Is it pointless to get breast implant removal without capsulectomy?

Question

I’m 46 years old On my third set Had the last set for 6 years, saline, 650 cc I have lupus , sarcoidosis ( non active) and fibro , I have done a lot of research on BII I’m scheduled to get them removed However, there’s no way I can afford to-get the full needed procedure and remove the capsule Is it pointless without doing the capsulectomy ? I’m so scared of how I will look after Thank you in advance

Robert M. Wald, Jr., MD · Answer

Recent studies have indicated that it is not absolutely necessary to do a capsulectomy at the time of implant removal. In fact, if there is very little breast tissue and a capsulectomy is performed, there is a higher incidence of deformity. Whether the capsule has a lot to do with BII is unclear. Your inflammatory diseases also are contributing to your overall symptoms.

Raffy Karamanoukian, MD, FACS · Answer

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

David Parizh, DO · Answer

There is no good data to mandate the removal of the capsule for the exception of a few cases involving cancer. Is your procedure insurance based? Did you mean afford a lift? I feel that a board certified plastic surgeon should be able to guide you through this process. There are several points above that are conflicting. I believe your fear should be about your nipple position and looking deflated. The capsule shouldn’t be a concern and isn’t removed routinely in this instance. 
Please let me know if you have any questions.

Alan Gonzalez, MD, FACS · Answer

Hello @boobilious, thank you for your question. Yes is imperative that when you remove the implants that you remove the capsule as well. Complete capsulectomy. The capsule does not get reabsorbed by the body. This way the mammary tissue can recuperate better and avoid a future inflammatory response from the body. Also it would be necessary to carry out a preventive biopsy on each capsule. If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS.

Zoran Potparic, MD · Answer

Providing that you do not have any visibly pathologic (tumor like) changes in the capsules, there is no need for capsulectomy, partial or full. It is very difficult and bloody procedure and, if not clinically indicated, unnecessary. Seek a second opinion consult by another board certified plastic surgeon. Good luck.

Daniel Barrett, MD · Answer

Dear boobilious,
it is hard to tell for sure without an examination. Generally speaking, it is possible to remove implants alone if the capsules are thin. If you are considering surgery, I would suggest you 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

Connie Hiers, MD, FACS · Answer

If the capsules are thin, they can be left in place and just remove the implants.  With many saline implants, once the implant is removed, the capsule may slowly absorb over time.

Camille Cash, MD · Answer

If you are concerned that you have BII then it is recommended to have the implants and capsules both removed.  Many surgeons accept financing for various procedures through credit agencies that specialize in this.  This may be an option for you.