Implant removal - total capsule or partial removal? What are the cons of total capsule removal?

Hello @BAquestions23, thank you for your question. Taking into account that you are experiencing BII symptoms there is no cons, because the capsules can cause future inflammatory processes if it's they are left in the body. From hundreds of breast implant removal I have performed I can attest that the capsules do not get reabsorbe by the body. To shed more light on this, I have included a video. . Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Hello, thank you for your question. I'm really sorry to hear that you’re experiencing symptoms of Breast Implant Illness (BII) and that it’s affecting your physical and mental health. Your desire to have implant removal with total capsule removal (capsulectomy) is completely understandable, especially if you're seeking a one-surgery solution to address the health issues you're experiencing. It's important that you feel heard, and that your concerns are taken seriously by the medical professionals you work with. Please see the attached video that discusses your question. While BII is not universally recognized by all surgeons or healthcare providers, many women report symptoms that they believe are linked to their breast implants. These symptoms can range from chronic fatigue, joint pain, brain fog, skin rashes, and other autoimmune-like symptoms, to more severe systemic responses. There is still a lack of consensus on the exact cause of BII, but many believe it may be related to the body’s response to the foreign materials of the implants or the capsule that forms around them.
Given that you were in peak physical condition before the surgery and now feel like your physical and mental health has declined, it's very valid for you to be considering implant removal as a step toward improving your overall health. If you've ruled out other medical causes for your symptoms and feel strongly that the implants are contributing to your health issues, total capsule removal may be your best option.Given your health concerns and desire to improve your physical and mental well-being, total capsule removal seems like the most appropriate choice for you. It addresses both the physical removal of the implant and the potential inflammatory effects of the capsule, which might be contributing to your autoimmune symptoms. While the surgery is more complex than a simple explant, it is your best option if you want to ensure a complete and lasting resolution to your concerns.
Make sure you consult with a surgeon who is experienced in these procedures and willing to address your concerns fully, as they will guide you through the process and help you make the best decision for your health and goals.

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

Dear BAquestions23. Current data don't show an increased benefit of symptom improvement when dealing with Breast Implant Illness. However, a capsulectomy can harbor increased surgical time bleeding risk, especially in submuscular implants, thoracic injury, or lung injury.

Dear BAquestions23,
it is hard to tell for sure without an examination. 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

We do not have all the answers to the BII problem. However, removing the whole capsule can sometimes damage the posterior wall of your breast which is the anterior wall to your heart and lung. In which case, it is much much safer to leave a small amount of capsule than risk damage to your chest cavity. Also, there is more risk of bleeding, numbness, and a much longer surgery to try and remove the capsule. With longer surgery, the risk of infection increases. Even removing the implants and all the capsules, not all women get better. Those, especially, with tattoos often don't get better since harmful minerals are present in the ink.

If you are experiencing what you feel is BII issues, then I would opt for the total capsulectomy at the time of the explantation. If you leave the capsule in place experience no resolution of your symptoms post operatively, you will always question leaving the capsule in place. Removing the capsule at the time of the explantation (removal of the implants) is much easier than searching for it sometime later.

I'm sorry to hear of the issues you are experiencing. It is recommended that the capsule be removed with the implant if it is thickened, there is a rupture, or it is causing issues. As you are requesting cons of a total capsulectomy, the removal of a thin capsule has the potential to be more traumatic to the surrounding tissues depending on each situation.

Total capsulectomy is indicated if the capsule is calcified or thickned .
Attempted total removal of a thin capsule ,especially if submuscular can lead to excessive bleeding and trauma to the rib cage