Confused About Implant Capsule Removal

In the vast majority of the
explantation cases, it’s not necessary to remove the capsule that surrounds the
breast implant. When these capsules are
left alone, they collapse upon themselves and the implant pocket is eventually
obliterated. In addition, capsule
removal may be associated with secondary complications such as bleeding. For this reason, removal of breast capsules
isn’t undertaken without specific indications.When patient’s have ruptured silicone implants with
calcified capsules or thickened capsules with breast distortion, capsulectomy
is usually indicated. Under these
circumstances, failure to remove the capsule will result in a persistent
deformity.In someone who has had breast implants for over eight
years and isn’t having problems, simple removal of implants without
capsulectomy is probably reasonable. Leaving
the capsule behind wouldn’t adversely impact cancer detection. Under these circumstances, it’s important to
discuss this issue with your plastic surgeon. Your surgeon should be able to formulate an appropriate treatment plan.

Good day! For your guidance, you may still be screened adequately for breast cancer even with implants. Regardless of the kind of implant, you must inform your doctor and technician beforehand so they can alter your exam. They usually take extra photos called implant displacement views.For the removal of capsule, this type of procedure will enable the surgeon to remove as much silicone as reasonable without creating significant deformity. However, this operation may require a larger incision and longer surgery and recovery time. General anesthesia is usually necessary and subsequently all of the costs associated with this operation will be higher. Do not hesitate to ask your doctor if this is the right procedure for you and discuss realistic goals and expectations. Best of luck! #RealSelf100

Hello! Thank you for your question!  It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. If minimal contracture is seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from rutptured implant vs pain vs simple pocket adjustment, etc).  This should not affect your ability for imaging studies on your breasts.Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you. Hope that this helps! Best wishes!

Breast implants can certainly be removed(explantation) under local anesthesia.

In regards to the capsule:

1. There is some controversy among surgeons if this should be removed and this is difficult to perform under local.
2. Over the muscle capsules are easier to remove than under the muscle capsules
3. With saline implants in which there is minimal capsule, i have left in place.
4.With saline implants that have a severe, thickened or infected capsule, I will attempt to remove all or significant portions of the capsule
5.In instances incwhich there may be concern about pathology such as Atypcial Lymphoma, I will remove signficant portions of the capsule
6.With intact silicone implants of relatively short term duration (,<5 years) I will leave these in place
7.Wtih silicone implants of long term duration with thickened capsules I will attempt removal of the capsules
8.In ruptured intracapsular silicone implants, I will attempt en bloc resection.
9.In ruptured extracapsular silicone implants, I will attempt en bloc resection in combination with involved tissues

It is standard in my practice to remove the capsule that forms around the implant. This is the scar tissue that forms in response to a foreign body.

The breast capsule is highly vascularized and can be left in place or removed during your surgery to remove your breast implants. Removal of the capsule is straightforward with minimal risk aside from bleeding which can be controlled intraoperatively.
Deciding on whether to remove the capsule depends on the thickness of the overlying breast parenchyma. Usually, the anterior capsule is removed while the posterior capsule is left intact.
Leaving the capsule in place risks seroma development.

Unless calcified, the breast implant capsule will be absorbed over time so there is no reason to attempt to excise it.

Also, capsule excision has the potential complications of bleeding and possible damage to structures adherent to the breast implant capsule.

It is possible to completely remove the capsule during breast implant removal. If you are having difficulty or thickness with the capsule this technique may be recommended. However if the capsule is soft and is not affecting adjacent structures, the capsule may be left in place.
 

Very often, the implant capsule does not have to be removed. If it is hard and calcified, then it is best to remove it as best as possible.  If the capsule is soft, then it usually  is left and eventually remodels.

The capsule around the implant needs to be removed only if it very thick and contracted to the point of creating pain,distortion of breast tissue. If you have a soft breast ,most likely you do not need capsule removal.