Explant Allergan silicone textured implants 7yr old overs , think I have symptoms of BII capsulectomy necessary or not?

I do not perform capsulectomies unless there is indication, which is usually decided at surgery.  However, sometimes pre-operatively calcified capsules can be detected and will need removal.  I do caution you about not doing a lift.  After explantation, many women are dissatisfied with the empty looking breasts and sagging skin envelope.  Often times, they require a 2nd operation for a lift.  It would be better getting them done at the same time.  The technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained, if not injured during your previous surgery.  At the same time or later, fat transfers can be performed if additional volume is desired.  Best Wishes,Gary Horndeski, M.D.

It is recommended, in a setting where there is concern for/suspicion of ALCL, that the capsule be removed. However, asymptomatic patients neither need their implants removed nor the capsule excised.
With regards to your specific question, Breast Implant Illness and silicone related medical complications/autoimmune disease are controversial topics. It is a phenomenon which is supported by a wealth of anecdotal data (patient testimony on the internet) but no empiric data (hard scientific research). Patients reports a litany of symptoms which they attribute to their implants but the connection is difficult if not impossible to prove via objective evidence (lab tests etc).
Physician scientists may recognize anecdotal data but unless it is supported by Class I empiric data, it is difficult to place a great deal of faith in it. Clinicians should make decisions based upon evidence based medicine as this is the best tool we have to evaluate new and emerging treatments and technologies. Any claim can be made about anything, but unless verified it is difficult to put too great a degree of stock in it. 
That being said, it is easier to identify what one knows rather than what one doesn't. What we do know is that by all available measures today...implants are safe and specifically silicone implants are safe.
Silicone breast implants are among the safest medical devices in use today. These devices are also among the most rigorously studied and tested medical devices currently being used in the U.S. today. It is biologically inert and in that respect no different than the titanium used for bony fixation. There has been no demonstrated link between silicone and the commonly cited myth of autoimmune disease.
BII is not (as of yet) been recognized as an actual phenomenon with a discernible link to silicone implants. As such, there is no recommendations regarding capsulectomy in this setting.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
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