Regarding ALCL.

If I choose simple implant removal without removing capsule and just happen to have ALCL cancer cells in the fluid and capsule surrounding implant will this free the ALCL cancer cells to flow through out my body?

Doctor Answers 6


Your question is somewhat  ambiguous. If you have ALCL as a diagnosis the treatment is removal of the capsule . If you just have breast implants without fluid collection around them that  is noticeable, the chance of having incidental AL CL  is minuscule . This is a question that you should discuss with a board-certified plastic surgeon who is experienced in augmentation surgery 

Sacramento Plastic Surgeon
4.9 out of 5 stars 106 reviews

En bloc capsulectomy

The treatment for ALCL includes removal of the capsule.For explant surgery, it is almost always best to remove the capsule in its entirety.  This will allow the space to heal.  If you leave the capsule in place, it does not heal.  Fluid can accumulate in the space.  The situation that brings the patient to implant removal will have an affect on the decision.  This is a surgery which requires discussion with the plastic surgeon about the problem, the goals, and the technical concerns.  The body does not re-absorb the capsule.  Revision surgery requires drains because the fluid is going to be generated when you operate on the scar capsule.  If you provide a mechanism for the fluid to be removed (i.e. drains), the risks are lower.  If the fluid accumulates because there were no drains, it will most certainly cause problems in the future.


If you truly have ALCL, then you will need the implant and the capsule removed. If you just want your implants removed, the capsule may or may not need to be removed. I would always recommend removing the capsule with the old gel implants.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews


Removal of the capsule is the treatment for ALCL so you should have the capsule removed if you have that type of cellular change. It is an incredibly rare disease in breast capsules. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Regarding ALCL

If the implants are textured and you have had a recent increase in volume with associated fluid outside the implant, it is recommended that the entire capsule and implant material be removed for analysis. If this is not the case, I don't feel compelled to take out normal capsules. Best of Luck!

M. Scott Haydon, MD
Austin Plastic Surgeon
4.9 out of 5 stars 83 reviews


The best prevention for ALCL is total capsulectomy, removal of any silicone laden axillary lymph nodes (with the texturing in the nodes), antifungals, and detoxification of chemicals.  Using this method, I have not had any ALCL that I know of in a large explamt patient population (since 2005) when prior to this lymphoma was the most common cause of death in my explant population.  I believe that chemicals and mold biotoxins and possibly bacterial biofilms cause this disease.  Retained capsules are likely to cause problems later, so they should be removed at the time of implant removal.

Susan Kolb, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 22 reviews

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.