Necessity of capsule pathology for symptomatic saline implants?

En Bloc capsulectomy, meaning removing the capsule AND surrounding tissue is not indicated for capsular contracture or BII. If you are having symptoms due to your implants which are 18 years old, it is likely due to capsular contracture, unless you have signs of breast implant associated lymphoma, like a mass or new seroma, there is no reason to send the capsule to pathology as long as it looks normal during surgery.Remember, the capsule is due to your body reacting to the implant. The majority of the time when you remove the implant, the body resorbs this tissue so it often doesn’t need to come out with the implants, but if you have really thick calcified capsules, sometimes these won’t go away. I just had a patient where her capsules were so thick and calcified that they felt and looked like egg shells and would crack when squeezed. Capsules like that won’t go away once the implants are removed, but again, there is no reason for en-bloc or to send to pathology.There is a lot of misinformation out there regarding these types of issues.
-Dr. Halka