Textured Breast Implant Removal - Should I consider a capsulectomy?

Based on out current knowledge about ALCL, tumor that may develop around or in the capsule of textured breast implant, it is recommended to remove as much of breast implant capsule as possible. In other words, total or partial capsulectomy should be performed with removal of textured implants. Hope this helps. Good luck/.

Hello @gabbyfloyd, thank you for your question. thank you for your question. Yes, it is essential that the capsule be removed along with the implants. A complete capsulectomy must be performed. There is no resorption of the capsule by the body. In this way, the mammary tissue can recover more quickly and avoid an inflammatory response from the body in the future. Additionally, each capsule would require a preventive biopsy. It is essential that you consult with a plastic surgeon who has experience with this procedure if you are considering breast implant removal to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

I would recommend a complete capsulectomy (en bloc) along with your breast implant removal for several reasons. Having a risk of breast implant associated lymphoma with textured breast implants, I feel it best to not only remove the implants, but remove of the entire capsules as well. Furthermore, leaving the capsules in place could potentially lead to pain or discomfort if the capsules are hard and calcified. Subglandular textured implants have an increased risk of capsular contracture with subsequent development of hard, calcified capsules. Although more invasive than simple removal of breast implants alone, simultaneous capsulectomy has a low rate of complications in my practice, and even fewer, when the implants are subglandular/placed above the muscle. Best of luck!

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

Explant surgery mandates removal of all capsule—that is the entire operation in itself, plus the removal of not only the capsule, but all inflamed tissue, along with the implant. If any of the capsule is left behind, that is considered incomplete surgery. We can tell this from not only the many pathology reports that show silica within the capsules, but also the many patients who have had residual silicone capsules removed, an ultimate improvement in their health. This is not an easy operation, and not everyone can do it. I would absolutely not recommend removal of implant only, the capsule must ABSOLUTELY be removed. You do not want to have to go back for a second surgery just to remove the residual capsules.

If you do have a thick capsule and are suffering from capsular contracture, it may be advisable to do a partial capsulectomy, as long as the anterior breast skin flap is not compromised in the process.

Dear gabbyfloyd,
it is hard to tell for sure without an examination. If you have thick capsules, it should be removed together with implants. 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

If you are removing the implants because of pain, I would suggest removing as much of the capsule as possible since it might be contributing to your pain.

In my opinion a capsulectomy, partial or total, should always be performed when removing implants especially if being done for reasons other than aesthetics. In your case I would also recommend a capsulectomy because of the textured implants. You should call your surgeon and voice your concerns about this issues. A little extra time and cost may be better for you in the long run.

I encourage you to discuss this matter with your surgeon to learn more about the procedure and have the opportunity to ask questions. If you are having issues with the implants it may be advisable to remove the capsules as well. Further discussion is needed to provide a personalized recommendation.