During explant do I need to remove all the capsule?

It is not always necessary to remove the entire capsule and sometimes it is not recommended. If the capsule is very thin it may be safer to leave it, or at least part of it, behind in order to prevent damage to tissues in the attempt to remove it. I encourage you to visit with your surgeon for an evaluation and to learn more about your options. I've included a video I hope you find helpful.

Thanks so much for your question.  If your capsule isn't causing any problems such as pain or distortion, removal of your capsule around the implant or a capsulectomy isn't necessary.  However, in your case with your new symptoms only after placement of your implant, removing the capsule may help these symptoms improve further.  Hope this helps...best of luck!

Joyce C. Chen, MD

The removal of capsule depends on the extent of pain you are having and the thickness of the scar tissue. Often a portion of the capsule will be removed from beneath the pectoralis muscle 

This is a very good question.  As you have realized you will get many answers on this topic.  There is significant variation and it depends a lot on what the surgeons sees and what the surgeon is dealing with. In general, if the capsule is very thin then it is unnecessary to attempt to remove all the capsule as it tends to be very difficult and very bloody if the implant was originally behind the muscle.  In certain cases as noted, removing the capsule would be a better option.  Some of those cases included in a case of capsules associated with ruptured silicone implants, calcified capsules, in a setting of infection, significantly diseased (thickened) capsules.  Having said that it some cases the thickened capsule maybe left behind if it is felt that removing it would case significant deformity or loss of volume or both.Hope that helps.

If you don't have significant thickening of the breast implant capsule, then it does not necessarily need to be removed. Especially implants that are subpectoral since these capsules are more difficult to remove and are associated with more bleeding. Thin capsules can remain behind but your surgeon should shrink the pocket and place some sutures to prevent a seroma;  along with leaving a drain for a few days.Best wishes,Dr.Bruno