Can a capsule be present after implant removal and a mastectomy?

Hello Jlbrown,
It is very unlikely that there is any capsule remaining after your mastectomy that would contribute to the asymmetry in shape between your breasts. If your implants were placed above the muscle, the entire capsule would be removed as part of the mastectomy; the goal of a mastectomy is to remove all breast tissue and the fascial covering of the chest wall, which are outside of the capsule. Even if your implants were placed below the muscle, the capsule behind the muscle likely would also have been removed as part of the mastectomy.