If I take my implants out (explant only) & leave capsules am I still at risk for SCC?

Question

I was wondering with taking my implants out, explant only, leaving capsules. Am i still at risk for SCC? I had my implants for 5 years, no problems with them at all just want to look more natural. Now I am worried about getting SCC if i leave the capsules in even though the implants are coming out

Gary M. Horndeski, MD · Answer

SCC is exceedingly rare. If you are very concerned about this then you might get an ultrasound or MRI of the breasts to look at the capsules to see if there any concerns. Removing the capsules can often lead to devascularization and nerve injury and complications. If the capsules are totally normal then I prefer to leave them in to avoid complications. Also, removing implants alone is usually insufficient. Patients often complain of the excess skin hanging after removal. Most time a lift is required. You may be better off with explant and breast lift. I would need photographs, bra size and implant size to give you a more accurate answer.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Alan Gonzalez, MD, FACS · Answer

Hello @Crafty1227, thank you for your question. For starters, it is the ideal approach to remove the capsules during the explantation procedure since it is not known what can be found in the tissue. Afterward, it would be necessary to carry out a preventive biopsy on each capsule. The removal of the capsules avoids any future inflammatory process. I linked a video about capsular contraction that will shed some more light.   The most appropriate course of action is to consult one or several board certified plastic surgeons. This will allow you to get more information and options tailored specifically to your needs.  Best wishes! Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science”  Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Randal Haworth, MD, FACS · Answer

Scar tissue capsules form around breast implants and can remain in the body even after the implants are removed. These capsules are not harmful in most cases and can be left in place after explantation.

However, it is important to note that there is a very rare risk of developing a type of cancer called anaplastic large cell lymphoma (ALCL) associated with breast implants. ALCL is not breast cancer, but rather a type of non-Hodgkin's lymphoma that can develop in the scar tissue surrounding the implant.

The risk of developing ALCL is extremely low, but it is slightly higher in women with textured implants and those who have had implants for a longer period of time. If you are concerned about the risk of ALCL, you may wish to discuss this with your healthcare provider, who can help you weigh the risks and benefits of explantation with or without capsule removal.

It is also important to have regular check-ups with your healthcare provider to monitor your breast health and detect any changes or abnormalities.

Shaher W. Khan, MD · Answer

Hello, thank you for your question. Please see the video that I have attached that specifically answers your questions. Leaving the capsules in can leave the potential for SCC, even if the implants are removed.

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

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Connie Hiers, MD, FACS · Answer

About half the population in the USA will be a risk for developing a skin cancer in their lifetime and many will be SCC. However, the risk of developing SCC in the capsule is unknown, but it is still a very rare tumor.  The few SCC's that have been reported in capsules around implants are linked with textured implants.  Since you only had your implants for 5 years, the risk should be very low.

Camille Cash, MD · Answer

It is recommended that the capsules are removed along with the implants if they are thickened, causing issues, or if there has been a rupture of the implant.  They typically do not cause issues if left behind.  There is a rare form of cancer called ALCL that is associated with textured implants.  If you have this condition you will want to have both removed.  I encourage you to discuss your concerns with your surgeon.  It is important that you feel comfortable and confident in your surgical plan.

Douglas Taranow, DO, FACOS · Answer

Dear Crafty,
This is a weighted question.
First, capsules may be left in place when performing an explantation procedure without issues.
There is a VERY rare consequence related to having TEXTURED implants (not smooth).  This is called ALCL which is a type of Lymphoma.  If you have ALCL, then removal of the implants AND capsules are indicated.
If you have smooth implants, no issues.  If you have textured implants (more commonly Natrelle), then you should discuss the potential of a capsulectomy with your explanting surgeon.
Best wishes

If I take my implants out (explant only) & leave capsules am I still at risk for SCC?

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