When getting an explant..... Capsules removed or not?

I see both opinions on here & I really would like to know what each option entails. Taking them out... Is it harder on you, more expensive, what are the benefits and downsides. Leaving them in: Same questions...also I've seen doctors say they capsules shrivel away or shrink. Do they feel like a lump when they get small? Would it add more breast tissue? Would it cause the appearance to look funny if left in? I want to be prepared & make the right decisions. Thank You.

Doctor Answers 4

If you have health problems that could be from the presence of the implants, removal of the capsule is critical

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The capsule is your body's response to your implants. It may contain silicone gel, silicone shell fragments, bacteria, calcification, and inflammatory cells which have been mobilized by your immune system to react to different components of the implant. Research has shown that the capsule does not disappear on its own when only the implant has been removed (See Nancy Hardt's paper in Plastic and Reconstructive Surgery.) In addition, if you have pain around the implants, it is usually due to the pulling effect of the scar on surrounding muscle and tissue. If you have health problems that could be from the presence of the implants, removal of the capsule is critical in improving your health. Linked is my en bloc video. I hope this helps.

When getting an explant..... Capsules removed or not?

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Thank you for the question. Don't be surprised if you receive a variety of differing responses.

Generally speaking (in my opinion), unless the breast implant capsules have thickened (and/or are otherwise symptomatic), are associated with the ruptured silicone gel breast implants, or if the patient has concerns about "medical conditions" related to the breast implants, capsulectomy is not universally necessary. For these patients, en block removal of breast implants is a good procedure.
***On the contrary, capsulectomy can expose you to additional risks, such as bleeding and minimal size loss. In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity).
Recently I have become more aware of the fact that there are plastic surgeons who, instead of using good judgment and individualized patient care, are causing fear and unnecessary anxiety among patients. These patients then feel that complete capsulectomy is always necessary and undergo unnecessary surgery associated with additional morbidity and unnecessary expenses.
I hope this, and the attached link, helps. Best wishes.

Capsules do not shrivel away or shrink

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For explant surgery, it is almost always best to remove the capsule in its entirety. This will allow the space to heal. If you leave the capsule in place, it does not heal. Fluid can accumulate in the space. The situation that brings the patient to implant removal will have an affect on the decision. This is a surgery which requires discussion with the plastic surgeon about the problem, the goals, and the technical concerns. The body does not re-absorb the capsule. Revision surgery requires drains because the fluid is going to be generated when you operate on the scar capsule. If you provide a mechanism for the fluid to be removed (i.e. drains), the risks are lower. If the fluid accumulates because there were no drains, it will most certainly cause problems in the future.

Breast Implants Removal: should the capsule be removed or not?

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Thank you for your question. I am sorry to hear that you have decided to have your implants removed but I must assume you have your good reasons. The decision of having the capsulectomy ( partial or total) or not, depends on the reason of the removal (capsular contracture, rutpure of the implant, purely cosmetic, etc) and also on the position of the implants (submammary or subpectoral). If the patient decides to have her implants removedĀ  following capsular contracture or rupture of the implants, normally a capsulectomy is appropriate (total or partial, depending on the case).

Hope it helps.
All the best

Andrea Marando
Plastic and Cosmetic Surgeon

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.