Is re-implantation a more complicated procedure following implant removal with capsules in place?

Question

Dear Doctors, after I found out that after 8 years one of my textured Allergan’s implants is damaged, I decided (a month ago) to remove them -I was scared of the risks. Now I regret that I did not replace them with smooth implants .. Capsules were not removed, as they looked good. Is re implantation more complicated procedure in such a case? What happens to the old capsules then - are they left inside? Don’t they distort the image later during future examinations - imitating disturbing changes?

Alan Gonzalez, MD, FACS · Answer

Hello @Neat582454, 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. Therefore, it would be necessary to carry out a preventive biopsy on each capsule. Reimplantation requires that a place be found for new prostheses again. For more information and recommendations, it is best to consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS.

Richard Baxter, MD · Answer

If the capsules were not thickened enough to require removal, then there should be no problem leaving them in when placing new implants. They will not interfere with future examinations. However, if you had textured implants, be sure to discuss whether to have a capsulectomy.

Martin Jugenburg, MD · Answer

Hello, thank you for your question. Yes it is possible to go back after explantation. Since your capsule has collapsed and healed down to itself. The tissue is less supportive and more dissection would have to take place. It is not a bad thing and certainly possible. The only issue that may occur is the loss of support "bottoming out" which is likely if your implant is large and heavy.

Daniel Barrett, MD · Answer

Dear Neat582454,
it is hard to tell for sure without an examination. Generally speaking, reimplantation is a straight forward procedure. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Heather Vande Ven, DO · Answer

Re-implantation following the removal of implants with capsules in place can potentially be a more complicated procedure compared to a simple implant placement. The complexity depends on various factors including the condition of the capsules, the reason for the removal, the duration the implants were in place, and the overall health of the patient. Here are a few points to consider:1.) Capsule Condition: The capsules that form around breast implants are made of scar tissue. If these capsules are thin, pliable, and free of complications such as excessive scar tissue (capsular contracture), they might not pose significant challenges during re-implantation. However, if the capsules are thick, calcified, or problematic, removing them completely or manipulating them during surgery can increase the complexity of the procedure.2.) Surgical Approach: Surgeons might need to make adjustments to their surgical technique if there are existing capsules. They might need to carefully dissect and remove the old capsules, which requires precision to avoid damaging surrounding tissues.3.) Potential Complications: Capsular contracture is a common complication that can lead to the capsules becoming tight, thickened, and potentially painful. If capsules were removed due to severe contracture, preventing its recurrence during re-implantation might require additional steps, potentially involving different implant placement techniques or using materials to prevent the formation of new capsules.4.) Risk of Infection: If the reason for implant removal was an infection or if there was a risk of infection, ensuring a sterile environment during re-implantation becomes crucial. The presence of existing capsules can complicate infection control measures.5.) Tissue Changes: The removal of implants and capsules can cause changes in the surrounding breast tissue. This might affect the available tissue and skin elasticity for re-implantation. Additional procedures like a breast lift might be required to achieve desired aesthetics.6.) Patient Preferences: Patient preferences and goals play a role in determining the complexity of the re-implantation procedure. Some patients might want a different implant size, shape, or material during re-implantation, which can influence the surgical plan.It's important to note that the complexity of re-implantation varies from case to case. Surgeons will assess each patient individually, taking into consideration their medical history, physical condition, and desired outcomes. If you're considering re-implantation after having implants removed with capsules in place, it's recommended to consult with a board-certified plastic surgeon who can provide personalized advice based on your specific situation.

Connie Hiers, MD, FACS · Answer

In many women, once the implants are removed, the thin capsules dissolve. Getting implants now may be like the first time you had implants.

Is re-implantation a more complicated procedure following implant removal with capsules in place?

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