My implants are making me ill. Do I need the capsule removed?

Question

I had implants Dec 2021 they are making me ill do i need the capsule removed or just have the implants removed? there is a big price difference

Shaher W. Khan, MD · Answer

Hello, thank you for your question. I'm really sorry to hear that your implants are making you feel ill. If you're experiencing symptoms that you believe are related to your implants, it’s important to address the issue promptly. Please see the attached video to address your concerns. If you are feeling ill and believe that both the implant and the capsule may be causing these symptoms, it is generally recommended to remove both the implants and capsules (full capsulectomy) to ensure the best possible outcome. While this may be more expensive, it might help resolve your symptoms more effectively. If cost is a concern, discussing your options with your surgeon and getting a second opinion will be crucial in making the best decision for your health and recovery.

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

Tommaso Addona, MD · Answer

Thank you for your question.
Capsules are a layer of scar tissue surrounding the breast implant, it will not be absorbed by the body over time. If the implants are causing you to be ill, it would be in your best interest to remove the capsule as well in my opinion. I recommend speaking with a board certified plastic surgeon to discuss your options.

Daniel Barrett, MD · Answer

Dear LiseyPoos88,
it is hard to tell for sure without an examination.If your capsules are thick and cause issues, then they can be removed. 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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Irena Karanetz, MD · Answer

Hello, 
And thank you for the question and the photos.
Following removal of breast implants without replacement, a patient may choose one of two options: do nothing and see how much the skin retracts and then decide about fat grafting or breast lift at a later point, or undergo a breast lift and fat grafting at the same time. 
If you are planning to remove your breast implants for any reasons, as long as the breast capsules are soft without any issues or evidence of capsular contracture, it is safe to just remove the implants without performing capsulectomy.
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast surgeries to further discuss your options, specific techniques, concerns and expectations. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. 
I hope this helps.
Best, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Alan Gonzalez, MD, FACS · Answer

Hello @LiseyPoos88, thank you for your question. Yes is imperative that when you remove the implants that you remove the capsule as well. Complete capsulectomy. The capsule does not get reabsorbed by the body. Also it would be necessary to carry out a preventive biopsy on each capsule. This way the mammary tissue can recuperate better and avoid a future inflammatory response from the bbody.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.

Erik Hoy, MD · Answer

The recommended treatment for BII is removal of the implant, and removal of the surrounding scar capsule/preserving any natural/normal tissue of the breast. While some patients may find relief with implant removal alone, it is thought that it is the interplay between the body's tissues and the device that is ultimately responsible. Sending the scar capsule for pathology exam, microbiology cultures, etc., may provide additional information to the patient and surgeon.   If patients have not already, it is recommended that they be evaluated by a rheumatologist, because they can help rule out other causes, but also because some insurers require this prior to covering surgical treatment of breast implant illness.
Best wishes, 
-Dr Hoy

Connie Hiers, MD, FACS · Answer

You are very vague about your question, but removing the capsules with the implants might be your best choice if for certain the implants are the cause of your illness.  You do need to be checked for food allergies and avoid toxins in dyes for tattoos and hair dyes and many cosmetics.

Peter Andolina, DO · Answer

If you believe that your implants are making you ill then I would recommend removing the implants. In regards to the capsule, removing it is going to depend on how developed it is. Everyone's body reacts to the implants differently and people form capsules differently. If your capsules are very thick I would think they would need to be removed. The price difference is going to depend on your surgeon. Typically a capsulectomy does increase the price.

Camille Cash, MD · Answer

If you suspect you are having Breast Implant Illness then often the capsules are removed along with the implants.  In general if you elect to remove implants and are not having issues with the implants or the capsules then it is an option to remove the implants along with the capsules, or leave the capsules behind. I've included a video I hope you find helpful.