Volume loss after subfascial capsulectomy?
Doctor Answers 3
The capsule should have been removed with the implant to address the issue of ALCL. The breast would not have looked much different.
#Explant #BreastImplantRemoval - Volume loss after subfascial capsulectomy?
I'm sorry about the problems you're having but your case raises several important issues, some of what are unresolved at this time. First, unless the capsule was thickened it probably did not contribute that much volume to your breast. Even capsules that are tight (ie capsular contractures) are actually pretty thin once they're removed. I am of course speculating but I'd guess that the capsule removal only contributed a small amount to the overall volume of your breast and, therefore, it's removal only a small amount (correspondingly). It's understandable that some of the capsule was left in a subfascial or subpectoral implant removal in the sense that that portion of the capsule is (often) densely adherent to the underlying tissues over the ribs and intercostal muscles. Removing that can increase the risk of thinned tissue in that region, and even pneumothorax and/or injury to the pleural space (the area around the lungs). On the other hand, relatively little is known about ALCL right now. Total capsulectomy is recommended with that diagnosis, and is believed to be curative. You should of course follow the advice of your own board-certified plastic surgeon but do not hesitate to seek additional opinions for confirmation or to get additional ideas. I hope that this helps and good luck. Dr. Alan Engler, Member of #RealSelf500