Breast Scar Capsule After Implant Explantation

I want to have my silicone gel implants removed. I have had them for two years. I have had no problems, just feel it was a big mistake and would like to have them out. My plastic surgeon told me he would open me up and pull the implant out. I have been reading about the scar capsule, and am wondering if that can stay in? Will my body absorb it in time? I have them placed under the muscle. Thank you for your advise.

Doctor Answers 13

Capsule removal after breast implant removal a matter of opinion

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I tend to remove most of the capsule to encourage the pocket to close. This is a matter of opinion. Some surgeons do not believe this is very important, for example when the capsule is not very thick. Capsule removal might also make mammography easier to interpret over your lifetime.

A debatable item here.

Orange Plastic Surgeon

Either way is OK for removing implants

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I personally like to remove the capsule (capsulectomy) at the same time. The capsule will not go away by itself. On the other hand, capsulectomy is a slightly bigger operation, and will likely involve drain tubes. Still, I like the capsules out if the implants are removed.

Implant Capsule

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Dear Littleagain,

I think you may have some confusion regarding a "capsule" and a "capsular contracture".

The formation of a "capsule" is the natural response of the body to any foreign material.

Occasionally, a "capsular contracture" can develop around an implant. This is an uncommon complication of having implant surgery. It makes the implant hard and causes the implant to move up on the chest.

A "capsular contracture" can cause pain and asymmetry of the implants.

The fact that you have had no problems with your implants indicates that you are not suffering from a "capsular contracture".

Several large studies have confirmed the safety of silicone breast implants.

Most surgeons would likely not remove the "capsule" at the time of implant removal since the capsule will generally go away by itself once the implants are no longer in the body. However, it is likely that you will have drains placed in the space where the implants were located to prevent the accumulation of fluid during the healing process.

Good luck with your procedure.

A. Peter Salas, MD
Manhattan Plastic Surgeon


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If the scar capsule is thin, it may be left in place.  If it is removed, it will help obliterate the space that was created by the implants, however.  It will not be absorbed.

Capsule & Removal

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                  If you’re not comfortable with your breast implants after two years, it’s probably not unreasonable to remove them.  When this situation arises, each patient should be considered individually.  In the vast majority of cases, it’s not necessary to remove the capsule that surrounds the breast implant at the time of explantation. 

                  When thin capsules are left behind, 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 patients have ruptured silicone implants, calcified capsules or thickened capsules with breast distortion, capsulectomies are usually indicated.  Under these circumstances, failure to remove the capsule will result in a persistent breast deformity.

Breast scar capsule after explantation of breast prostheses.

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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).  

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 implant removal

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If your implants were soft and all you want is to have them removed, then all you need done is to remove the implant itself. The capsule will not be a problem.


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Dear Little,

If you haven't incorporated your implants into your body self image by two years, it is not likely to happen.  You may proceed with removal and the capsules may remain in place.  Good luck!

Okay to just remove the implant

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With older generation gel implants, produced prior to 1999 there was a problem with silicone gel bleed. That is gel could leak through an intact bag. If this occurs then it would be recommended to have the capsule removed otherwise a simple removal of the implant is all that is needed. In many circumstances the insertion of a drain may be required. Usually ths procedure can be performed under local anesthesia depending upon the location of the original incision.

At least part of scar capsule should be removed

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Part or most of the capsule should be removed, otherwise a long-term fluid collection can occur. This is not very invasive and a partial capsulectomy (removal) takes about 15 minutes for each breast. This, combined ith drain placement, will minimize fluid collection and assure the pocket collapses down, long term.

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.