After Breast Augmentation with Saline 7 months ago, I need a Capsulectomy. Is it necessary to replace the implants?

The risk of recurrence of capsular contracture is quite high without implant replacement. If the implants are not under the muscle then that should be considered also. In my experience the best protection against recurrent CC is Strattice in addition to capsulectomy and implant replacement.

There is no certain answer to this question. Despite lots of research, we still do not know for certain what causes capsular contractures. A popular theory is that there is a biofilm on the implant that contributes to the inflammatory response that causes the contracture. Surgeons that believe this theory might suggest doing everything possible to remove anything that might be associated to this biofilm. This would include complete removal of the capsule and anything touching the capsule which would include the implant. Even if this is done, there is no guarantee that you will not develop another contracture. My rule of thumb is that if the implant pocket appears to be contaminated, has areas of calcification, spilled gel implants, etc., then implant replacement should be done. If the pocket looks clean, but just the wall of the capsule is thickened, I tend to complete a capsulotomy or change the implant pocket and often use the same implants after bathing them in an antibiotic solution.

This is a very complex question and we don't have enough information to answer this fully. You may benefit from implant exchange because some implants have less of a chance of recurrent capsular contracture. You may also benefit from pocket change, acellular dermal matrix, etc.  You need a full consultation. If your previous surgeon is a board certified plastic surgeon who specializes in revisional breast surgery, speak to him/her. If not, seek another opinion. If this is not treated appropriately, you can be in for a long haul of repeat surgeries and medical bills. 

Capsular contracture is caused by your body's reaction to "biofilm" on your implants.  Bacteria (usually that live within the breast) can colonize the surface of the implant and they make a thick and sticky substance that binds them to the shell and makes them impenetrable to antibiotics.In order to treat the contracture this must be removed.Unfortunately i still see situations in which surgeons did not change the patient's implants during a capsulectomy.  Perhaps some don't know the importance of this, and for others there may be a concern over payment for the implants.It is also important to be sure that you are going to have a complete capsulectomy.  Some surgeons will just make cuts in the scar tissue to release it.  This does not work long term.

There is not enough information to sufficiently answer your question. If you have bilateral capsular contracture seven months after breast augmentation, some very relevant questions must be asked.First, what is the size of the breast implants? Secondly were the implants placed under the muscle, or over the muscle? Lastly, what was the size of your native breast tissue that  is now over lying the implants?one cause of Capsular contracture is inadequate soft tissue overlying implants or, what we call an imbalance between soft tissue coverage and underlying implant. The fact that you had bilateral capsular contracture so early after breast augmentation leads me to suspect that you have large implants for your soft tissue. However, this is just a guess as we do not have this information.so, if your problem is inadequate soft tissue overlying your saline breast implants, the solution may not necessarily be a capsulectomy at all.  

Open Capsulectomy voids the warranty on the implants. Depending on your initial implant choice, sometimes this is a good opportunity to switch.  Discuss with your plastic surgeon to ascertain his position.  Best of luck to you.

I'm sorry to hear about the need for additional surgery. Although different plastic surgeons may handled the situation differently, I tend to  replace breast implants when ever capsular contraction is involved. I hope this and the attached link helps.