Why is it recommended to remove a thick capsule?

Hello, thank you for your question. It sounds like you've been dealing with a challenging situation, and I understand why you’re concerned. When breast implants are placed, the body naturally forms a capsule of scar tissue around them. In most cases, this capsule is thin and soft, but in some individuals, especially those who experience capsular contracture, the scar tissue can become thick, tight, and firm. Capsular contracture occurs when the capsule hardens and tightens around the implant, potentially causing pain, deformity, or discomfort. Please see the attached video to discuss your concerns. If you still feel the capsule is thick and your breast feels hard and firm, it's a good idea to discuss a potential capsulectomy with your surgeon. Given that you’ve already sought second opinions from multiple surgeons, and they all recommend removal, this suggests that the thickened capsule is likely contributing to your ongoing issues. It’s worth considering further surgery to alleviate pain and prevent long-term complications.
Since you’re still experiencing pain and complications, it may be a good idea to pursue the removal of the thick capsule to improve your symptoms and reduce any future risks. While capsulectomy can involve some additional recovery time and complexity, many patients find relief and improved outcomes after having the capsule removed.
I would recommend discussing your concerns in detail with a trusted plastic surgeon who specializes in these types of procedures. They can offer more personalized advice based on your individual case, helping to alleviate any concerns you have moving forward.

Thank you for your question.
Capsules are thick layers of scar tissue. Although your implants were removed due to capsular contracture, you left the capsule behind. This scar tissue will never be absorbed by the body hence the firmness of the breast that you are feeling. This also can contribute to any discomfort or abnormal appearance to the breasts. I recommend speaking with a board certified plastic surgeon to discuss your options.

Dear Elsa9431,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. Generally speaking, thick capsules should be removed in order to reduce the chance of complications. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question. It's not mandatory to remove the capsules while having an implant removal. Implant removal is a simple procedure; adding capsule removal to this surgery will add time, cost, and risk. However, in some cases, the capsule tightens causing the tissue to become dense. This will result in distortion and pain and Capsulectomy will be necessary. Best wishes.

Hello @Elsa9431, thank you for your question. When there is a breast implant removal the capsule thick or thin has to be removed entirely. Complete capsulotomy because the capsule does not get reabsorb by the body. Also it would be necessary to carry out a preventive biopsy on each capsule. This way the mammary tissue can recuperate better and avoid a future inflammatory response from the body . 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.

If the capsule is thick and hard it is best to remove it so that the hardness is gone and no longer painful. Some capsules, even thick ones, have been known to disappear over time once the implants were removed. Anything calcified will not absorb and needs to be removed.

Typically when the capsule has thickened or tightened around the implant, or is causing issues it is removed along with the implant. A thickened scar capsule can cause pain, distortion, and may contain microcalcifications which could potentially impact mammogram readings.

Thank you for your question. You do not mention how long you have had the implants before you took them out and You don't mention what kind of implant you had and whether its surface was textured or not since a BIA ALCL has been associated with textured breast implants. The capsule is like scar tissue that forms around the implant with time and can cause pain and the breast becomes hard and deformed. I would recommend doing un ultrasound/ MR and then probably taking the capsules out.
I hope this helps
Best regards
Dr Layth Gurgia
Consultant plastic surgeon
Stockholm
Sweden