I Have Been Told That an Explantation with Capsulectomy Could Cause More Tissue Loss?

I am due to have silicone implants removed in one week.They are 250cc and been in for 7 years. I am 47yrs old or young!! I have developed a capsular contracture on one side and think this is a grade 2-3. I have also had breast cysts which became infected 5 months ago. I also have some autoimmune symptoms. For these reasons i asked surgeon if he would perform capsulectomies but he said this would make me lose more of my own tissue and i dont have a lot! Is this tissue loss inevitable. Help asap?!

Doctor Answers 5

Breast Implant Removal and Capsulectomy?

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Thank you for the question.

Generally speaking, unless the breast implant capsules have thickened and/or are otherwise symptomatic, there is no indication to have them removed. On the contrary, capsulectomy  can expose you to additional risks, such as bleeding and minimal size loss. 

Sometimes patients request removal of the breast implant capsules ( if they feel that this should be done in an effort to improve “autoimmune symptoms”);  in these cases I usually do remove the capsule  for them.

Best wishes.

Explantation and capsulectomy

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One of the most common problems with #cosmeticsurgery is #breast #capsularcontracture or the development of thickening, and contracture of the capsule that exists around the breast implants. Severe capsule contracture probably occurs in less than 15% of augmentation patients. Every woman has a breast capsule around their #implant and this is a normal phenomenon. The capsule itself could be as thin as Saran Wrap but may also become calcified and thickened. As it thickens and shrinks, the patient may develop a feeling a firmness of the breasts and in its worst situation, the breast may become painful and abnormal in appearance, achieving a very round, hard, and uneven appearance. There may be distortion and possible breakage and leakage of an older implant, but may also include a newer implant. Nicotine users, such as smokers, have up to a 30x increased risk of capsular contracture.
#Salineimplants may deflate spontaneously. When the patient has significant symptoms, complete or partial leakage of their saline implant, or concerns regarding silicone leakage, it is recommended that the implant is removed and exchanged. Frequently, this is performed on both sides depending upon the age of the implant. #Capsulotomy or opening of the capsule may be required or frequently #capsulectomy, which is removal of the scarred capsule, is recommended to ensure adequate pocket dimensions.
New implants may then be placed in the same existing position or may undergo a change of placement frequently from submammary to subpectoral position and, on occasion, the other way around.

Explantation is the term that has been given to describe the removal of the breast implant.
What does explantation involve? Two choices exist for explantation:
1. Implant removal while leaving the capsule. This is a simple procedure and requires local
anesthesia, IV sedation, or (uncommonly) general anesthesia. It is relatively inexpensive. Microscopic amounts of gel may remain in the capsule.
2. Capsulectomy: This will enable the surgeon to remove as much silicone as reasonable without creating significant deformity. This operation may require a larger incision. The surgery and recovery time will be longer. General anesthesia is usually necessary and subsequently all of the costs associated with this operation will be higher.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Removal of Breast Implants

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Having the breast capsule removed will cause little to no difference in breast size after surgery.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Capsule removal

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The capsule removal can cause a slight reduction in the amount of tissue you have left after surgery but it is usually not too significant.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast implant removal

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Breat implants can cause presure on the breast tissue. After 7 years of having breast implants, the breast has aged and changed over the 7 yeras. Removal of breast implants without replacement should do a total capulectomy, this will require a longer incision, and can remove the implant and the capsule with minimal loss of fat. Using the Harmonic scalpelwill make the reoval of the capsule with minimal loss of faty tissue from the breast. But can not reverse the aging process without a lift  and a smaller breast.

Samir Shureih, MD
Baltimore Plastic Surgeon

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.