Explant surgery, and travelling for it, raises a number of practical and clinical questions. The most common are answered directly below, grouped by topic. For questions not covered here, the patient coordinator can be contacted directly.
About BII & surgery
The surgery itself.
En-bloc removal takes out the implant together with the surrounding capsule as a single, intact unit, so the capsule is not opened and no capsular tissue is left in place. Where the anatomy does not safely allow a complete en-bloc, Dr. Urzola performs a total capsulectomy, removing the whole capsule in sections. Further detail is set out on the science page.
No. Many patients have implants for years without systemic symptoms. Breast implant illness appears to affect susceptible individuals, with susceptibility likely involving genetics and individual immune biology. BII refers to a specific pattern of symptoms and is not an inevitable consequence of having implants.
Outcomes cannot be guaranteed. In the practice's internal, patient-reported outcomes at six-month follow-up, a majority of patients report measurable improvement, and published cohort studies indicate a similar direction. Recovery is individual, and the practice presents outcomes conservatively rather than as a guarantee.
A total capsulectomy removes the entire capsule that formed around the implant, though not necessarily in one continuous piece. Where removing the capsule intact would risk injury to the chest wall or nearby structures, it is removed completely but in sections. The whole capsule is removed in either case.
This depends on the patient's tissue, implant size, and objectives. Some patients elect Dr. Urzola's U-flap breast lift, which uses the patient's own tissue through the incision already required, while others elect fat transfer to restore volume once fully healed. Many require neither. Recommendations are made on clinical grounds specific to each patient. See the procedures page for details.
Not in every case. Where a capsule is very thin, ruptured, or tightly adhered to vital structures, removing it fully intact can carry greater risk than benefit. In those cases Dr. Urzola performs a total capsulectomy instead. Patient safety determines the technique; complete removal of the capsule is the constant, and capsular tissue is not intentionally left in place.
Before you travel
Planning your trip.
For most patients, no. Citizens of the United States, Canada, the United Kingdom, the European Union, and Australia are granted tourist entry of up to 90 days on arrival, with no advance visa required. A passport valid for the length of the stay and a return or onward ticket are needed. Requirements can change; confirm the current rules for your nationality before booking flights.
Most patients arrive two to three days before surgery to rest and complete final checks, and remain for approximately ten days afterward. This allows for the first follow-up and drain removal before travelling home. The patient coordinator assists with planning the exact dates.
A standard panel establishes fitness for surgery: a complete blood count (CBC), coagulation testing (PT), blood typing, a pregnancy test, and an EKG. A breast ultrasound is also required, and a mammogram for patients aged 40 or older. Some tests may be completed at home before travelling and some in San José. The patient coordinator provides an individualized checklist.
To review a case, Dr. Urzola typically requests clear front and side views of the chest, in good natural light. Photographs are shared securely and reviewed only by the care team. Guidance on what to include is provided on request, and patients share only what they are comfortable providing.
Most patients stay in recovery-appropriate accommodation close to the clinic in San José, and many travel independently with support from the coordination team. A companion for the first days after surgery is recommended where possible. Travel and lodging guidance is provided by the practice.
Costs & booking
Pricing, deposits and what's included.
After Dr. Urzola reviews the case, the patient receives an itemized written quote based on the individual anatomy and the procedures indicated, valid for six months. Because cases differ, pricing is quoted individually rather than as a single flat rate. Full detail is set out on the pricing page.
Yes. Once the patient decides to proceed, a deposit secures the surgical date. The remaining balance is settled closer to surgery. The patient coordinator sets out the terms in writing before anything is confirmed.
The quote sets out what the surgical fee covers: the surgeon, the operating facility, general anesthesia, and standard post-operative follow-up. Optional items such as pre-operative blood work (approximately US$900) and capsule pathology analysis (approximately US$300 to 700) are itemized separately. Travel and accommodation are arranged by the patient, with guidance from the practice. Costs are itemized rather than bundled into an unspecified total.
Several common payment methods are accepted, including bank transfer and card. The patient coordinator confirms the current options, along with currency and timing, when the quote is issued. Specific requirements can be raised directly with the coordinator.
Explant is frequently classified as elective by insurers, so coverage varies by provider and country. The practice provides documentation for submission to insurers, though reimbursement cannot be guaranteed. Where financing is relevant, raise it early and the coordinator will confirm the options currently available.
Recovery
Healing, and getting home.
Most patients describe the first few days as tightness and soreness rather than sharp pain, managed with the medication provided. Discomfort typically eases over the first week. Individual experience differs, and the clinical team remains in close contact throughout. The full timeline is set out on the recovery page.
In most cases, yes. Small Jackson-Pratt drains help prevent fluid accumulation during healing and are usually removed at the first follow-up before travelling home. The nursing team provides instruction on how to empty and record output. Patients are not discharged to manage anything they have not been shown.
Most patients are cleared to fly approximately ten days after surgery, once the first follow-up is complete and any drains are removed. Fitness to travel is confirmed before departure, along with guidance on hydration, movement, and compression for the flight.
Gentle walking is encouraged early. Driving, strenuous activity, and upper-body exercise generally wait until approximately one month, once stronger medication is no longer required and healing is established. A gradual return protects the surgical result, and the clinical team provides staged guidance for each stage of recovery.
Some swelling is expected and typically settles over weeks to a few months as the tissues heal. Numbness or altered sensation around the incisions is common and usually improves gradually, in some cases taking up to a year to resolve fully. Steady improvement over this period is the norm.
For any question not addressed here, the patient coordinator can be contacted directly and will respond with a clear, factual answer.
Consultations
Request a consultation.
Submit your history for review by Dr. Urzola. Consultations are confidential and carry no obligation.