Should the Capsule Be Removed with the Implants?

In the vast majority of
explantation cases, it’s not necessary to remove the capsule that surrounds the
breast implant.When these capsules are
left alone, they collapse upon themselves and the implant pocket is eventually
obliterated.In addition, capsule
removal may be associated with secondary complications such as bleeding.For this reason, removal of breast capsules
is not undertaken without specific indications.When patient’s have ruptured silicone implants, calcified
capsules, or thickened capsules with breast distortion, capsulectomy is usually
indicated.Under these circumstances,
failure to remove the capsule will result in a persistent deformity.In someone who’s not having problems with capsule
formation, simple removal of implants without capsulectomy is probably
reasonable. Under these circumstances,
it’s important to discuss this issue with your plastic surgeon.Your surgeon should be able to formulate an
appropriate treatment plan.

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 capule 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 contracture is 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 and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies 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. Hope that this helps!  Best wishes!

If the capsule is symptomatic (thickened, firm or calcified) it is in your best interest to have the capsule removed to avoid problems such as firmness and irregularity  of the breasts postoperatively. These problems may confuse self breast exam (for cancer detection). Furthermore, calcification in the capsule may confuse mammography use for breast cancer screening. Of course, it is important during this process of removal of the capsule to avoid excision of normal breast or subcutaneous tissues.

If the capsule is soft and asymptomatic then excision is unnecessary.

Best wishes.