Removal vs. non removal of the capsule during a breast implant removal procedure? (Photo)

Good morning!
Unless you have a capsular contracture or concerns about BII, then there is no absolute reason you must remove the capsules. Not removing the capsules winds up being less traumatic, the surgery is shorter, and you wind up healing faster.

Thank you so much for your questions and photos. I would say that if you have no issues with the implants (capsular contracture, pain, scar tissue, etc) and you want them removed simply to remove weight from the breast, then there is no clinical indication to remove the capsule as well. Especially if the implant is beneath the muscle, removal of the capsule can increase pain, surgical risk, and may not be worth the extra surgery and time. Make sure you are seeing a plastic surgeon who is board certified by the American Board of Plastic Surgery and please make sure you are getting your medical information from reliable sources online.

Good luck!

Dallas R. Buchanan, MD, FACS
VIVIFY plastic surgery

Leaving a capsule behind is preferred if it is thin and pliable. If there are calcific components, or silicone granulomatous material, or if the capsule is deforming the breast tissue, then removal of the capsule may be warranted. Removing a capsule unnecessarily could result in bleeding and slight tissue loss.

The technique I recommend is explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery. The surgeon will determine at the time of surgery whether to leave the capsules or remove them based on infection or calcification.

Best Wishes,

Gary Horndeski, M.D.

Dear K Hunt,
as long as there is no capsular contracture and your capsules are thin, then implants can be removed alone. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for sharing your question and photograph. If you are not having issues with your implants, the capsules are neither thickened nor calcified then you can have the implants removed alone. This depends on an in-person examination of your tissues, as well as thorough understanding of your motivation and reason(s) for removal. Hope this helps.

If your capsules are thin, they can be left in place. You might want to consider going down in size that fits your frame and tissue better with a possible lift. Remember, you were not happy with your breasts prior to surgery and may not be happy after removal.

Thank you for your question. Your situation is not uncommon. I have heard many stories of women having some dropping to the breasts after child bearing and breast feeding, and the solution to the problem being placement of a large implant to fill out the breast and lift the nipple complex. In the end, this works but many patients are left feeling that they are too large. If you are removing your implants permanently, I would always recommend removing the capsule. You can have an en bloc implant removal where the capsule is removed with the implant still inside. If you have your implants removed, you don't have to accept the excess tissue in the breast and can always have a mastopexy which would lift the nipple and maximize your existing tissues to create the best breast shape.

Typically if you are having issues with your implants or the capsules, such as rupture of the implant or thickening of the capsules it is recommended that the capsules are removed along with the implants. If you are not having any issues then it is an option to remove the implants alone, or to include the capsule removal as well. Your surgeon will help you in your decision after an examination.