Is a capsulectomy only performed on the side with capsular contracture or is it standard to do both? (photos)

Capsular contracture is the result of aggressive scar
capsule formation and contracture around the implant. Although all breast
implants have a capsule, occasionally the capsule becomes thick and firm. When
capsule tightens around the implant it can cause the affected breast to become
hard and painful (8-16%). The cause of capsular
contracture is unknown, however, bacterial contamination, rupture, and hematoma may be factors. The treatment for
contracture is usually surgery to release or remove the capsule around the implant. The unaffected breast is typically left alone.



Breast implant rupture occurs when
the outer shell of an implant develops a hole or tear. It occurs in about 10%
of breast implants. The rupture of saline implants often manifests in the
deflation of the affected breast as the saline leaks out and is absorbed by the
body. The rupture of silicone implants is often silent (asymptomatic), however,
some patients will complain of a change in shape, lumpiness, or new onset pain
on the side of the rupture. The FDA recommends that ruptured implants be
removed or replaced.



The best non-invasive test for
implant rupture is an MRI. It has an accuracy of 92%, a sensitivity of 89%, and
a specificity of 97% at detecting implant rupture. In real world terms, if a
rupture is seen on MRI the implant is likely ruptured (94%). There are some
ruptures, however, missed by MRI (5%).



Consultation with a plastic surgeon would be the next best
step.

Given the age of your implants, it is likely that you have rupture or
bleed of silicone with associated reactive, calcified capsules which
would require removal to restore your breasts to native, soft tissue. Since your not excited about replacing your implants, I
won't argue with your plan to explant, and then decide what you want once
your breasts have healed and recovered to a stable state; it is certainly a safe and conservative plan of action. Good luck and thanks for sharing.