Is leaving the capsule in during breast implant removal ever beneficial?

Thank you for sharing your excellent question. I do not think that the capsule is beneficial from a shaping point of view, but at times it is left in place if there are concerns of skin healing issues due to thin breast skin.  As the capsule is your own body's response to the implant, it does not pose a danger to you in the future.  Hope this helps.

Leaving a capsule behind is preferred if it is thin and pliable. If there are calcific components, or silicone granulomatous material, or if the capsule is deforming the breast tissue, then removal of the capsule may be warranted.  Removing a capsule unnecessarily could result in bleeding and slight tissue loss.Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

Unfortunately, you have not provided photographs or told us your bra size.  However, I rarely remove the capsule unless there is indication such infection or calcification.  The technique I recommend is explantation using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained.  At the same time or later, fat transfers can be performed if additional volume is desired.Best Wishes,Gary Horndeski, M.D.

Dear easycoast,
most plastic surgeons don't remove capsules when removing implants. Only in case of thick capsules or capsular contracture, plastic surgeons remove implant together with capsules around it. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Explantation in the setting of an intact implant with a soft normal capsule is a relatively uncomplicated procedure. Your prior access incision can be used to remove the implant. Post operatively there will be some mild soreness and most will return to full activity in a few days.
In the setting of rupture (silicone) or an abnormal capsule will require capsulectomy which will be somewhat more complicated. The capsular tissue must be peeled out either to minimize spillage of silicone or for the purpose of removing calcified hardened or abnormal scar tissue. Depending on the plane of augmentation (over vs under) this can be more difficult (submuscular being more difficult to remove). Ultimately, capsulectomy comes with greater post operative pain, recovery and risks (bleeding, fluid collection etc.).
With regards to your specific question, assuming your capsule is normal, there is no need for capsulectomy in concert with implant removal. Some point to a purported link between residual capsule and BII. The issue of breast implant illness is a difficult one as there is no definitive medical evidence to support many of the online claims. This is not a commentary on the legitimacy of BII, but rather on the value of capsulectomy in these cases. There is no guarantee capsulectomy in the setting of a normal capsule will make any difference in the symptoms (while at the same time increasing the risk).
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
RealSelf Hall of Fame

Hello! Thank you for your question. If you don't have any unusual physical exam findings and simply want your breast implants out, the capsules may be left in place. If there are calcified capsules, capsular contracture, or distorted anatomy, the capsules should probably be removed. 
Keep in mind that if you decide to pursue surgery it’s very important that you find a surgeon whom you are comfortable with and trust and who evaluates you in-person and tailors an individualized treatment plan for you and your aesthetic goals. Best of luck!
Matthew A. DelMauro, M.D.

Leaving the capsule behind doesn't necessarily help with shaping.  If the capsule is thin and there are no issues with the implants it is option to have it removed or leave it behind.  If the capsule is thickened it should be removed along with the implants.  Leaving the capsule behind makes for a simpler surgery and may also make for an easier recovery.

Leaving the capsule at the time of breast implant removal surgery is not necessarily beneficial but removal of capsules may result in skin contour irregularities, if there is damage to the overlying tissue/skin (during the capsulectomy procedure).  Some general thoughts regarding the need for capsulectomy may be helpful to you.Generally speaking (in my opinion), unless the breast implant capsules have thickened (and/or are otherwise symptomatic), are associated with the ruptured silicone gel breast implants, or if the patient has concerns about "medical conditions" related to the breast implants, capsulectomy is not universally necessary. For these patients, en block removal of breast implants is a good procedure.
***On the contrary, capsulectomy can expose patients to additional risks, such as bleeding, size loss, contour irregularities and other serious complications. In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity). For example, attempting to remove very thin capsule densely adherent to the patient's rib cage may expose the patient to significant bleeding and/or entrance into the thoracic cavity.  The good news:  breast implant removal surgery is a very well-tolerated procedure with minimal discomfort,  compared to first-time breast augmentation surgery. Patience is definitely indicated after removal of breast implants; it will take many months for the skin to “bounce back” and for you to see the final appearance of the breasts.
I hope this helps. Best wishes for uneventful surgery and an outcome that you will be very pleased with.

If you have the old gel implant, the capsule needs to be removed to try and remove all the leaked gel. If you have a saline implant or the new gel implant, the capsule may or may not be removed. If the capsule is very thin, it can be difficult to remove and may cause some bleeding. If the implants have not been present long, the capsule may not have completely formed and can be left. Women who have very little breast tissue or whose tissue has been thinned with heavy implants may do better if the capsule is left in order to avoid tearing the skin or interfering with circulation to the skin. Every case is different and requires judgment on the part of the surgeon to decide what is best.