What is the Capsule That Many Doctors Refer to with Regards to Breast Implants?

I am exploring breast implant explantation, and in many Q&As, the Doctors refer to the 'capsule' created by the implant. What is this made of? What are they refering to? And what are the risks associated with keeping it in the body versus removing it? I am also keen to understand the risks associated with local versus general anesthetic for the explantation. I had silicon implants put in 16 years ago when I was 21 years old. I had a 32A cup prior to the operation and a 32C after. Thanks!

Doctor Answers (7)

Breast implant removal and capsules

+2

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. 

 

 


Denver Plastic Surgeon
4.0 out of 5 stars 1 review

What is the capsule

+1

The capsule is basically an inflammatory reaction to the implant itself.  It is the body trying to wall off the material.   If the capsule is removed it increases the risk of bleeding.  If a silicone gel implant has ruptured then removal of the capsule would be recommended otherwise I would leave it alone unless it was calcified.  If there is distortion of the breast after implant removal may also be a reason to remove the capsule.  The capsule probably never fully gets resorbed and refinements will be there for a long time.  This would not cause a health risk.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

What is the capsule around breast implants

+1

The capsule that is being described is scar tissue that forms around the implant.  This is a normal occurrence in the body and happens with all breast implants.  If you choose to have your implants removed you do not necessarily have to remove the scar capsules as well.  Your body will break down and absorb the scar capsule over time.

Mennen T. Gallas, MD
Katy Plastic Surgeon
5.0 out of 5 stars 8 reviews

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Capsules around implants

+1

simply put, the capsule is scar tissue.  it is a colection of collagen (scar tissue) which surrounds the implant.  the scars may be soft or thick but it is neverheless scar tissue.  

James Apesos, MD
Dayton Plastic Surgeon
4.5 out of 5 stars 9 reviews

Breast capsule

+1

The body forms a natural barrier of collagen around the implant.  Usually this stays soft and thin but in some patients that capsule becomes thick and tight.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

The capsule is a very thin layer of your own tissue around the breast implants.

+1

Hi.

1)  There is always a capsule around implants.  It is the body's natural reaction.  What you do with the capsule depends on whether the implants are leaking.  If they are leaking, most of the capsule should be removed because there might be bits of silicone in it.

2)  If the implants are intact, we simply curette (scrape) the surface of the capsule and leave it in place.  It disappears spontaneously after the implants are gone.

3)  The surgery is best done under light general anesthesia.  We always use suction drains in the breasts for several days to prevent fluid accumulations (seromas).

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breast Implant Removal and Capsules?

+1

Thank you for the question.

When breast implants,  or any other foreign body,  is inserted into the human body,  the body forms a lining around it.  This lining is referred to as the “capsule”.   This capsule is normally very thin and soft;  however, it can become  thick and hardened in a process called encapsulation or capsular  contracture.

In the process of breast implant removal,  assuming the breast implant capsules are soft and asymptomatic,  there is no reason to remove them (capsulectomy). Removal of breast  implant capsular  tissue increases  the risks of surgery (for example bleeding).

Generally speaking what breasts look like after explantation  depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back),  the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation). 

Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will  potentially influence the factors discussed above. If you take these factors into consideration and apply them  to your specific circumstances you may get a good idea of what to expect after the implants are removed. 

Breast implants can be removed safely under local or general anesthesia depending on the specific situation and patient. 

I hope this helps.

 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 719 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.