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Should the Capsule Be Removed During Breast Implant Removal?

asked 3 years ago by littleagain in Iowa
Latest answer by Steven Wallach, MD
Question viewed 5,790 times
Tags: capsule

I have only had my implants for 2 years. Silicone, places under muscle. I have had no trouble but would like them out. I am wondering if the capsule should be removed? I don't quite understand this process. En bloc? Thank you for your help.

14 answers to Should the Capsule Be Removed During Breast Implant Removal?

+1

Capsule removal

Not all capsules have to be removed with implants.  If the gel has leaked then I usually try to remove it with the capsule intact.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Implant removal issues

I too have never heard the term “en bloc” in reference to breast implant removal with the associated capsule. The term “en bloc” refers to cancer removal when the entire specimen of cancer and surrounding effected organs are removed as a single unit to prevent cancer spread. Today doctors are creating terms which serve to hype techniques which are actually common to all of us. The term “en bloc” in this situation seems to refer to breast implant... more
James Apesos, MD

Dayton Plastic Surgeon
+1

When implants are removed, the capsule does not necessarily have to be removed.

Most of the time with explantation, the capsule need not be removed with the implant.  If a silicone gel implant has failed and the capsule has taken up some of the silicone, I will remove it.  It is generally thick and calcified which is no a health risk to the patient but could create some aesthetic problems.  If the capsule is thin and normal in appearance, it will generally resorb once the implant is removed.
Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon
+1

Reasons to remove breast capsules...

When I am performing revisional breast implant surgery, there are usually two reasons to remove the breast capsule. The first is if the capsule appears to be thick, calcified or abnormal. The second is in order to close down the space following removal of an implant. Although the capsule does not necessarily need to be removed completely, doing so will help close down the space and prevent fluid from accummulating.
Kevin Brenner, MD

Los Angeles Plastic Surgeon
+1

Capsulectomy during breast implant removal I

T is possible to completely remove the capsule during breast implant removal. If you are having difficulty or thickness with the capsule this technique may be recommended. However if the capsule is soft and is not affecting adjacent structures, the capsule may be left in place.  
B. Pat Pazmino, MD

Miami Plastic Surgeon
+1

Breast implant removal usually does not require capsule removal

As tempting as it is to perform capsule removal (capsulectomy) with implant removal, it is not routinely necessary. A surgical drain should be placed to provide negative pressure (a vacuum seal) and to remove any residual fluid. In the absence of a breast implant, most capsules will gradually shrink in volume, though they will never go away completely. The difficulty with routine capsulectomy is that it adds time, expense, and significantly more pain without any tangible benefit. When is... more
Ronald Friedman, MD

Dallas Plastic Surgeon
+1

Breast implant removal - Silicone breast implants

Breast implant removal is commonly requested by patients. As a matter of policy, breast capsules are not removed en bloc if there is no evidence of hypertrophy of this layer.
Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon
+1

En Bloc means in one piece

Hello, I usually have the capsule removed in part (at least) depending upon how firm and thick it is. They tend to be thicker with old silicone gel implants, but of course this varies. With really old implants, I remove most if not all of it. In this case, "En Bloc" means to remove an implant and its scar capsule in one piece.
John P. Di Saia, MD

Orange Plastic Surgeon
+1

Removing the capsule during removal of breast implants

Thanks for your question - Capsule formation is a normal part of healing after any implantation of foreign material (like a breast implant). Capsules can be thick or even painful when the scarring is excessive. In our San Francisco office we use techniques to minimize capsule formation. When we see patients who have thick capsules we encourage removal of the capsule at the time of implant removal or exchange. The technique typically involves removal of the implant and then removal of... more
Steven H. Williams, MD

San Francisco Plastic Surgeon
+1

Implant and capsule removal

 With non-encapsulated under the muscle implants that have only been in for 2 years you do not need to remove the capsules with the implants.  Just be absolutely you want the implants out and understand the consequences of their removal.
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

Capsulectomy with breast implant removal

I'm sure you have reasons for removing the breast implants, despite your declaration that they are causing you no problems. Make sure you know, though, that your breasts will not return to their pre-operated look. Intact implants for 2 years will have undoubtedly stretched the skin envelope, undoubtedly making you look more droopy. Capsulectomy may or may not be necessary - I usually err on the side of performing it, even if the implants are not ruptured. The capsule represents a... more
Sam Jejurikar, MD

Dallas Plastic Surgeon
+1

En Bloc breast implant removal

The 'en bloc' removal is usually needed for silicone breast implants that have been in the body for many years. If your implants were placed prior to 1992 then it may be necessary for a capsulectomy. Since you appear to have the latest generation of Silicone gels implanted only two years ago, it may not be necessary for a capsulectomy. I suggest consulting with an appropriate surgeon who can examine the existing condition and give you a proper assessment.
Robert Vitolo, MD

Manhattan Plastic Surgeon
+1

Capsule removal during breast explantation

"I have had no trouble but would like them out." Breast implants were not meant to be replaced frequently. Each surgical procedure changes and irreversibly scars the breast. If you are absolutely intent on having your implants removed, you need to understand that the resulting breasts will likely NOT be the breasts you had before the operation 2 years ago. They will be smaller and more droopy (ptotic) breasts. We rarely perform complete capsulectomies these days because they do not... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Capsule Removal

It really depends. If there is any chance of the implant being ruptured then I like to do an en bloc remove of the implant with the capsule without entering the capsule so to not spill or have any of the silicone touch the breast tissue. But this is probably not absolutely necessary. You could have the implants removed and have drains placed and allow things to heal without taking out the capsules and you will likely heal fine. The capsule will scar down and close off. Good luck. more
Farbod Esmailian, MD

Orange County Plastic Surgeon

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