Sir: The removal of a breast implant is a relatively frequent operation in both plastic surgery and reconstructive surgery. As for the implant also, the removal occurs through rather small skin incisions with respect to the dimensions of the prosthesis. In general, the implant to remove is eliminated from its pocket manually by the operator who, to be able to proceed in such an operation, is forced to pinch the implant with his or her fingers to ensure optimal take, and to put it in traction with a force directly proportional to the dimensions of the prosthesis and inversely proportional to the dimensions of the skin incision. This solution exposes the prosthesis and in particular its external coating to two forces: one of compression (because of the initial pinching) and one of traction (the amount of which greatly increases the possibility of rupture of the prosthesis). Despite the high frequency of this action during surgical procedures with the use of prostheses in mammary areas, only a few solutions have been proposed.1,2 To reduce the mechanical stress on the prosthesis as much as possible, in our clinic practice, we developed a simple system based on the use of negative pressure applied on a unique surface reduced by the coating of the implant, allowing simple removal, by avoiding manual contact of the operator and reducing the possibility of rupture of the implant. In particular, a syringe of 60 ml is used, without the plunger, which is connected with the beak of the flask to the aspiration system (Fig. 1).Fig. 1.: A 60-ml syringe, without the plunger, connected with the beak of the flask to the aspiration system.The back part of the syringe is then made to adhere to the implant's surface, creating a vacuum system that allows the implant to be removed through a soft traction toward the outside. The advantages of such a system are many and represented (1) by the absence of the pressure and back-pressure exercised by the digital pinching with mechanical stress limited to a sole surface of the shell (Fig. 2), allowing safer removal, especially in case of a ruptured silicone gel implant; and (2) by greater control of the force of traction exercised by the operator through the comfortable grip offered by the length of the syringe cylinder.Fig. 2.: The back part of the syringe is made to adhere to the implant's surface, creating a vacuum system that allows the implant to be removed through soft traction toward the outside.Giuseppe Nisi, M.D. Matteo Campana, M.D. Massimiliano Calabrò, M.D. Anna Brafa, M.D., Ph.D. Carlo D'Aniello, M.D. Department of General and Specialistic Surgery Plastic and Reconstructive Surgery Unit “S. Maria alle Scotte” Hospital University of Siena Siena, Italy