Denver Breast Implant Removal doctors

I would add that I don't think it's possible to "clear" your tissues of microscopic silicone whether the implants are intact or not and whether the implant is intact or not. It's certainly not possible to know that all silicone and risk is removed although there's no solid evidence to support the supposed specific risk of the "industrial silicone". Removing the capsule if it is normal looking involves a bigger operation with more risk of bleeding and scarring and no assurance that this will remove all risk or all microscopic silicone. However, if the patient is properly informed as to the increased risks and costs of removing the capsule as well as the inability to completely clear all silicone from the tissues even with the capsulectomy, I would feel that the patient could make this choice. 

A breast implant capsule is the way the body heals around an implant or any foreign body that it cannot heal into. It is made of scar tissue similar to scars on the surface of the skin from incisions. There is nothing abnormal about most capsules and no reason to remove them just because they're there. Removing them will result in a new layer of scar tissue as the body heals the raw area from the removal of the capsule and the surgery involved with removing them is much more involved and carries its own risks. I am always surprised by how many plastic surgeons seem to think something must be done for the capsule. Even with a ruptured silicone gel implant you are not going to clear the body of silicone by removing the capsule and there's no evidence that the microscopic silicone causes problems wether the implant is there or not. There are situations where the capsule might need to be removed. If it is thickened, calcified, or inflamed then it might be indicated to remove part or all of it. 

Removing saline-filled implants can be done under local anesthesia with a minimal incision in the inframammary crease (one of the minor advantages of the saline breast implant), but removing silicone-gel filled implants is more problematic and the surgeon must be prepared for a possible ruptured gel implant or capsule work if there is an abnormal area. Therefore, a full scale breast surgery approach is needed with either IV sedation/local or general anesthesia. This is more involved and costly. 

Removing implants that were properly sized and placed and did not distort the breast should result in a natural looking breast that looks the way it would have if the implant had not been there aside from the external scar. This is usually the case whether the implant is removed or the implant and the capsule. 

I would agree that removing an implant through a previous periareolar incisional scar is probably low risk for problems although an inframammary crease incision would still be easier and could be done under local-only anesthesia. However, I would caution against replacing implants through a a second periareolar approach as this not only risks bacterial contamination from breast ducts but there is more chance of the implant herniating up through the breast tissue. Overall, the inframammary crease incision has proved to be the best for short term results, avoiding injury or contamination from the breast ducts, and for long term needs such as revision, replacement, or removal. For saline-filled implants this incision can be 2 cm and for gel-filled implants currently available about 3 1/2 to 4 cm.