 2019; Allergan recalled BIOCELL implants in 2020.
Aesthetic shift
"Smaller, more natural" became a common request. The Instagram-era emphasis on enhanced upper bodies gave way to a more natural aesthetic. For some patients, that meant going back.
Aging patient base
A 50-year-old who got implants at 25 may have very different feelings about them. Body image, comfort, and health priorities evolve over decades.
1
The streak is unmatched.
15 consecutive years of growth, through recession, boom, and pandemic. No other cosmetic procedure comes close.
2
The "explant economy" is real.
At 41,271 procedures per year and $5K–$10K per surgery, the explant market represents $200–$400M in annual revenue for plastic surgeons.
3
The scissors are closing.
Augmentation is flat at ~306K. Removals double from ~20K to ~41K. The gap shrinks every year. Projected ratio by 2030: 1 removal per 5.5 augmentations (vs 1:7.4 today).
4
2024 may signal a plateau.
Growth slowed to just 0.4% (41,115 to 41,271). The slowest in the 15-year streak. Whether this is a pause or the beginning of a ceiling remains to be seen.