Do implants have to be removed when doing plication, closing the lateral pockets to bring implants closer together?

Hi.  Yes, the implant is removed.  Pocket adjustments are then made doing the plication or what may be referred to as capsulorrhaphy to adjusting close off the pocket.  The implant is replaced and the breast is evaluated.  Adjustments may or may not need to be made.  When the surgeon is satisfied that the result was achieved and things are closed.  That is the typical way that I would do that type of procedure, and probably most other surgeons.  Good luck and take care, Dr. Howell

For my patients, we tell them that the implants have to be removed, otherwise the risk of a sharp needle puncturing the implant would be high. Another word for the plication or repairing the side breast tissue is called a capsulorrhaphy. This means that the internal capsule or scar rind that formed around the implant, will be sewn together to make a tighter pocket. We often like to also use a temporary implant called a sizer to put into the repaired pocket to make sure that it is just right. Then the sizer is removed and the final implant can be placed. Advanced experience is important for precision with this plastic surgery procedure. 

Thank you for sharing your question.  In most cases the implants are temporarily removed to do the suturing but if only a small amount is needed, one or two stitches can be placed without removing the implant.  Hope this helps.