Confused About Implant Capsule Removal

I've had my implants for 8 years and would like them removed. I have no trouble, but my aunt just found out she had breast cancer, and has gone through surgery and receiving radiation treatment. I just want them out to better monitor my health in the future. I am confused about the removal of the capsule. My doctor said he would leave them in since it's too difficult to remove them all. He said, it would not show or hardly show in X-rays and would heal (disappear)? Please explain this to me. I'm supposed to face breast implant removal surgery next week. Thank you so much in advance.

Doctor Answers 10

Leaving Capsule: Wouldn't Adversely Impact Cancer Detection

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.

Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

No need to remove the capsule.

The capsule that forms around your implants forms in response to a foreign body (the breast implant). Therefore, by removing the implant, the capsule will eventually go away too! It becomes very vascular with a robust blood supply and can bleed a lot during removal. Therefore, it is best not to mess with it during removal if not necessary. I agree with your surgeon here.

David Rankin, MD
Jupiter Plastic Surgeon
4.9 out of 5 stars 163 reviews

Capsule removed if you have pain, breast distortion, etc.

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.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Confused about implant capsule removal

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!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

Breast implant explantation (removal) and managment of the capsule

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

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Should Breast Implant Capsules be Removed?

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.

Fredrick A. Valauri, MD
New York Plastic Surgeon

Capsulectomy during breast implant removal

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.

Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 101 reviews

Implants and removal

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.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Breast Capsule Removal with Removal of Implants

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.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Many times the capsule does not need to be removed

If your implants don't have a hard capsular contracture around them and if you don't have leaking old silicone gel implants and if your implants are below the muscle, it would be fine to just remove the implants and leave the scar capsules alone.  They shouldn't delay the detection of breast cancer. 

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.