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.
I would not recommend leaving the deflated implant in your body. Once it is punctured, it is contaminated. This could cause infection.
Once an implant has been punctured percutaneously (through the skin - which is what is done when implants are deflated as part of a staged procedure), it's theoretically contaminated and, at any rate, will most likely continue to leak. So you'll wind up with a deflated implant that's been punctured through the skin. That is at best a temporary solution. There is a risk of infection even in doing that but, assuming that does not happen right away, it could and I would not recommend or advise leaving a deflated implant in place on a long term basis (it's a little different if an implant deflates on its own because there was no connection to the outside); it tends to become uncomfortable. Once you've made a decision to remove your implants it's better to have a complete plan in place that includes removal of the deflated shell, with or without replacement. I hope that this helps and good luck. Dr. Alan Engler, Member of #RealSelf500