Is there evidence that proves the capsules will be "reabsorbed" into the body after breast implant removal? (Photo)

Question

I ask because there are some contradicting answers here on realself as well as with surgeons in my area. I myself and hoping to have the capsule removed with my explant surgery.

Lu-Jean Feng, MD · Answer

The capsule does not get absorbed by the body. In fact, Nancy Hardt's research in Plastic and Reconstructive actually disproves this theory. The capsule (scar tissue) is your body's response to your implants and begins to develop very early on after augmentation. The capsule may contain silicone gel, silicone shell fragments, bacteria, calcification, and inflammatory cells which have been mobilized by your immune system to react to different components of the implant.
In addition, if you have pain around the implants, it is usually due to the pulling effect of the scar tissue on surrounding muscle and tissue. If you have health problems that could be from the presence of the implants, removal of the capsule is critical in improving your health.

Richard Baxter, MD · Answer

The capsule is the layer of scar-like tissue that forms around an implant - any type of implant anywhere in the body. Like scar, a capsule will not re-absorb into the body but can change over time. This is called scar remodeling. The question of whether to remove the entire capsule depends on individual circumstances, because it it not a trivial procedure.

York Jay Yates, MD · Answer

The capsule is not resorbed after implants are removed.   I have been back in years after implant removal and there is still often a plane of smooth scar tissue representing the old capsule.  In general, there is nothing inherently wrong with having a capsule as it is just scar tissue created by the body but there are differing opinions on this.   The risk of hematoma is higher with removing the capsule but the risk of seroma is higher with leaving it.  There are indications to remove the capsule and I would consider one of those indications to be if the patient prefers to have it removed so long as it can be done safely.

Kouros Azar, MD · Answer

No, as far as I know, there is no evidence that the capsule is reabsorbed after the implant is removed. Hope this helps and best of luck.

Tom J. Pousti, MD · Answer

No, there is no evidence that capsules will be "reabsorb"; a capsule is a layer of scar tissue that will remain despite removal of the breast implants.
Generally speaking (in my opinion), unless the breast implant capsules have thickened (and/or are otherwise symptomatic), are associated with the ruptured silicone gel breast implants, or if the patient has concerns about "medical conditions" related to the breast implants, capsulectomy is not universally necessary. For these patients, en block removal of breast implants is a good procedure.
***On the contrary, capsulectomy can expose patients to additional risks, such as bleeding, size loss, contour irregularities and other serious complications. In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity). For example, attempting to remove very thin capsule densely adherent to the patient's rib cage may expose the patient to significant bleeding and/or entrance into the thoracic cavity.
Recently I have become more aware of the fact that there are plastic surgeons who, instead of using good judgment and individualized patient care, are causing fear and unnecessary anxiety among patients. These patients them feel that complete capsulectomy is always necessary and undergo unnecessary surgery associated with additional morbidity and unnecessary expenses.
 
 The good news:  breast implant removal surgery is a very well-tolerated procedure with minimal discomfort,  compared to first-time breast augmentation surgery. Patience is definitely indicated after removal of breast implants; it will take many months for the skin to “bounce back” and for you to see the final appearance of the breasts.
I hope this, and the attached link, helps. Best wishes for uneventful surgery and an outcome that you will be very pleased with.

Steven Wallach, MD · Answer

If the capsules are hard then iti s best to remove them..  Sometimes it can be quite difficult to remove the entire capsule because of the soft tissue envelope being very thin,. or severe adherence to the chest wall.

Robert Whitfield, MD · Answer

Capsules that are long standing don't reabsorb.  This is especially true on the face of previous hematoma or seroma.  A capsulectomy is appropriate when removing implants for breast implant illness and associated symptoms.

Susan Kolb, MD - Account Suspended · Answer

Capsules are not absorbed upon implant removal.  Many plastic surgeons do not like to remove capsules as it is tedious and not well compensated.  Sometimes capsules can contract in size if they are infected.  All capsules should be removed in order to prevent future complications per the plastic surgery peer reviewed literature.

Is there evidence that proves the capsules will be "reabsorbed" into the body after breast implant removal? (Photo)

Answers (8)

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