I‘ve had smooth gel implants since 11/2015 (over the muscle). Recently I started to notice a tightening and firmness in my right breast (only). My surgeon who placed them had me get an MRI. The images confirmed there is NO rupture, but I do have capsular contracture. I’ve decided to explant. My surgeon said there was no need for a capsulectomy and to remove the implant only. I’m torn. I don’t think I have any BII issues. I’m concerned about long term issues with the scar tissue. Recommendations?
Answer: Capsule removal or not? Hello @kimberniki, thank you for your question. I believe that every time an explant is performed, the capsule must be removed. Complete capsulectomy. Whether it is en bloc does not matter as long as the whole capsule is removed and the tissue is sent for pathology after taking the capsule out. This will prevent future inflammatory responses from the body because capsules do not get reabsorbed. A capsule will always form around a prosthesis because it surrounds it and isolates it, since the prosthesis is a foreign tissue. To shed more light, I share a video. If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)
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CONTACT NOW Answer: Capsule removal or not? Hello @kimberniki, thank you for your question. I believe that every time an explant is performed, the capsule must be removed. Complete capsulectomy. Whether it is en bloc does not matter as long as the whole capsule is removed and the tissue is sent for pathology after taking the capsule out. This will prevent future inflammatory responses from the body because capsules do not get reabsorbed. A capsule will always form around a prosthesis because it surrounds it and isolates it, since the prosthesis is a foreign tissue. To shed more light, I share a video. If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)
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CONTACT NOW Answer: Recommend doing a capsulectomy Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.
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CONTACT NOW Answer: Recommend doing a capsulectomy Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.
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January 6, 2023
Answer: OK to leave the capsule with implant removal With implants in front of the muscle it is probably safer to leave the capsules in, unless there is a very specific reason to remove them.
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Answer: OK to leave the capsule with implant removal With implants in front of the muscle it is probably safer to leave the capsules in, unless there is a very specific reason to remove them.
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December 14, 2022
Answer: Capsule Unless the capsule is very thin, I would suggest removing it a well, because it may have some thick areas of scar tissue.
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Answer: Capsule Unless the capsule is very thin, I would suggest removing it a well, because it may have some thick areas of scar tissue.
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January 31, 2023
Answer: Breast explant - Should you remove the capsule? Hi, it appears that you have a breast capsular contracture. This is more common when the implant is placed in a subglandular position (above the muscle). You have multiple options in treatment depending on the severity of the capsular contracture. You can remove the capsule, alter the capsule by cutting it in several places, use absorbable scaffolds, and or change the implant pocket position to a submuscular position. Explant surgery is also a reasonable option if you no longer want your implants. I typically remove the capsule when I perform an explant surgery in order to reduce the risk of a seroma (fluid collection) following surgery, however it is not mandatory and may be associated with an elevated surgical risk in individuals with very little breast tissue (can effect skin and nipple blood supply). I would need to perform an exam and get further history for a more accurate recommendation.
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CONTACT NOW January 31, 2023
Answer: Breast explant - Should you remove the capsule? Hi, it appears that you have a breast capsular contracture. This is more common when the implant is placed in a subglandular position (above the muscle). You have multiple options in treatment depending on the severity of the capsular contracture. You can remove the capsule, alter the capsule by cutting it in several places, use absorbable scaffolds, and or change the implant pocket position to a submuscular position. Explant surgery is also a reasonable option if you no longer want your implants. I typically remove the capsule when I perform an explant surgery in order to reduce the risk of a seroma (fluid collection) following surgery, however it is not mandatory and may be associated with an elevated surgical risk in individuals with very little breast tissue (can effect skin and nipple blood supply). I would need to perform an exam and get further history for a more accurate recommendation.
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