Can I do a capsulectomy with local/twilight anesthesia? And what's the risk of not removing my capsule?

Hello! Thank you for your question! It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capsule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. If minimal contractureis seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from rutptured implant vs pain vs simple pocket adjustment, etc).  Without knowing your issues andwithout an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies (in an en bloc fashion) in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you.  It would be difficult to do a full capsulectomy without general anesthesia. Hope that this helps! Best wishes!

If your capsules are thickened or causing issues they are typically removed at the time of explant. If they are not causing issues you can elect to have them removed or leave them behind. The surgery to remove them is more involved than simple implant removal and therefore it is recommended that it be performed under general anesthesia.

Thank you for the question. Given your concerns regarding "health issues" and the presence of breast implants, you will likely  be better off undergoing  capsulectomy surgery.  In my practice, this is best done under general anesthesia supervised by a board-certified plastic surgeon.  Having said that, I have done this procedure under "twilight" anesthesia again expertly administered by a board-certified anesthesiologist.Generally speaking, anxiety prior to surgery is very normal; its complete elimination is usually not possible. Assuming you have chosen your plastic surgeon carefully, other important "variables" such as anesthesia provider and surgery facility will be selected based on everyone's first priority: safety. This careful selection should give you some peace of mind that you will be safe around the time of surgery. Discuss your specific areas of concerns with your plastic surgeon who will be in the best position to help you calm your nerves.  





I ask my patients to try to be as calm as possible prior to surgery; this “calmness" tends to translate to a smoother postoperative course. You may be able to alleviate some pre operative anxiety with music, exercise, meditation, a glass of wine (if ok with your surgeon),   and positive/objective focus on the long term outcome/benefits etc. prior to your procedure.



Generally, patients find that they did “get worked up for nothing” after their recovery is completed.



I hope this, and the attached link, helps.   Best wishes.