Scar tissue remaining after explant, is this rationale only relevant to under muscle implants?

Hello, thank you for your question. It sounds like you’re navigating a complex situation with your breast implants and concerns about scar tissue removal. I have answered your question specifically in detail. Open communication with your healthcare provider and potentially seeking a second opinion can help you make a more informed decision about the best course of action for your specific situation. 

Dear deedee44,
it is hard to tell for sure without an examination. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Hello @deedee44, thank you for your question. When it comes to breast implant removal, there are a few different approaches that can be taken. These include removing just the implants, removing the implants and the scar tissue (also known as the capsule), and my personal approach to and explant that is performing breast implant removal, total capsulectomy where the entire capsule is removed, as well as immediate reconstruction with BRALAN (Breast Reconstruction Anatomical Lift Augmentation) technique. When the capsule is so tight against the edge of the ribs and the intercostal muscles and an en bloc capsulectomy is not possible, it can be segmented. What does segmented mean? The implant is removed, the whole area is cleaned so that it does not become contaminated, and is resect it under direct vision. Here is a video that sheds more light on the topic. 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. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

If the scar capsule has tightened around the implant (capsular contracture), is thickened, causing issues, or if there is a rupture to the implant then it is recommended the capsules are removed along with the implants. If none of those apply then it may be recommended to leave the capsule behind. Each patient must be evaluated individually for what is best.

If the capsule, or scar tissue, is thin, it can cause more harm trying to remove it, especially on the back side of the implant where it is close to the lung cavity. Removal of the capsule can be different with each lady depending upon why the implant and capsule are being removed, and the thickness of the capsule, and the age and type of the implant, and how much of the capsule actually needs to be removed.

The formation of scar tissue, known as capsular contracture, can occur after breast implant removal (explantation) regardless of whether the implants were placed under or over the muscle. However, the risk may vary between these placements. Discussing your specific case with a healthcare professional is crucial for recommendations.