I want to have my 25 year-old implants removed. Is removal of the capsule necessary?

I've have above the muscle saline implants. Thankfully, I've had no issues and my breast are soft. I've read many explant reviews where local anesthesia is given, an incision is made, and the implant is simply removed. However, the first PS office I called, the office manager said the doctor would want to do general and remove the capsule. I've never been to this office before, so I'm wondering if it's a process that's done based on the doctor preference, and not the patient's situation.

Doctor Answers 5

Capsule removal with implant removal?

As you can tell from the different answers this is a controversial topic. In my experience if the capsule is soft and you do not have contracture issues, the implant can easily be removed a drain placed to help close the pocket over several days  and all of this through a small incision . Your best option is to seek several other opinions from board-certified plastic surgeon is experienced in breast surgery 

Sacramento Plastic Surgeon
4.9 out of 5 stars 106 reviews

Capsule removal with implant removal

Thank you for your question. You may find that you will get mixed opinions regarding capsule removal. It can be dependent on the surgeon's preference and opinion of what he/she feels is right but it is also patient dependent as well. My personal preference is to remove the capsule to decrease complications and chance of future corrective surgeries. I suggest that you get a second or third opinion from board certified plastic surgeons who specialize in breast surgery to ensure that you get the best possible result with the least amount of risks/ complications.

Mennen T. Gallas, MD
Katy Plastic Surgeon
5.0 out of 5 stars 18 reviews

En bloc capsulectomy

For explant surgery, it is almost always best to remove the capsule in its entirety.  This will allow the space to heal.  If you leave the capsule in place, it does not heal.  Fluid can accumulate in the space.  The situation that brings the patient to implant removal will have an affect on the decision.  This is a surgery which requires discussion with the plastic surgeon about the problem, the goals, and the technical concerns.  The body does not re-absorb the capsule.  Revision surgery requires drains because the fluid is going to be generated when you operate on the scar capsule.  If you provide a mechanism for the fluid to be removed (i.e. drains), the risks are lower.  If the fluid accumulates because there were no drains, it will most certainly cause problems in the future.

Implants removal surgery; is removal of the capsule necessary?

In many areas of plastic surgery, including breast implant removal surgery, you will find many different (often strong) opinions as to the best way to handle a specific situation. In my practice, generally speaking, unless the breast implant capsules have thickened and/or are otherwise symptomatic, I do not remove them. On the contrary (unless indicated), capsulectomy can expose you to additional risks, such as bleeding and some breast size loss. Your plastic surgeon, based on your physical examination, will be able to inform you whether the breast implant capsule is thickened or abnormal.

Having said that, I often remove a small segment of capsule tissue when removing breast implants ( even when not encapsulated) with the hope that this maneuver will help with fluid resorption (and help prevent seroma formation). I usually use drains also. 

You may find the attached link, dedicated to breast implant removal surgery concerns, helpful to you as you learn more. Best wishes.

Is is always necessary to remove the capsule?

Thank you for your question.  There is no consensus in the medical literature on removal of a capsule in a soft breast with a saline implant.  Most surgeons I know would not remove it unless some suspicion present including myself.  It would be worthwhile to have another opinion.  Always seek a board certified plastic surgeon who specializes in breast surgery.   Good luck.

David J. Wages, MD
Peabody Plastic Surgeon
5.0 out of 5 stars 18 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.