Implant removal with fat transfer 1 year after implant placement?

Question

I’m a 25 y/0 female, 5’4, 150lbs . I had 400cc implants placed in August 2021. Fast forward today and I’ve been experiencing the following symptoms of bii: brain fog, memory loss, hair loss, depression. I’m scheduled for explant and fat graft in 2 weeks. I’m really struggling with whether to remove the capsule or not. My surgeon says it’s more dangerous than leaving it bc it’s been such a short time period and the capsule will be tissue paper thin. I need relief asap bc I’m in grad school. Help!

Alan Gonzalez, MD, FACS · Answer

Hello @Fabulous805405, thank you for your question. An explantation with capsulostomy is safe in expert hands, even if it's been one year from implantation. In case of an explantation with capsulostomy, the surgical procedure would imply a breast reconstruction, because taking out the volume that the prosthesis gave will require repositioning of the tissues. In this way, you would achieve an aesthetic result you would be happy with. If what you want is to do an explantation with capsulostomy is not convenient to do the fat transfer to breasts in the same procedure, it is advisable to wait 3 to 4 months to avoid the fat to die or risk of infection. In this case the incision would be periareolar and inverted J-shaped to avoid making a T. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD, FACS.

Daniel Barrett, MD · Answer

Dear Fabulous805405,
it is hard to tell for sure without an examination. Generally speaking, thin capsules can be left inside the breast after the removal of implants. If you are considering surgery, I would suggest you 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

Connie Hiers, MD, FACS · Answer

Since it has only been one year, your capsule made be very thin and hard to completely remove. If it is thick, it does need to be removed. Please remember, that removing your implants may not correct some or all of your concerns, and other factors could still be involved, especially like heavy metals from hair dyes and tattoos.

Camille Cash, MD · Answer

Typically if the capsules are thickened or causing issues they should be removed at the time of explant.  If they are thin then it is an option to have them removed or leave them behind.  If you are experiencing BII symptoms the capsule is often removed along with the implants.  Please understand that fat grafting will not be able to replace the volume of your implants.  I encourage you to discuss your surgical goals and concerns with your surgeon.

Implant removal with fat transfer 1 year after implant placement?

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