Is capsule removal required for breast implant removal if wanting fat transfer later on?

Capsule removal is not required whether you want fat transfers or not. The indications for capsule removal is infection or calcification and is determined at the time of surgery.

Best Wishes,

Gary Horndeski, M.D.

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hello @Original466058 thank you for your question. It is always necessary to adequately remove the capsule and reconstruct the tissue. In my opinion the fat transfer or fat implant should be given in a later process with a prudent time of 2 to 3 months to ensure the fixation of this to the tissues and minimize the possibility of infection. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD FACS

Dear Original466058,
it is hard to tell for sure without an examination. Generally speaking, it is possible to remove only implants if the capsules are thin. If you are considering surgery, I would suggest you 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

Hello,
And thank you for the question.
Following removal of breast implants also known as explant surgery, one option is to leave breast capsule (scar tissue) behind, especially if it appears soft without any issues or evidence of capsular contracture. Another option is to remove the capsule (partially or fully) knows as capsulectomy.
Sometimes, the scar tissue/capsule can be very adherent to the muscle and chest wall, and removing it may case more damage to the nearby structures. In those cases, the capsule remains in place.
Fat grafting can typically be performed at a later point even after partial or full capsulectomy.
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast Explant surgeries to further discuss your options, specific techniques, concerns and expectations.
I hope this helps.
Best, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

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. The breast implant removal and breast fat grafting can be completed during the same surgery. Some of the success will depend upon existing tissue available for receiving the fat. Fat grafting will likely take several sessions to produce a similar result. I usually perform the explant first. Fat grafting I typically perform about 3 months later. This gives the patient and the PS time to assess the chance of the breast returning to the preoperative state.

The need for capsule removal during breast implant removal in preparation for a future fat transfer procedure can depend on various factors, including the condition of the existing implant capsules, the surgeon's assessment, and the individual patient's goals.
Capsules are the scar tissue that naturally forms around breast implants as part of the body's response to a foreign object. When breast implant removal is planned, the surgeon may decide whether to remove the capsules as well. This decision can be influenced by factors such as:
1.) Capsular Contracture: If the capsules have become thickened or contracted, leading to discomfort or distortion of the breast shape, it's more likely that the surgeon will recommend removing the capsules along with the implants.
2.) Aesthetics: The appearance of the breasts after implant removal might be a consideration. If the capsules are causing deformities or irregularities, their removal might be recommended to achieve better results.
3.) Future Fat Transfer: If you plan to have a fat transfer procedure after implant removal, the surgeon may have specific recommendations based on their assessment of the existing capsules and your individual circumstances. Sometimes, leaving a thin layer of capsule tissue in place can help support the transfer of fat and improve its survival in the breast tissue.
It's important to consult with a board-certified plastic surgeon who specializes in breast surgery and fat transfer procedures. They can evaluate your situation, discuss your goals, and provide personalized recommendations based on your medical history, physical examination, and desired outcomes.
Remember that medical advice should come from a qualified healthcare professional who can assess your specific situation. It's always a good idea to have a thorough consultation with a skilled surgeon before making any decisions about implant removal, capsule removal, or fat transfer.

If your capsules are thickened or have been causing issues it is recommended that they are removed. If they are thin, it is an option to remove them or leave them behind. If you had your implants deflated they were saline. Saline implants are comprised of silicone shells that are filled with sterile saline solution. Once deflated only the silicone shells need to be removed.

First, if you implants were deflated, you had saline and not silicone implants. If your capsules are thin, then can be left in place or just removed the anterior portion. Drains may be needed. The fat is placed inside breast tissue and not into the capsule or the space of the implant.