One of my implants never formed a capsule, how rare is this & could it form completely now?

Thanks for your question. All breast implants will form a capsule as this is what happens when any foreign material (in this case the breast implant) is inserted into your body. If your wounds have now healed and you still have your implant, then yes a capsule will form around it. The incision opening up would not be due to the lack of capsule formation, but for another reason such as poor quality soft tissues, infection, or implant dimensions. Best of luck with your ongoing care.

Dear Bright905055,
you probably mean soft tissue pocket that is created to hold the implant. Sometimes if the soft tissue is poor or implant is too big, it can cause this kind of problem. You should follow your surgeon's instructions.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

I am guessing that you are very thin? Sometimes when you are very thin, there is very little subcutaneous tissue between the skin and the implant. Sometimes this subcutaneous layer composed of mainly fat, thins out causing the implant to sit against skin directly. Wound opening tends to form thick scar so hopefully once closed the scar in this area will thickenBest

It is possible that the capsule was never able to fully form. If the implant was exposed due to the incision opening it could be contaminated. Keep a close eye for signs and symptoms of infection. If you have thin skin or large implants you may benefit from placement of mesh to give support to the tissues.

This is not rare since it can take several months to a year for the capsule to form completely around the implant. If the capsule forms early and quickly, this is usually trouble and becomes too thick. A capsule will form around foreign objects in the body. If your implant was large and heavy and/or you have very little breast tissue, the implant will thin out what lower tissue is present and can erode through and open the incision. Again, this is not rare and mostly is seen in small breasted women who choose implants too large for their tissue.

This problem of an extruding implant is usually because of an indolent infection. An alternative also is a use of peri- prosthetic steroids, which is rarely done now. That was used in the past, but led to thinning of the lower pole.

It is possible that your surgeon was able to salvage your implant, but it is also likely that you will thin again and lose the implant for a time.

After a month or so, without an implant, it can be replaced.

Some people don’t form a significant capsule around the implants. We generally prefer to see the least amount of scar tissue formation possible so not having a thick capsule is the ideal outcome.
During breast, augmentation, surgery envelope should not be supporting the weight of the implant.
This should ideally be done by pectoralis muscle fibers.
If your implant was exposed, then it may be contaminated.
Continue following up with your plastic surgeon or consider scheduling in person a second opinion consultations.
Dehiscence of your wound with exposure of your implant (if that happened) is not due to failure of capsule formation.
Your situation sounds complex and is perhaps beyond what is appropriate to get advice for by posting on this website.Best,
Mats Hagstrom, MD