Thank you for your question. The recent increase in reports of BIA-ALCL (Breast implant associated anaplastic large cell lymphoma) which is a rare kind of lymphoma that can develop in the scar tissue around the implant, has led to change the approach in the treatments of capsules. In the past there was no indication in removing a thin and normal capsule, where there has always been an indication in removing a thickened, calcified capsule. If the implants removed are textured, it is now considered preferable, when surgically possible, to perform a total capsulectomy (to remove the entire capsule) so that the risk of the onset of BIA-ALCL is nearly erased. If however the old implants are smooth and the capsules appear normal, there is no indication to remove it as the BIA-ALCL seems only related to textured implant. Hope it helps.All the bestAndrea MarandoPlastic and Cosmetic Surgeon, Manchester and London, UK

Capsulectomy is only warranted/indicated in a few situations: -Capsular contracture -Ruptured silicone implants -Suspicion of BIA-ALCL in the setting of a textured device (late fluid collection with ALK+ and CD30+ lymphocytes present) A thin, soft (non-calcified) capsule in the setting of an intact silicone implant does not necessitate removal. Following explantation, it will simply shrink down. However, high grade firm/calcified capsules will remain so if not removed. In the absence of the implant this remain palpable and may be a source of discomfort. As always,discuss your concerns with a board certified plastic surgeon (ABPS). Donovan Rosas MD Board Certified by the American Board of Plastic Surgery Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons RealSelf Verified Member RealSelf Top 100 RealSelf Hall of Fame

Capsular tissue is nothing but collagen that is deposited by your body. There are certain instances where I would recommend having a prophylactic capsulectomy, but in most cases there is no need to go through the added trauma and surgical time of having a capsulectomy if there is no acute problem with it. Each case is unique, but if you have smooth round implants and do not have a rupture or capsular contracture then the only reason to remove the capsule would be for your piece of mind, however it is important to know that there is no medical reason to do this and there are significant risks that come with capsulectomy which are not present with a simple explant. The only way to know for sure is to book a consultation with a board certified plastic surgeon near you to discuss your specific case. Best of luck!

If the capsules are thickened, causing issues or if there is a rupture to the implant than it is recommended to remove the capsules along with the implant. If the patient is experiencing symptoms or is uncomfortable having the implants remain, they can be removed.

A capsule is your body's reaction to a foreign body, it is like scar tissue. It occurs around anything that is placed into the body tissues. If it is thin and soft it is not normally removed. If it is calcified or not smooth or is changing the shape of the breast, it is usually better to remove it.The surgery to remove a capsule can itself cause bleeding and change in breast shape and so it is best to do it only when absolutely indicated. Specifically to your question of BII and the safety of not removing the capsule, it is safe to leave the capsule, as it is part of you, not part of the implant.All the best to you,Dr. Nancy de Kleer