When you have replacement breast implants, does the surgeon keep the old capsule?

Question

I am confused as to whether the surgeon (any) keeps the old capsule surrounding the previous implant or if they remove it. I am planning a 3rd op & I was advised not to have the op in case of complications such as infection but surely an infection was a risk the previous two times as well? I had Capsular contracture towards the end with my first op, what would my ps have done? Isn't it better to start fresh with each op? Classic case of 'I have no idea lol'

William Andrade, MD · Answer

If a breast implant capsule is soft and thin, it is not always removed by a plastic surgeon during revisionary surgery because there is no clear benefit.  However, if you have had multiple operations and/or had the implants in for a long time, the capsule may be quite thick or even have eggshell-like calcium deposits.  In this case the plastic surgeon will often remove it so a new, normal capsule can form.

Alejandro Nogueira, MD · Answer

I can't believe your words, sorry no offence, I mean... I can't belive a
 plastic surgeon told you seriously you will be left with capsules, 
silicone, nodes and the risks involved; aged implants (renewed or just 
removed) NEED TOTAL CAPSULECTOMY and the removal of every tiny bit of 
leaked silicone; each micro-drop of silicone left will become calcified 
and when you do a mammograp the radiologis may
 think it is a cancer (tumours of breast look like micro 
calcifications), and you'll be cancerophobic very regularly without any 
need. I strongly recommend you clarify this point with your surgeon, and
 if he insists do change the surgeon immediately.I am an UK's 
GMC registered plastic surgeon with number 7357207 as well as registered
 in Spain, Madrid, where I do practice attending almost exlusively 
English speaking patients coming from the UK and USA, also other 
countries; I kindly invite you to a free of charge consultation online 
with me without any obligation; google about my reputation and this may 
show to you my experience in such cases, you'll also find easily our 
website of UK patients.To minimize the risks of capsular contracture do demand latest generation of macrotextured implants, or if available the polyurethane coated implants.

Steven Wallach, MD · Answer

How the capsules is treated really depends upon the quality of the capsuel and the indications for surgery.  Many times the capsules or part of it is remove during a revisoin procedure.  Sometimes if the capsule is soft and the implants is being exchanged for a size issue,  then it is not always necessary to remove it.

Andrew Kornstein, MD, FACS · Answer

Techniques vary. However one theory has to do with contamination of the capsule so removal of the capsule is best, in general, that's my opinion. There are of course exceptions to every rule.The question remians why are you still having issues(with cap/con)?There are so many options available now to lower/minimize your risk---they should be investigated.Hope this helpsSee Dermal Matrix in Breast Augmentation, attached for additional information

Khashayar Mohebali, MD, FACS · Answer

Thanks for your question. Its hard to specifically answer your question without knowing all the history and an exam.    However, what I do with the capsule in a revision case depends on the reasons for the surgery.  If purely for capsular contracture, then I do try and remove as much as safely possible.  However, there are many other reasons for revision surgery that don't involve removal of capsule.  Discuss specifically with your plastic surgeon and good luck.

Tom J. Pousti, MD · Answer

Thank you for the question but online consultants will not be able to provide you with specific enough answer to be helpful.  Generally speaking, how the breast implant capsule is handled during revisionary surgery depends on exactly what the nature of the capsule is and exactly what operation is being performed. Again, generally speaking, if the breast implant capsule has thickened or is symptomatic, it is removed (if possible). Best to clarify with your plastic surgeon exactly what was done in the past and what is planned in the future. Best wishes for an outcome that you will be very pleased with.

When you have replacement breast implants, does the surgeon keep the old capsule?

Answers (6)

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