Augmentation 5 Years Post Explant - Will the capsules left behind a few years ago pose a problem, cosmetically speaking?

You need a thorough evaluation before considering putting in new implants. The remaining capsule is soft and will not pose a huge problem but the surgeon should be experienced. Also, you need a good evaluation to see if a breast lift would give you the fullness you want with minimal scarring. A virtual consultation might help and I'd be happy to do this.
Best of luck.

Yes, the old capsules can potentially affect your new augmentation cosmetically and structurally but not always. It depends on the condition of the capsules and how your body heals. Let’s break this down:
What are the Implant Capsules?
Capsules are scar tissue your body forms around implants. If your explant surgery did not remove them (no capsulectomy), they are likely still intact to some degree.
Potential Issues with Keeping the Old Capsules During Re-Augmentation
1. Distortion or Irregular Shape
If the old capsule has contracted (capsular contracture) or is uneven, it can distort the shape of the new implant. This might not be visible now because there’s no implant pushing against it.
2. Implant Malposition
The capsule can guide or restrict where the new implant sits, possibly making the implant appear too high, low, or to the side.
3. Palpability or Rippling
A thick or uneven capsule could show through the skin more if the implant is placed again especially if you’re thin or using saline implants.
4. Unknown Integrity of the Capsule
After 5 years, capsules may be calcified, thickened, or fibrotic, not ideal for a smooth, natural look.
What to Consider
• If your breasts look normal now and the capsules aren’t contracted, there’s a chance they won’t pose a major issue, but it’s not guaranteed.
• If you want a different size, shape, or type of implant, the capsule may not fit properly and should be modified.
• If you had any symptoms of capsular contracture before, removing or releasing the capsule is more strongly recommended.
You can get new implants after explant without capsulectomy but the old capsules may need to be addressed during surgery. Most likely, an experienced surgeon will inspect them and adjust as needed to ensure your cosmetic result is smooth, symmetrical, and natural-looking.