Is it possible not to have capsules? 11 year old implants.

Hello, thank you for your question. It's understandable that you're feeling concerned about your breast implant removal (explant) and the options being presented. Please see the attached video to answer your question. In summary, it’s unusual to have no capsule after 11 years. If you're looking for a more comprehensive approach, such as capsule removal or a lift, it’s a good idea to have a detailed conversation with your surgeon or consult another expert.

Hi Calm3644,
Surgeons have different protocols regarding implant removal, especially surrounding how to address the capsule.
Your body has two reactions to foreign bodies, be they a splinter, orthopedic hardware, or breast implants....your body will kick it out to the surface or wall it off with a layer of scar. I'd expect that an 11 year old implant would have a capsule around it...but what your surgeon may have meant is that you don't have capsular contracture (as opposed to not having capsules).
My biggest concern with your scenario is the lack of followup--as a surgeon, I want to see my patients through the entire process, and clinic followup visits are a part of that process. If any surgeon suggests doing your operation and never seeing you again, I'd consider another opinion.
Hope this helps.
Best,Christopher Pannucci MD MSBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Hello @Calm3644, thank you for your question. I believe that every time an explant is performed, the capsule must be removed. Complete capsulectomy. Whether it is en bloc does not matter as long as the whole capsule is removed and the tissue is sent for pathology after taking the capsule out. This will prevent future inflammatory responses from the body. A capsule will always form around a prosthesis because it surrounds it and isolates it, since the prosthesis is a foreign tissue. This capsule is not normally seen or felt, but is there. To shed more light, I share a video. 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. International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

You have to be aware that removal of breast implants with or without removal of capsule, will leave you with some deformity, usually ptosis like. That will have to be addressed by meanso lift, volume relacement (fat grafting) or combination of these. This type of surgery, inculding discussion about capsule (that can only be evaluated in surgery) should be performed by an experienced, board certified plastic surgeon. Good luck.

Dear Calm3644,
it is hard to tell for sure without an examination. In case of thin capsules, you can get only implants removed. 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

The creation of a capsule is a natural occurrence when anything foreign is placed into the body. The capsules are simply a layer of scar tissue. For many patients this capsule remains thin and does not cause issues, but for some the capsules may become thick, may have microcalcifications, or cause other issues. If this occurs it is recommended that the capsules are removed at the time of implant removal.

All implants form some degree of capsule around it. I think what he was referring to was the fact that your capsules aren't thickened so we is unable to feel them (which is normal). There are many patients who undergo implant removal without the need for capsule removal and heal just fine without any issues. Hope this helps!

HI Calm3644, great question! The question is if the capsule bothers you. A capsule is normal scar tissue that develops around a foreign object (implant). If the capsule is normal and thin, you don't necessarily need to remove it. Without knowing the specifics, I would inquire about why the implants were recalled. Textured implants have been associated with a rare condition called ALCL. The recommendation in the US is removal if you develop problems (a late fluid collection, hardness around the implant) - however, you're not required to have them removed just because they're textured.
However, I would advise you get a second opinion from a doctor who offers routine follow-up after surgery. I see all my patients to ensure they have the best care and recovery.

With regard to all 4 objects within in the body, including breast implants, A capsule will be formed by the body in order to wall it off from the surrounding tissue. This is a natural response whether the foreign object be breast implant or a knee replacement. Some capsules are very thin and do not cause problems. Other capsules can be thicker and cause capsular contracture. There is a spectrum here between the 2. Textured implants are known to cause less capsular contracture than smooth-walled implants. However your correct, a certain type of textured implant was recalled from the shelf( this would be that Allergan Biocell textured implant). It is likely that her surgeon was just trying to help you uunderstand that the Capsules that you have or safe to be left inside the body if they are normal and thin.
Primary breast augmentation as well as breast augmentation revision surgery is something we do commonly in our practice. Please see the attached link

Capsules form around every implant and artificial thing implanted into the body. However, your capsules may be thin and soft. It would be best to remove the capsules if possible.