Can a 40% capsule left behind five years ago be removed during a second capsulectomy?

If your current implant was placed in the same pocket as the new implant then it is likely thet the new and the old capsule have become one, and likely could be remove if necessary.  Old capsules do not always need to be remove and can sometimes increase surgical risk. Some surgeons will relese a capsule (incise it) rather than remove it . This is a judgement call in capsular contracture surgery.  If the current implant is not in the same place as the old implant  your new ps will have to determine if it makes sense to remove the old 40%. Your notes from the first doctor will help the second.Recurrent contracture is frustrating because it can sometimes recur with or without complete capsulectomey. Be sure to discuss all options with your PS. Complete capsulectomy, textured implant,new plane for the implant , possible use of strattice (off label) so that you are well informed.Best wishes.

Thank you for your question.  I may not be able to answer your question sufficiently because I need more information.  I am assuming that except for the firmness of the capsule, your capsule is normal and you have never had a seroma around the implants.  If you are removing your implants and not putting anything back in, then the existing capsule and the old one if it can be found, can be removed.  However, this is only true if the capsule is not adherent to your ribs.  If it is stuck to your ribs, it sometimes physically cannot be removed completely.  It is very important that you discuss this with your plastic surgeon as there is a rare instance when the whole capsule should be removed and you and your plastic surgeon would need to discuss what should be done if this is the case for you.  If your capsule is  not one that absolutely must be removed, then sometimes a portion capsule is left behind because to remove it would cause a cosmetic distortion of the breast.  However, if you wish the entire capsule to be removed and it is possible to do so, then you could have this done as long as you accept the risk of cosmetic deformity.  In the vast majority of patients, having some capsule left behind does not cause a medical problem but you need to speak with your plastic surgeon who has the details of your situation.

Sometimes it is impossible to remove all the capsule because of issues with thinness of the tissues or adherence to the rib cage.