I'm looking to get my breast implants removed due to BII. Do I need a total capsulectomy or is it ok to leave it in? (Photo)

Good afternoon!
If you think you have BII, then yes absolutely you need to have an en bloc capsulectomy/explant. If you are just done with implants and want them removed and your capsule is otherwise soft and normal then you do not need a capsulectomy. Big difference. I also do not think you need a lift!

From your photographs, you appear to be quite thin and there is some rippling from implants. If your capsules are removed then some of the normal breast tissue is removed as well and your breasts may be distorted, may lose nipple sensation or may even have skin necrosis. Unless there is indication such as infection or calcification I would not recommend removing the capsules. Also, you will need a lift after removing the implants otherwise you will be dissatisfied with the hanging skin and empty appearance. Depending on how the implants were placed, you may benefit from a mini lift or a lift using The Bellesoma Method. I would not recommend doing this under local anesthesia as it would be inadequate to both explant and lift simultaneously.

Best Wishes,

Gary Horndeski, M.D.

BII is poorly understood and there is no data to suggest that a radical en bloc resection is necessary. Simple implant removal and capsulectomy (partial or complete) should be adequate. Capsulectomy does not have to be performed in the instance of thin, pliable capsules. Leaving a capsule behind is preferred if it is thin and pliable. If there are calcific components, or silicone granulomatous material, or if the capsule is deforming the breast tissue, then removal of the capsule may be warranted. A number of scientific studies have demonstrated the safety of silicone implants; yet, many patients continue to have anxiety about their use.

Thank you for sharing your question and photographs. Because of the breadth of symptoms associated with BII a thorough discussion will need to be had in order to offer the best explant advice. In most cases explant and total capsulectomy “en bloc” will be needed and under general anesthesia. If you simply want your implants out, then this can be done under local anesthesia in your surgeon’s office, without a capsulectomy. Hope this helps.

Thank you for your question and posting appropriate pictures. I am sorry you’re having issues with your implants. Unfortunately, breast implant illness is very undefined and a lot of unknown elements. Having said that especially with your concerns of anesthesia, I would recommend removing your implants under local anesthesia with internal suturing for a lift leaving the capsules behind. If your symptoms are not resolved, total capsulectomy which is a bigger procedure will need to be done under general anesthesia. Best to have a virtual consultation to discuss options.

Dear Mandie95082,
If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

If you have BII it is best to have the implants and capsules removed en bloc. If you were not having issues and the capsules were thin, then it would be your option whether to have them removed with the implants or left behind. If you are trying to avoid a lift you can have the implants removed and allow the breasts to fully heal. The skin will retract to some degree. If you are happy with the result then you have avoided the lift. If you are unhappy with the appearance of your breasts you can return for a lift at your convenience.

If you truly think you have BII, not an actual diagnosis, you will want to remove the capsules. This is best done under general anesthesia. If you just want the implants out for other reasons, then they can removed in the office under local anesthesia.