Should the Capsule Be Removed with the Implants?

asked 3 years ago by worried and nervous in PA
Latest answer by Tom J. Pousti, MD
Question viewed 1,386 times
Tags: capsular contracture

If someone wants to permanently remove their saline breast implants, does the capsule need to be removed as well? If the capsule stays in, what happens to it? Will it move to other parts of the body or does it dissolve eventually? I've heard conflicting information about it. I heard from some that it is risky to remove it and it will dissolve over time. On the other hand, I read other stories about women who get sicker from leaving it in. Which is correct, to remove the capsule or leave it in after removing the implant permanently?

11 answers to Should the Capsule Be Removed with the Implants?

Managment of the capsule with breast implant removal (explantation)

Breast implants can certainly be removed(explantation) under local anesthesia. In regards to the capsule: There is some controversy among surgeons if this should be removed and this is difficult to perform under local. Over the muscle capsules are easier to remove than under the muscle capsules With saline implants in which there is minimal capsule, i have left in place. With saline implants that have a severe, thickened or infected capsule,... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Do breast Implant Capsules need to be Excised?

No, most breast implant capsules do not need to be excised following breast implant removal because they will be absorbed by your body. If your are doing having a breast implant exchange, particularly if a larger implant is being placed, and the same pocket is being used then sometimes a cutting of the breast implant capsule to release it might be done.

Fredrick A. Valauri, MD
New York Plastic Surgeon

www.drvalauri.com

Partial removal of capsule or total removal

It is a normal process to form a capsule around breast implants. Most surgeons will remove a portion or totally remove the capsule at the time of implant exchange. Total capsule removal can be a messy operation with prolonged drainage. I try to avoid this if possible reserving total capsulectomy for cases where other options do not exist. Implants can be placed in a different position with a fresh pocket created allowing the surgeon to avoid some capsule removal.... more

Pramit Malhotra, MD
Ann Arbor Plastic Surgeon

Capsulectomy with implant removal?

If the capsule is symptomatic (thickened, firm or calcified) it is in your best interest to have the capsule removed to avoid problems such as firmness and irregularity of the breasts postoperatively. These problems may confuse self breast exam (for cancer detection). Furthermore, calcification in the capsule may confuse mammography use for breast cancer screening. Of course, it is important during this process of removal of the capsule to avoid excision of normal breast or... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

Capsule of implants

Most capsules that are soft around the implants do not need to be removed. They will often just resorb over time.

Steven Wallach, MD
Manhattan Plastic Surgeon

Everyone is right!

Capsules left in can be nothing or they can fill with fluid and create a bulge. Ideally, some or all of the capsule should be removed and then the pocket sutured closed. I prefer to lift the breast tissue at the same time, by suture the anterior pocket a little highr than befor removal.

Robert M. Freund, MD
New York Plastic Surgeon

Capsulectomy during breast implant removal

It 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

At least part of capsule should be removed

Saline implants do not tend to produce firm capsules, but the pocket wil heal in better of at least a part of it is removed. If you have ever had silicone gel implants, the scarring will likely be worse and a more complete removal may be helpful. Best Regards. see video

John P. Di Saia, MD
Orange Plastic Surgeon

Treatment of the capsule in explantation

The considerations for removing implants are to streamline a woman's life (ie eliminate the maintenance concerns) and optimize the appearance of her breasts. Assuming that your nipples are at or above the inframammary fold (where the breast meets the chest wall) and your skin brassiere is elastic, there is a chance that your eventual result will be acceptable, even if somewhat deflated. My approach is as follows: a) for low grade capsules (Baker I & 2); capsulotomy, drain placement,... more

Lavinia Chong, MD
Orange County Plastic Surgeon

Capsule and removal of breast implants

In general the implant is removed and a drain is placed. Now if you have silicone implants are there is some possibility of rupture, I like to remove everything en bloc. Remove the capsule and the implant all at once. If the capsule is very thick, I also like to remove the capsule and place drains. Drains are a necessity whether the capsule is left or taken out. Good Luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon

Firm capsules with silicone breast implants should typically be removed

For a patient with a saline implant and a simple explant (removal), the capsule can be left to collapse. A drain is typically left in to encourage the closure of the capsule. In a patient who has a firm or thickened capsule with a silicone implant, it is best to remove the capsule. There really shouldn't be a reason for a woman to become sick unless there was some infection. This is best discussed with the plastic surgeon who will be performing your surgery. Dr Edwards