During explant, is scoring, rubbing or partial capsule removal required if capsule is thin?

removing saline implants without replacement within 6 months of getting them , plan to leave capsule in (feel soft and not stiff). Am thin and couldn't fill an A cup prior to augmentation. Would it be a good idea to rub, score or do a partial removal of the capsule or is it best to leave it as is?

Doctor Answers 8

Removing the capsule with implant removal

There is no medical or even cosmetic reason to remove the capsule surrounding an implant unless it is abnormal or distorting. To do so increases the time of the surgery, the cost, and the risks. Also removing a scar tissue layer results in a new one forming even though it isn't circular and called a capsule without the implant present. 

Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

Dealing with the capsule when implants are removed

Thank you for asking about your breast implant removal.

  • This is a matter of discussion for you and your surgeon.
  • Some surgeons always remove the capsule, some never and some use their judgement.
  • For me, if the capsule is thin and soft - I leave it in place.
  • I may lightly score it to encourage it to seal to itself.
  • If you have a thick capsule, it should be removed, in my opinion as it is clearly abnormal.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

During explant, is scoring, rubbing or partial capsule removal required if capsule is thin?

Thank you for your question.  If the capsule is thin then the capsule can be scored, partially removed or left alone.  Drains and/or sutures can be used to close the pocket.  Consult with a board certified plastic surgeon. Best Wishes

Jeff Angobaldo, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 81 reviews

Breast implant removal

Since you are not experiencing any complications with your implants or the capsules, it is fine to leave the capsules alone when the implants are removed.  Drains may be placed during the procedure to collect any fluid that may be in the pocket, but they are usually removed within a week.

Camille Cash, MD
Houston Plastic Surgeon
4.8 out of 5 stars 31 reviews

Implant removal

After removal of an implant, or ex-plantation, it is necessary to remove, or score the capsule if it is thin and pliable.  In some cases, complete capsular excision is required.  Factors that may contribute to the need for more extensive capsular excision include the thickness or hardness of the capsule, the length of time the implant has been in.  At the time of surgery the extent of casulectomy is often determined.

Steven H. Wiener, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 reviews

During explant, is scoring, rubbing or partial capsule removal required if capsule is thin?

Simple removal of your breast implants do not require manipulation of the capsules. It is OK to leave it as is if the capsules are thin and normal. Thank you for sharing your question. Best wishes. Dr. Gregory Park, San Diego Plastic Surgeon.

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 164 reviews

Implant removal

Thank you for your question. There is no reason to do anything with the capsule as long as it's not thick. However the pocket needs to be closed or collapsed using a drain so there isn't fluid build up in the empty space after removal of implants. 

Payman Danielpour, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 35 reviews

During explant, is scoring, rubbing or partial capsule removal required if capsule is thin?

I think that you are correct in that removal of breast implant capsules is not necessary in your case.  Exactly what maneuvers are done during surgery will vary from one practice to another; your chosen plastic surgery will likely have his/her own thoughts for you.

 In my practice, for patients in your situation, I generally remove a small segment of capsule with the hopes that this will allow for better fluid absorption and decrease chances of fluid buildup. I also use drains.

 Best wishes for an outcome that you will be very pleased with.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,448 reviews

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.