I've consulted with two plastic surgeons and I've gotten two opinions. One wants to remove the capsule; the other said it's bloody, more invasive and not necessary--that she would just clean up any visible silicone. What do you advise?
My Silicone Implant Has Ruptured and I'm Planning Explantation & Replacement. Does the Capsule Also Need to Be Removed?
Doctor Answers 4
Ruptured gel implant
If you have a firm(capsule formation) breast, then I would be in favor of a more aggressive partial capsulectomy, and possibly put in some alloderm,with your new implant to try to prevent recurrent capsule formation. Otherwise with soft breasts-remove both implants and use the same pockets with new implants. Mentor co. sells a warrenty to cover implant replacement and some operating room expenses the first 10 years after sutgery.
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Without an exam and without more history it is hard to sya what is best. If the implant is contained within the capsule, sometimes it is easier to remove the entire capsule with implant as one unit.
Removal of Capsule with Explantation
Thank you for the question. Although I am not able to provide you with specific advice, some general thoughts may be helpful to you. In cases where breast implants need to be removed ( for one reason or another), I generally do not remove the surrounding breast implant capsule, if the capsule is soft and asymptomatic. However, if the breast implant capsule is thickened, calcified, or otherwise symptomatic, I think that removal is helpful. As you have heard, breast implant capsule removal does care additional risks.
Often, in cases where silicone gel breast implants have leaked, the surrounding breast implant capsule is thickened and removal is indicated.
I hope this helps.
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Capsule care with implant replacements.
You must rely upon the experience of the examining plastic surgeon to decide upon the best care for the capsule. Without examining your breast and seeing a mammogram or MRI, I can only discuss the options for care of the problem you described.
When the silicone implant capsule is thickened and hard with significant calcium deposits, capsule removal (capsulectomy) is, in our opinion, a good option. This is more invasive and has greater risk for bleeding.
When the capsule surrounding the ruptured implant is thin and soft, our preference is to perform a capsulotomy (cutting the capsule to loosen the cavity for the replacement gel implant). This is a simpler approach for the right patient.
Before your surgery, discuss your options again with your surgeon.