Will I have issues with the other capsule being left in?

Question

I had a consult with my PS and I have capsular contracture on my left breast. I am going to get my implants removed and my PS said he will remove the contactured capsule but leave the other capsule in. Will I have issues with the other capsule being left in? I am wondering if the right breast will look different due to the capsule being left in. He wants to leave the capsule due to blood supply

Alan Gonzalez, MD, FACS · Answer

Hi @amberkate14, thank you for your question. I believe that every time an explant is performed the capsules should be completely removed as they do not resorb. Complete capsulectomy, I also recommend that you should send the tissue to pathology once the capsule is removed. This will prevent future inflammatory responses from the body that could hinder recovery. In cases where the capsule is not completely removed during explant surgery, it is important to discuss other treatment options with your physician. This may include additional surgery to remove the remaining capsule. To shed more light, I am sharing a video. If you are considering breast explantation, consultation with a plastic surgeon experienced in this procedure is essential to ensure optimal results. Best wishes.

Alan Gonzalez MD, FACS. Member of the International Federation for Adipose Therapeutics and Science (IFATS), Member of the American Society of Plastic Surgery (ASPS), Member of the Colombian Society of Plastic Surgery (SCCP).

Alan Gonzalez MD, FACS. Member of the International Federation for Adipose Therapeutics and Science (IFATS), Member of the American Society of Plastic Surgery (ASPS), Member of the Colombian Society of Plastic Surgery (SCCP).

Shaher W. Khan, MD · Answer

Leaving a breast implant capsule in the chest will allow Breast Implant Illness symptoms to arise. The capsule itself contains the gel bleed from the implant causing silicone toxicity. As for the look, the body does not absorb the capsule. Your best bet is to fond a surgeon that will remove both capsules in its entirety.

Daniel Barrett, MD · Answer

Dear amberkate14,
in case of thin capsules, they can be left inside the breast as they won't cause difference in size or shape. Thick capsules or capsular contracture should be removed. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Wayne I. Yamahata, MD · Answer

In the absence of a significant capsule, the risks of removal probably outweigh any potential benefits. A normal asymptomatic capsule is typically very thin and translucent and should be indetectable if left in place.

Tyler Frew, MD · Answer

Hi there
Sorry to hear about the contracture, bummer. Be sure to check your implant warranty as some implant companies will give you money back or a set of implants if under warranty.
That being said, There is no issues with leaving the unaffected capsule in your body. You will also not be able to tell, there wont be any visible difference.
You could also ask to have both capsules removed fully, however this will cause more swelling and pain during recovery
Sometimes it is also very difficult/impossible the dissect the capsule fully free, especially if it is very thin. 
All the best

Gary M. Horndeski, MD · Answer

Leaving the capsule behind in a normal breast is not a problem.  However, if it is removed, it may take out additional breast tissue and cause asymmetry.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

I doubt there will much difference in looking at both breasts. With the capsule left in place, you do have a higher risk of a seroma or fluid collection. Your surgeon may choose to place drains in both breasts.

Camille Cash, MD · Answer

If the other capsule is normal and not causing any issues it is fine to leave it behind.  There would not be expected future complications from leaving a normal capsule behind and simply removing the implant.  Your surgeon is the best one to determine if, when, and how much of a capsule should be removed.