Methods and systems for removing an object, such as a lead, from formed tissue are provided. Specifically, a lead removal sleeve is configured to engage patient formed tissue at a dilation engagement point. The lead removal sleeve is configured to dilate the formed tissue around a lead, while providing an inner lumen with clearance for the lead to move within the sleeve. It is an object of the lead removal sleeve to support the formed tissue, and even forces of the formed tissue, with a structure of the sleeve as the lead is removed from a patient. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.