If you leave the breast capsules in after explant what happens to it?

Question

I can’t manage to find any accurate information online about what happens to the capsule if you leave it in after explant. I’ve seen answers like it dissolves, it remains inside, it breaks down. What is the true answer? If it remains does it keep its shape attached to the chest wall and muscle? Or does it change shape and shrivel? Some more details information would be good. I don’t believe in BII but I still need to make a decision on removing or keeping them in.

Irena Karanetz, MD · Answer

Hello, 
And thank you for the question.
Following removal of breast implants also known as explant surgery, one option is to leave breast capsule (scar tissue) behind, especially if it appears soft without any issues or evidence of capsular contracture. Another option is to remove the capsule (partially or fully) knows as capsulectomy. 
Sometimes, the scar tissue/capsule can be very adherent to the muscle and chest wall, and removing it may case more damage to the nearby structures. In those cases, the capsule remains in place.
Although some women report improvement or resolution of symptoms following removal of the implants and capsule, the cause of the symptoms and the degree to which they may be related to the implants/capsule are unclear at the current time. Research continues to be performed to better understand any potential association with breast implants and breast implant illness (BII). 
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast Explant surgeries to further discuss your options, specific techniques, concerns and expectations. 
I hope this helps.
Best, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Alan Gonzalez, MD, FACS · Answer

Hello @Justhavefaith, thank you for your question! In my opinion the ideal approach to remove the capsules, all of them (total capsulectomy) 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 en bloc and total capsulectomy 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.  American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS),Colombian Society of Plastic Surgery member (SCCP).

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Without removal the breast capsule remains and largely does not change shape.  Hope this helps.

Connie Hiers, MD, FACS · Answer

Capsules, especially around saline implants, that are very thin may actually dissolve over time. I have seen this in reconstructive patients and in patients who wanted implants out and then chose to have implants back in at a later time. However, thick capsules tend to remain and appear not to change much. Again, I have also seen this in patients. However, the thick capsule might possibly change with a long enough period unless it is very thick. Calcified capsules remain as they are.

Lina Rodriguez, MD · Answer

Although when an explant surgery is done I usually remove all tissue that belongs to the implant. That is including capsule. There are doctors that leave capsules and its also fine. Latest studies indicate that symptoms related to implants in BII are not related with removing or leaving capsules. It usually becomes scar tissue. Please continue doing your yearly follow up ultrasound.

If you leave the breast capsules in after explant what happens to it?

Answers (6)

Answer: Capsules

Answer: Capsules

Answer: Its ok, you should be fine.

Answer: Its ok, you should be fine.

Recommended reading

Everything you need to know about Breast Implant Removal

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If you leave the breast capsules in after explant what happens to it?

Answers (6)

Answer: Capsules

Answer: Capsules

Answer: Its ok, you should be fine.

Answer: Its ok, you should be fine.

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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.