Does having a capsulectomy cause your breasts to be smaller?

Question

If my implants are under the muscle, the capsule would be a part of my pec muscle, would that cause my breasts to look smaller after explant? So many women say that after having their capsules removed they lose breast tissue in the process- I would like to know if this is true for under the muscle implants as it doesn't make sense to me.

Gary Lawton, MD, FACS · Answer

The capsulectomy is contributing little to the change in shape. 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.

Jed H. Horowitz, MD, FACS · Answer

hello Hopedforbetter  You may not be satisfied with the appearance of your breasts. Incorrect implant size, inappropriate scar location or appearance, and misplacement of implants may interfere with a satisfactory appearance. Asymmetry (unequal breast size or shape) may occur. The implanted breast may sag or droop (ptosis) over time, much like a natural breast. The explanted breast may droop or be distorted in shape. #causes #smaller

Jeanette Padgett, MD, FACS · Answer

In most cases, removal of the capsule does not require a lot of tissue removal.  The scar capsule is separated from the muscle/breast tissue in such a way to remove only the capsule.  Removal of the implants themselves will change the size of the breast. Removal of the capsule itself does very little to change the size of the breasts.  Be sure to discuss all of your concerns with your plastic surgeon.  Best wishes.

Camille Cash, MD · Answer

With a capsulectomy there is very minimal breast tissue removed.  It would be surprising that any difference in size would be noticeable from having this done.  You lose the volume of the implant certainly, but the amount of breast tissue at the time of surgery essentially remains the same.

Kamran Khoobehi, MD · Answer

The results post implant and capsule removal will depend on the amount of soft tissue you had before surgery and if you have capsular contracture. Please see the link for the implant removal and fat grafting

Kim Taylor, FRACS · Answer

The aim with a capsulectomy is to remove the capsule only.  We always try to leave all normal tissue (breast, muscle) behind.  It is rare that the capsule is actually invaded or going in to any of the surrounding normal tissues.  Breasts are always smaller after removal of implants & capsules but that is because of the volume of the implant that has been removed, not usually any normal tissue.  Your surgeon should be able to explain all of the details of what can & can't be removed & give you realistic expectations of how your breasts will look after the procedure. All the best

Tom J. Pousti, MD · Answer

Much will depend on how thick the capsule is and how carefully the procedure is performed. For example, if the capsule surrounding the breast implant is very thin and care is taken to avoid removal of any non-capsule tissue, the  patient's breast should not be any smaller after breast implant removal surgery.  
Generally speaking, what your breasts will 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.
Patience is definitely indicated after removal of breast implants; it will take many months for the skin to “bounce back” and for you to see the final appearance of the breasts.
 
Best wishes.

Robert E. Zaworski, MD (retired) · Answer

When removing a capsule, we try to avoid taking any extra tissue.  We always try to leave all normal tissue (breast, muscle) behind. Consult with your surgeon regarding his treatment plan.

Does having a capsulectomy cause your breasts to be smaller?

Answers (8)

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