Breast implant revision - do I need to have the capsule removed?

Thank you for your question. I have been in practice for 30 years and breast revision surgery is a large portion of my practice. There is absolutely no reason to remove capsule for a size change. Do not even think about it and find a different surgeon. Best wishes to you.

I recommend you have an ultrasound or MRI done to look at the capsule. If the capsule appears normal then it does not need to be removed. If you are going to a larger implant, it may need to be released to accommodate a larger implant. If the capsule appears abnormal then you may want to remove it. Removing the capsule does not increase the incident of capsular contracture.

Best Wishes,

Gary Horndeski, M.D.

If you do not have capsular contracture and you only want a size change I would not perform a capsulectomy

Most of us would recommend leaving the thin capsule alone to decrease risks. Thick capsules need to be removed. However, since you are going up in size, the capsule may need to be opened. Your surgeon can decide this when you are in surgery.

Thank you for your question. I believe that your Dr is perhaps a little bit misinformed about the recent understanding regarding capsule and capsule contracture. In the recent summary of papers published, there is little Benefit noted by complete capsulectomy prior to implant exchange in most cases. In fact, removal of a very thin capsule is quite difficult to do in its entirety.

It would seem a second opinion is worth your time.

The indication for a select me is completely dependent on how thick the capsule is going.
This has nothing to do with how long you’ve had implants
Sometimes the thickness of the capsule can be determined by examination based on evidence of capsular contraction.
Sometimes the final decision needs to be made during surgery.
Anytime, excessively large implants are used chance of having undesirable side effects, complications or the need for revision surgery will increase.
Best,
Mats Hagstrom MD