I Am Having an Explant, Capsulectomy, and Lift Soon. Should Things Be Sent to a Pathologist?

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

Typically, if there are no other signs/symptoms/concerns, it is not typical to send the tissue for pathology.  Certainly if anything found abnormal during the procedure, it may be sent.  If you desire this be done regardless, discuss with your surgeon who can give you a pathology cost, which will likely be $200-1000.  Best wishes!

Unless there is a suspicion or suspicious tissue the breast implant/capsule does not necessarily have to be sent to pathology.  Discuss this with your doctor.

unless there is a family history or personal history of malignancy there is no need for this. if you are requesting this then paying the fee is also appropriate.

Thank you for the question.

Generally speaking, unless there is an abnormality on imaging studies and/or found during the surgical procedure, I do not routinely send breast implants, capsules, or tissue to pathology for evaluation. If you choose to have this performed, patholgy costs may vary from one institution to another ( probably ranging from $500-$1000).

 Best wishes with your upcoming procedures.

It is quite unlikely that anything will come out from the path report that is of any use, and the cost is about $500. Unless there is some abnormality on a mammogram or MRI, I generally do not send capsule tissue to the lab. 

Thanks, and best wishes.

The only reason to send an implant, capsule, or tissue to pathology and incur a charge is if there is something abnormal or unexpected and a diagnosis is needed. 

I would add that although there is a difference of opinion on this, there is no good reason to remove a normal capsule when removing an implant and it adds cost, time, and risk to the procedure. There is also no reason a lift must be done when an implant is removed. Implants do not lift breasts and removing them does not make them actually sag. There is only the illusion of lift or sag. Whether a patient would benefit from a lift has to do with where the nipple sits in relation to the inframammary crease behind it. 

There are certainly exceptions, but the simplest and least costly procedure is to remove the implant alone under local anesthesia or IV sedation/local anesthesia.