Will an implant removal without capsule removal cause problems in the future? What should I expect from scarring?

Question

I had my breast done 5 years ago and recently decided id like them out. My dr seemed upset but said he would do whatever i would like to do. The consult he said because they are not hard or causing problems he would just remove the implant not perform a "ebloc" because he said it was un necessary. Is it likely i will have problem in the future because it is still there? will the scar tissue be hard and lumpy after if he leaves it there or will they likely go back to what it was before

Raffy Karamanoukian, MD, FACS · Answer

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Shaher W. Khan, MD · Answer

The capsule has in it the impurity and the toxicities of silicone that has leeched from not only from the silicone breast implant, but also the saline breast implant. Leaving the capsule behind will inevitably leave the silicone toxicity behind that will continue to harm the body. Explant surgery mandates removal of all capsule; that is the entire operation in itself, plus the removal of not only the capsule, but all inflamed tissue, along with the implant. If any of the capsule is left behind, that is considered incomplete surgery. We can tell this from not only the many pathology reports that show silica within the capsules, but also the many patients who have had residual silicone capsules removed, an ultimate improvement in their health. This is not an easy operation, and not everyone can do it.

Gary M. Horndeski, MD · Answer

Plastic surgeons do not routinely remove the capsules unless there is indication such as infection or calcification.  Also, en bloc is used from cancer patients not for explant and lift patients.  Depending on the size of your implants, one of the issues you may encounter is sagging of the breasts.  Often times, patients require a lift at the time of explant.  The technique  I recommend is explantation and lift 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 (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery.  Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Alan Gonzalez, MD, FACS · Answer

Hello @Crafty1227, thank you for your question. I believe that every time an explant is performed, the capsule must be removed. Complete capsulectomy. Whether it is en bloc does not matter as long as the whole capsule is removed and the tissue is sent for pathology after taking the capsule out. This will prevent future inflammatory responses from the body as the capsule does not get reabsorbed by the body as previously believed. To shed more light on the scarring process, I share a video. If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS.

Michele A. Shermak, MD · Answer

I remove implants typically under local through a small incision under the breast, oftentimes the access scar for the augmentation procedure. If the implants are smooth implants and soft, then no question capsule does not need to come out. 
I hope this helps!

Will an implant removal without capsule removal cause problems in the future? What should I expect from scarring?

Answers (10)

Answer: Will an implant removal without capsule removal cause problems in the future? What should I expect from scarring?

Answer: Will an implant removal without capsule removal cause problems in the future? What should I expect from scarring?

Answer: Explant require capsule removal?

Answer: Explant require capsule removal?

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Everything you need to know about Breast Implant Removal

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Will an implant removal without capsule removal cause problems in the future? What should I expect from scarring?

Answers (10)

Answer: Will an implant removal without capsule removal cause problems in the future? What should I expect from scarring?

Answer: Will an implant removal without capsule removal cause problems in the future? What should I expect from scarring?

Answer: Explant require capsule removal?

Answer: Explant require capsule removal?

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Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.