by Juliette Goodrich and Molly McCrea

SAN FRANCISCO (KPIX) — For a growing number of women, when it comes to breast enhancements with implants, there’s been a cultural shift toward a “less is more” attitude. Even during this pandemic, Bay Area doctors are seeing a big difference in what women want and are hearing surprising reasons why they want it now.

“The actual demand for plastic surgery actually increased to levels that I would have never believed during a pandemic,” said Dr. Carolyn Chang, one of the Bay Area’s premier plastic surgeons.

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For the past few years, she’s seen rising demand for a certain kind of procedure called “explant” surgery.

“I’ve noticed an increased desire for women to have their implants removed,” Dr. Chang said. “I’ve had a much larger number of people asking for explants than ever before.”

The FDA recommends replacing implants every 10-15 years. Now, more women are replacing them with a smaller size or with nothing at all.

KPIX spoke to women who have had explants for various reasons.

“Becky” got implants following a divorce. She got a notice that her specific implants, made by Allergan, were under a voluntary recall. Instead of swapping them for a different type, she decided simply to have them removed and not replaced.

“I’m at a point where I’m like I don’t want to be over-sexualized, you know? I’m a mom,” she explained.

There was an additional benefit. Becky no longer was top-heavy and her back pain vanished.

“I just feel so much lighter,” she said with a laugh.

A woman we’ll call Sonia told us a different story. She spoke to KPIX before she went into surgery at Sutter Health CPMC Davies campus in San Francisco.

“I loved the way they looked. I still love the way they look. If I had no problems I would absolutely 100 percent keep them in,” Sonia said.

Five months after Sonia got implants she began to experience back and leg pain as well as headaches.

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Specialists could find no explanation for her problems.

“Up the stairs takes me 10 minutes and I’m only 45. I shouldn’t be living like that,” Sonia said.

Sonia wondered if her implants played a role. While there’s no guarantee she’ll feel better, she asked Dr. Chang to remove them.

“It’s a matter of choice. It’s a choice to put them in. It’s a choice to take them out. It can be a very positive experience on both ends,” Dr. Chang said.

Michelle had an explant procedure and replaced them with what she prefers: smaller implants. She told KPIX she felt the pandemic was the right time to swap them out: there’s a lot of downtime for recovery at home.

“It actually worked out perfect. We didn’t have any plans and I knew that I would have time to recover,” Michelle explained.

She prefers to go small and look natural.

She told KPIX how, in the past, she was pressured to go big.

“Sometimes a man will look at it and say, ‘Oh you’re tall you could go bigger’ and I really kind of had to almost fight to make sure I got what I wanted the first time,” Michelle said.

“People are more confident and they have been looking at this time as a time for self-improvement,” added Dr. Chang.

Dr. Chang said that, when performed safely and according to strict guidelines, there is no extra risk of contracting COVID-19 from explant surgery.

“As far as personal exposure and exposure to patients, I think it’s a very controlled environment,” Chang said.

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Another reason why the pandemic may be fueling a boom: for those who are employed, there is more disposable income as extravagant vacation travel has fallen off.