I want simple explant. As long as the capsule is soft will the pocket close by itself & whats chance of fluid build-up?

Will it be of benefit to remove a small piece of capsule even if it's thin & soft, will this prevent fluid build-up? Is it better to suture,score or cauterize the pocket/capsule? What about suturing the breast tissue higher on chest wall, will the breast look better after explant if this is done? Thank you for your comments :)

Doctor Answers 5

#Explant #BreastImplantRemoval - I want simple explant; no capsulectomies.

In general, if the capsules are soft and thin and show no other problems (such as calcifications), I would advise removing the implants without doing any specific treatment to the capsules.  Removing the capsules, even partially, significantly increases the risks of this surgery - specifically bleeding and its sequelae - and there's no reason to do that routinely.  You may need to do that later but, if so, you'll have tried the simplest approach first.  To do capsulectomies on every procedure adds, in my opinion, needless risk in the majority of those cases.

You should of course be examined by a board-certified plastic surgeon who can discuss the pros and cons of each option with you.

I hope that this helps and good luck,

Dr. Alan Engler
Member of #RealSelf100
@RealSelf

Breast implant removal

Hi,

Thanks for posting your question. I am happy to try and help you. It is important to remember that a board certified plastic surgeon will be your best resource when it comes to an accurate assessment of your situation, and concerns.

For breast implant removals, as long the capsule is thin, soft and without calcium deposits, it is fine to leave them in. The body will reabsorb the thin layer over time. This is of no consequence and is entirely safe. If the capsule is thick, it should be removed.

Best wishes,

Dr. Michael J. Brown
Northern Virginia Plastic Surgeon

Explantation without capsulectomy

The peer reviewed literature in plastic surgery recommend total capsulectomy in order to avoid future complications.  I see patients every other week who developed problems after either no drains or incomplete capsular removal, who are very ill from this treatment. 

Susan Kolb, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 23 reviews

Simple Explant

Hi Gailski
I too do not remove a capsule unless it is greatly thickened and hard with calcium( see my photo gallery).
My experience is that a drain in the old implant space for a few days, followed by external compression is enough to prevent problems.
As to suturing breast tissue, that would be something not commonly performed.
Thanks
Best Wishes

Richard Sadove, MD
Gainesville Plastic Surgeon
4.8 out of 5 stars 20 reviews

I want simple explant. As long as the capsule is soft will the pocket close by itself & whats chance of fluid build-up?

Thank you for the question.  

In many areas of plastic surgery, including breast implant removal surgery, you will find many different (often strong) opinions as to the best way to handle a specific situation. In my practice, generally speaking, unless the breast implant capsules have thickened and/or are otherwise symptomatic, I do NOT remove them.

On the contrary (unless indicated), capsulectomy can expose patients to additional risks, such as bleeding, breast size loss and/or irregularities... Your plastic surgeon, based on your physical examination, will be able to inform you whether the breast implant capsule is thickened or abnormal.

Having said that, I often remove a small segment of capsule tissue when removing breast implants ( even when not encapsulated) with the hope that this maneuver will help with fluid resorption (and help prevent seroma formation). I usually use drains also.

Hopefully, you have chosen your plastic surgeon carefully; do not hesitate to address your questions/concerns directly to him/her and ask about the rationale behind any decisions that you question.

You may find the attached link, dedicated to breast implant removal surgery concerns, helpful to you as you learn more. Best wishes.

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.