Can Breast Implant Removal be done WITHOUT Capsulectomy? (photos)

Question

I am a retired 71 yo physician who wants her subpectoral breast implants removed. This is mostly a cosmetic decision and I believe I am an excellent candidate for just leaving the capsules in place. I had poor healing after my last surgery 9 years ago when a mastopexy was also performed. My sternal notch to nipple distance is 20cm on each side and I have a fair amount of subcutaneous tissue and skin elasticity is pretty good. I desire to have this more minimally invasive surgery.

Alan Gonzalez, MD, FACS · Answer

Hi @HikerTriker, thank you for your question. I believe that any time an explant is performed a complete capsulectomy is essential, regardless if the technique is en bloc, as long as the entire capsule is removed and the tissue is sent to pathology after removal. This will prevent future inflammatory responses in your body because the capsules do not resorb over time. Here is a video that sheds more light on the subject. Best regards.

Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation for Adipose Therapeutics and Science" (IFATS), Member of the Colombian Society of Plastic Surgery (SCCP).

Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation for Adipose Therapeutics and Science" (IFATS), Member of the Colombian Society of Plastic Surgery (SCCP).

Donald R. Revis Jr, MD · Answer

Good morning,
Yes indeed- you may explant without capsulectomy, place a drain in each pocket for five days, and then compress for 12 weeks in a nice sports bra. I just did this not too long ago for a local female plastic surgeon in my community. The surgery is quick and easy and the recovery is very brief!

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Yes, an implant removal can be done without capsulectomy  and at times under local anesthesia alone.  Expect some additional breast sagging after the implants are removed.

Gary M. Horndeski, MD · Answer

Breast implants can be removed without capsulectomy. 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 and nipple sensation (in 95%) is maintained, if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear HikerTriker,
it is hard to tell for sure without an examination. Generally speaking, it is possible to remove implants only. 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

Connie Hiers, MD, FACS · Answer

If your capsules are thin, the implants only can be removed. If you have saline implants, they can be removed under local in the office. The saline implants would be first drained and then removed. However, there is an increased risk of seroma if the capsules are left.  If you have textured implants, you  might want to have the capsules removed. I would suggest meeting with a surgeon and discussing your options.

Camille Cash, MD · Answer

Yes, it is an option to proceed with implant removal only and leave the capsules in place.  It is recommended that the capsules be removed along with the implants if they are thickened, causing issues, or if there is implant rupture.  See a board certified plastic surgeon near you for a consultation.

J. Michael Morrissey, MD (in memoriam) · Answer

Thank you for your question and photos. In the absence of any capsular pathology, ie; contracture or fluid consistent with BIA ALCL, the implants can be removed and not replaced without capsulectomy. A closed suction drain will typically be placed to allow the capsule to collapse on itself. Over time, the compressed breast tissue will fluff a bit, so you will not likely be flat chested. Now, having said that, if on entering the capsule, fluid is encountered, that fluid would be sent for histology and it would be recommended that capsulectomy be performed as there would be suspicion for ALCL. Preoperative ultrasound could help determine if there is any peri capsular fluid so a good decision can be made. 
As always, please consult an experienced Board Certified Plastic Surgeon in your area.

Can Breast Implant Removal be done WITHOUT Capsulectomy? (photos)

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