I am removing my Allergan Biocell textured implants, should I remove my capsules as well?

Question

I have placed the Allergan Biocell textured implants in 2009 and I want to remove them. I have had an MRI and 2 ultrasounds done and both results were perfectly fine. I do not feel sick or have any BII symptoms. I am comfortable with keeping the capsules but the “internet” tells me otherwise.

Shaher W. Khan, MD · Answer

Hello, thank you for your question. It is understandable that you are seeking advice about your Allergan Biocell textured implants and whether you should remove the surrounding capsules. There is a lot of conflicting information online, and it's important to make decisions based on both medical guidance and personal preferences. I have attached a video that answers your question specifically. If you are concerned about BIA-ALCL risk or want to reduce the potential for future complications, capsule removal may be a good option to discuss with your surgeon. Ultimately, the decision to remove the capsules is highly individual and depends on your preferences, risk factors, and the advice of your surgical team.

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Daniel Barrett, MD · Answer

Dear tshbib,
it is hard to tell for sure without an examination. Generally speaking, it is possible to remove implants alone and leave capsules in case you don't have capsular contracture or thick capsules. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Alan Gonzalez, MD, FACS · Answer

Hello @tshbib, thank you for your question. I believe that every time an explant is performed, the capsule must be removed. Complete capsulectomy. Whether it is en bloc does not matter as long as the whole capsule is removed and the tissue is sent for pathology after taking the capsule out. This will prevent future inflammatory responses from the body because capsules do not get reabsorbed. A capsule will always form around a prosthesis because it surrounds it and isolates it, since the prosthesis is a foreign tissue. To shed more light, I share a video.  If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS.   American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS), Colombian Society of Plastic Surgery member (SCCP).

Randal Haworth, MD, FACS · Answer

While some people may opt to keep the capsules during implant removal, others may choose to have a complete capsulectomy (removal of the capsules) due to concerns about potential long-term effects. There is ongoing research on breast implant-associated illnesses, but currently, the scientific community is still learning about the risks and possible links to textured implants.

Best of luck !

Best of luck !

Connie Hiers, MD, FACS · Answer

Yes, I would recommend removing the capsules to mainly to decrease the risk of a seroma, or fluid, forming in the capsular space, or I would suggest removing the anterior component at least.  You can discuss this with your surgeon. The seroma is a higher risk with the capsules left in place.

Camille Cash, MD · Answer

If your implants are ruptured, the capsules thickened or causing issues it is recommended to remove the capsules along with the implants.  If they are thin and not causing issues then it is an option to leave them in or have them removed.  I encourage you to discuss your concerns with your board certified plastic surgeon who can help you decide what is recommended in your case.

I am removing my Allergan Biocell textured implants, should I remove my capsules as well?

Answers (7)

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