When replacing implants is it common practice to use the capsule from the old implant as an internal bra?

The reason for implant replacement can be many, and depending on that reason a partial or total capsule removal may be indicated. From a purely general point of view though, leaving the capsule alone is always better than removing it, especially if it is normal in size and shape (allowing the implant to sit where it's supposed to be). In situations like capsular contracture, it should always be removed completely. For silicone gel implant leakage, there is more of a tendency to remove it, especially for suspected long term leaks or leaks from old implants with less viscous gel (low cohesivity). For implant malposition, the capsule should not be removed, but instead it should be tightened with cautery and oversewn with sutures. The use of mesh to overlay on the repair may also be indicated, depending on tissue laxity and the degree of implant malposition. This latter situation is known as an 'internal bra'.

It is common to use the capsule if it is a strong enough layer, all depending on the individual circumstance, size of implants, reason for exchange, and other things. If there is no reason to remove the capsule but more support is needed, the Galaflex would be used without removing the original capsule.