Should the Capsule Be Removed During Breast Implant Removal?

The capsule is your body's response to your implants. It 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. Research has shown that the capsule does not disappear on its own when only the implant has been removed (See Nancy Hardt's paper in Plastic and Reconstructive Surgery.) In addition, if you have pain around the implants, it is usually due to the pulling effect of the scar 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.  Linked is my en bloc video.

The surgeon should decide how much of the capsule should be removed at the time of the surgery depending on the character of the internal scar.

There are situations when the capsules should be removed. These include instances where there are capsular contractures, calcifications or distortion of the breasts due to the capsules. In addition, if a patient has ruptured gel implants, then the capsules should probably be removed. However, if the breasts are soft, and the implants are intact and free of the above problems (capsular contractures, calcifications), then the capsules can generally be left in place. 

Hi, if the patient is experiencing firm capsular contracture, there are generally two ways to make the breasts soft. Capsulotomy refers to incisions within the scar tissue that release the capsule allowing more room for the implant. Capsulectomy is a more involved operation that removes all or most of the scar tissue creating a “new, fresh pocket” for the breast implant.
The specific procedure to be performed will depend on the complications experienced and the condition of the implants. I advise the best course of action based on each patient’s individual circumstances. Contact your surgeon for more in depth information about your case. #RealSelf100

Thank you for submitting your question.  I will remove the capsule if it is thickened and/or calcified from a capsular contracture or silicone rupture. Consult with a Board certified Plastic Surgeon.  Best wishes.