Removal of the breast implant with removal of the capsule in the sub-muscular position can be done. Thick capsule is much easier to remove. Very miniscule amounts of muscle fibers may be adherent to the capsule but that does not affect the muscle or the function.The muscle needs to be re-attached to the chest wall in normal anatomic position and minimize the probability of deformity, such as animation.
Thank you for the question. Breast implant removal and capsulectomy surgery for patients who have breast implants in the sub muscular position is not very different compared to breast implant removal surgery for patients with breast implants in the sub glandular position. Regardless of breast implant position, care must be taken during the capsule removal to avoid injury to surrounding tissues. One main difference between the two scenarios is that patients who have breast implants behind the pectorals muscle may have capsule tissue densely adherent to her rib cage making overly aggressive surgery potentially very dangerous. In other words, care must be taken to avoid injury to intercostal structures and/or entering the patient's thoracic cavity. Potential risks include excessive bleeding, pneumothorax etc...Some general thoughts regarding capsulectomy surgery (frequently asked questions) may be helpful to you: Generally speaking (in my opinion), unless the breast implant capsules have thickened (and/or are otherwise symptomatic), are associated with the ruptured silicone gel breast implants, or if the patient has concerns about "medical conditions" related to the breast implants, capsulectomy is not universally necessary. For these patients, en block removal of breast implants is a good procedure.***On the contrary, capsulectomy can expose patients to additional risks, such as bleeding, size loss, contour irregularities and other serious complications. In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity). Again, attempting to remove very thin capsule densely adherent to the patient's rib cage may expose the patient to significant bleeding and/or entrance into the thoracic cavity.Recently I have become more aware of the fact that there are plastic surgeons who, instead of using good judgment and individualized patient care, are causing fear and unnecessary anxiety among patients. These patients them feel that complete capsulectomy is always necessary and undergo unnecessary surgery associated with additional morbidity and unnecessary expenses. The good news: breast implant removal surgery is a very well-tolerated procedure with minimal discomfort, compared to first-time breast augmentation surgery. 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.I hope this, and the attached link, helps. Best wishes.
