Remaining Scar Tissue After Capsulectomy?

What happens to any remaining scar tissue after a complete capsulectomy? Does it eliminate itself from the body if it is stuck to ribs, or does it stay? I am interested in breast implant removal en-bloc and am concerned if all the scar tissue can't be removed.

Doctor Answers 11

Remaining Scar Tissue After Capsulectomy?

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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 capsule 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 an en bloc fashion) 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!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Total capsulectomy means complete removal

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If your plastic surgeon tells you that he/she removed all of the capsule or scar around the implant, there should be none of it remaining. Whether ot not it needs to be removed is case by case dependant. Capsules around older silicone implants (greater than 20 years old) most often should be removed due to the higher chance of silicone free inside the capsule. If in the operation it is felt that the back of the capsule is very adherant to the chest wall, it is sometimes left. Capsule left behind will be remodeled for the most part by the body and become scar tissue.

Dr Edwards

Eventually tissue will remodel and soften.

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Every effort is made to remove the entire capsule when plastic surgeons perform total capsulectomies.Unfortunately, small amounts of capsule are occasionally left behind.In addition, capsule removal may be associated with secondary complications such as bleeding and rarely, perforation of the chest wall.For this reason, remnants of the capsule may be left behind on the chest wall surface.Under these circumstances, it may not be safe to remove the capsule from the anterior chest wall.

When capsule remnants are left behind they form scar tissue which eventually remodels and softens.This doesn’t generally create long term problems for patients and wounds tend to heal without difficulty, even when small amounts of capsule are left behind.If you’re considering capsulectomy surgery, it’s important to discuss these issues in detail with your plastic surgeon.Your surgeon should be able to discuss this in detail and alleviate any anxiety that you may have.

Capsulectomy Removes Abnormal Internal Scar Tissue

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Complete capsulectomy for all practical purposes means removal of all internal scar tissue. Your body as a part of natural part of healing under ideal circumstances will make a new thin and supple capsule rather than a thick stiff one that was removed. 

Scar tissue history after breast implant removal

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Scar tissue tends to dissipate over time through a process called scar maturation. It will generally be thin and soften as long as most of the foreign body is removed. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Removing breast implant capsule and scar

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There are two surgeries available, a partial or complete capsulectomy; to remove capsule and scar after augmentation.  It is usually not necessary to remove the entire contents of the capsule, as the anterior portion predominately contributes to asymmetry and distortion.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

All scar tissue from a capsule can be removed

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Once the implant is removed, the capsule is staring the surgeon in the face. it may be tough going, but all capsule should be removed if the will is there.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

Scar tissue remaining after a capsulectomy

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After a capsulectomy, you'll had a small amount of scar tissue at the junction of the breast tissue. If you receive another implant in this pocket, your body will re-create another capsule. If you receive an implant in a different location in your breast, your body will create capsule at the new breast implant location and the old implant location will collapse and eventually scar together.

Capsulectom or Breast Implant Scar Removal

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It really depends on the situation at hand whether the scar tissue around the implant is removed completely. In general, where there is suspicion of ruptured silicone and/or a thickened scar then it usually is all removed competely. If the scar tissue is thin and the implant is a saline implant, then most commonly it is left alone to adhere to each other and heal over time.

Hope that helps.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Removing implants

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The goal is to take as much of the capsule out if it is scarred in. Sometimes the entiere capsule can not and often this softens and disappears.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.