Explant surgeons advice needed please. 17 years of 270cc subglandular and 5 months submuscular, no capsulectomy.

My PS is kind and I trust him.He won't remove capsules as only 5 months in.I have capsules remaining on old sub-glandular pockets that were not removed from revision. PS's in Uk reluctant to remove them given my lack of native breast tissue. I have recurrent yeast infections;are there tests could be swabbed during my explant? My submuscular implants are very uncomfortable, one side feels like the pocket is too tight. What can be done to repair the muscle (PS says it repairs itself to a degree)?

Doctor Answers 3

Explantation with capsulectomy

For explant surgery, it is almost always best to remove the capsule in its entirety.  This will allow the space to heal.  If you leave the capsule in place, it does not heal.  Fluid can accumulate in the space.  The situation that brings the patient to implant removal will have an affect on the decision.  This is a surgery which requires discussion with the plastic surgeon about the problem, the goals, and the technical concerns.  The body does not re-absorb the capsule.  Revision surgery requires drains because the fluid is going to be generated when you operate on the scar capsule.  If you provide a mechanism for the fluid to be removed (i.e. drains), the risks are lower.  If the fluid accumulates because there were no drains, it will most certainly cause problems in the future.


Total capsulectomy of the subganlular capsules is needed for you to regain your health, along with immune support, antifungals, and detoxification.  Your plastic surgeon does not understand the biology of biofilms and the issues due to silicone in the capsules.  If the submuscular capsules are left in, you have an increased risk of complications per the plastic surgery peer reivewed literature.  I have much information on the internet re this and have done 2500 explantations so I understand your problem.  The yeast is not in the capsules in most cases.

Susan Kolb, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 22 reviews


Explant without capsule removal is often useful in pstients with minimal amounts of breast volume. Best of luck 

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 40 reviews

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