Do I Need to Remove Capsules due to Implant Capsular Contracture?

Do I need to have all the capsules removed and both pockets sewn up? What happened if my surgeon said there is no need for this to be done? He said the capsules will shrink in time and so are the pockets. Is this true?

Doctor Answers 8

Do I need to remove capsules due to implant capsular contracture?

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Hello! Thank you for your question!  It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. If minimal contracture is seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from rutptured implant vs pain vs simple pocket adjustment, etc).  

Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you. Hope that this helps! Best wishes!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Removal of Capsule after implant removal

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Every patient is different but the majority of the time, you do not need to remove the capsule when explanting breast implants. Sometimes the capsule is very thick or the patient is experiencing problems.. and a different approach needs to be taken.  Make sure you are confident in the surgeon you choose and make sure they are a board certified plastic surgeon to get the best results.

Removal of the capsule in patients with capsular contracture

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It is usually not necessary to remove the capsule if the capsule is thin.In fact attempts at total removal of thin capsules can cause excessive trauma and bleeding

If the capsule is calcified , the calcified portion should be removed.where the implant is ruptured and the capsule totally calcified the capsule and implant can be removed intact

The treatment of capsular contracture usually involves capsulotomy ,ie release of the capsuleby making multiple incisions in the capsule without removing it and replacing the implant with a new generation low bleed cohesive implant

In some cases the implant is placed in a new pocket ,eg sub fascial

In resistant or recurrent cases an adjustable implant can be used to splint the capsule at a larger volume while a new capsule forms and then reducing the volume at a later date

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Breast Capsules-should they be removed

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If the capsules are after a ruptured implant, I either remove them or the part that may have calcium deposits or not look good. If the capsule is thin and no rupture, I usually do not remove them but do give and discuss with the patient the options.

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 28 reviews

Capsular contracture and capsule removal

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Capsular contracture does not necessitate the capsule be removed. However, frequently the capsule may be scored to break up the scar tissue capsule or a partial capsulectomy (removal) is performed. If the capsule is thickened and calcified, it should be removed. New implants can be placed again, if desired at the same time as the capsule is treated.

Todd C. Case, MD
Tucson Plastic Surgeon

Capsule removal for implant capsular contracture

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The capsule does not need to be removed in many patients. There are some special circumstances where complete/partial removal will be beneficial, such as pain from the contracture or a thin patient with a thick capsule.

Anindya Lahiri, FRCS (Plast)
Birmingham Plastic Surgeon

Capsular contracture

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I completely concur with the comments of Dr Shureih.  In brief, you do not always have to remove a capsule partially or completely, or at all.  You can change the implant pocket to a new location.  However, if you have pain related to capsular contracture, I personally believe that capsulectomy will be helpful.  If you have more questions about capsular contracture, you can refer to the following page below.

Capsular Contracture

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capsular contracture treatment depend on many factors

1: where is the implant, above or below the muscle

2: age of the implant

3: Is there implant displacement or deformity

4: the thickness of the breast tissue over the implant.

There are many options

1: capsulotomy and insertion of new implant

2: Capsulectomy, Most of the time is partial capsulectomy, then insertion of new implant.

3: change of position of implant, to submuscular or NEO SUBMUSCULAR pocket. In this case the capsule is sutured together and a new submuscular pocket is created.

4: correction of the deformity if there is any.

A good analysis of the present situation and discussing your desired look  will dtermine the plan of action.

Samir Shureih, MD
Baltimore Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.