Breast implant removal - keep or remove capsule?

Hello - I am wanting to remove my 14 year old saline under the muscle implants. I've had one consult already, having another one Friday. I was told he would not remove the capsule...I have read several articles saying that the capsule should be removed?? This is scary and confusing as what to do. I have very little breast tissue (Dr said this) and I have 480-520 cc implants. Will I look deformed and concaved?? Also any oregon doctors that you can recommend would be very helpful. Thank you!!!!!!

Doctor Answers 10

Breast implant removal - keep or remove capsule?

Thank you for your question. There is no specific rule on this issue. In my practice, I tend to lean towards removing the capsule, but this is not a hard and fast rule. If you have very little breast tissue and the capsule is thin and soft, it may not have to be removed. However, if you have larger implants and very little breast tissue, just removing the implants with no other procedure is likely going to result in a very deflated appearance. You should discuss with your surgeon the option of a breast lift (mastopexy) at the same time as the implant removal.Best of luck!

Spokane Plastic Surgeon
5.0 out of 5 stars 30 reviews

Breast implant removal - keep or remove capsule?

Thank you for your question.  There are many opinions regarding this.  It all depends(this is a common statement) on the characteristics of the the capsule, the indications for removing the implants, and health of the patient.  If a patient were to have a thickened, firm, or symptomatic capsule then most surgeons would remove it.  On the other hand, if the capsule is thin and asymptomatic if may be left in place.  Removal of an asymptomatic thin capsule may increase the risks of bleeding and injury of the breast tissue which could lead to more scarring and a symptomatic post op breast.  Be sure to discuss this with your surgeon, preferably a Board Certified Plastic Surgeon with experience in breast surgery.  Good luck.

David J. Wages, MD
Peabody Plastic Surgeon
4.8 out of 5 stars 24 reviews

Capsulectomy After Breast Implant Removal

Capsule removal (capsulectomy) is generally recommended in the presence of capsular contracture where the capsule feels firm, causes visible deformity or causes pain. Many surgeons would not remove a thin pliable soft capsule that is not causing any symptoms. An exam is helpful in deciding if you might need a lift after the implants are removed. Visit a few experienced board certified plastic surgeons to learn more about your options.

David S. Motoki, MD
Draper Plastic Surgeon
5.0 out of 5 stars 16 reviews

#Explant #BreastImplantRemoval - keep or remove capsule?

There are no absolute answers with respect to the capsule.  In general, if it is a very thin capsule and otherwise asymptomatic, you do not necessarily need to remove it (in my opinion) where if it is a thicker, symptomatic capsule (pain, hardness, etc) then it is more likely that you'll be advised to remove some or all of it.Based on your description you may be very unhappy with your appearance once you have your implants removed.  You should discuss this carefully with the surgeons you see in consultations to make sure that you understand as much as possible what you can expect to look like.I hope that this helps and good luck,Dr. Alan EnglerMember of #RealSelf500

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Breast implant removal - keep or remove capsule?

Thank you for your question.If the capsule is thin there's no reason to remove it. Removing the capsule increases the risk of bleeding, visual deformity, and changes the blood supply to the breast particularly, when there is very little breast tissue between the implant and skin.The procedure is straightforward. The implant is removed. I prefer to place drains, so that excess fluid in the pocket is removed from the body. Drains come out after 1-2 weeks.

Austin Hayes, MD
Portland Plastic Surgeon
5.0 out of 5 stars 38 reviews

Breast implant removal - keep or remove capsule?

Thank you for the question. Don't be surprised if you receive a variety of differing responses.
Generally speaking (in my opinion), unless the breast implant capsules have thickened (and/or are otherwise symptomatic), are associated with the ruptured silicone gel breast implants, or if the patient has concerns about "medical conditions" related to the breast implants, capsulectomy is not universally necessary. For these patients, en block removal of breast implants is a good procedure.
On the contrary, capsulectomy can expose patients to additional risks, such as bleeding, size loss, contour irregularities and other serious complications. In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity). For example, attempting to remove very thin capsule densely adherent to the patient's rib cage may expose the patient to significant bleeding and/or entrance into the thoracic cavity. Recently I have become more aware of the fact that there are plastic surgeons who, instead of using good judgment and individualized patient care, are causing fear and unnecessary anxiety among patients. These patients them feel that complete capsulectomy is always necessary and undergo unnecessary surgery associated with additional morbidity and unnecessary expenses. I hope this, and the attached link, helps. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,503 reviews

Breast implant removal - keep or remove capsule?

With smooth saline implants and a thin capsule, there is no medical indication to remove the capsule, although it can be done if you like. It raises the cost and the risks. If the implant is thick or calcified it should be removed. With very little breast tissue and large implants, you probably will be disappointed with the look. We often deflate the implants in the office 6 weeks prior to removal so the tissues can contract as much as possible and so our patients will know exactly what they will look like in case they change their mind and want new implants at the time of removing the old ones. We would not recommend any type of lift be considered until after you have seen what the appearance will be either by deflation or removal and waiting 6 weeks. The tissues change more than you can imagine. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Breast implant removal - remove or leave the capsule?

Thank you for asking about your saline implant removal.
  • You will look very small after your implant removal -
  • And I recommend a vertical lift at the same time to correct the flattened widened breast shape caused by implants.
  • Generally I recommend removing the capsule - if it is thick or in other ways abnormal.
  • Given your lack of breast tissue, if the capsule is not easily separated from your normal tissues, some of it may be left in place to avoid taking normal tissue.
  • If the capsule is very thin and delicate however, I leave it but these are uncommon around so large an implant.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FAC

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews


If you have limited tissue  then I would not remove the capsule. This would thin the tissue even furthering thinning it out. A drain placement is important and a lift may also be required 

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 42 reviews

Removing breast implants

If a breast capsule is firm or thickened, it is best to remove part or all of it at the time of surgery. This is not because of a concern that the capsule will have you but that it may encourage fluid to accumulate inside the pocket or cause an odd shape to the breast. The other important consideration is what your breast will look like without an implant with you saying you don't have much breast tissue and a larger implant. Make sure you have a good idea of what to expect,post-op and you may consider discussing a breast lift as well.I wish you the bestDr. Edwards

Michael C. Edwards, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 35 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.