Do I need to removed my capsules? Can I do local anesthesia?

I got my first implants in 1995, 275 cc over the muscle, never had any issues and then in 2007 I decided to remove them and replaced them for 450cc over the muscle. Never had any problems. Now I would like to permanently remove them. I would like to have them done with local anesthesia. Do I need to remove the capsules? If I don't remove them, would it affect a mammogram? (Last one showed dense tissue)

Doctor Answers 9

Capsule left in for breast implants removal

Hi Corky,

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. It will not alter mammograms.


Best wishes,

Dr. Michael J. Brown
Northern Virginia Plastic Surgeon

Implant and capsule removal

If you just want the implants out for aesthetic or personal reasons, and no other leaks or complications eg dense calcifications or infection, the implants can be removed under local in selected patients.It is difficult to remove capsules under local and not recommended for safety and comfort,but all capsules don't necessarily need to be removed.

Robert Savage, MD (retired)
Wellesley Plastic Surgeon
5.0 out of 5 stars 3 reviews

#Explant #BreastImplantRemoval - Do I need to removed my capsules?

Not necessarily.  If you are otherwise asymptomatic and just want your implants out, that can - at least in theory - be done under local anesthesia alone.  There are of course risks involved in any surgical procedure and no disadvantage (costs aside) from at the very least having anesthesia available.  If your capsules are thin and the implants are easily accessible (ie, there is not too much tissue over the implants, etc) then you can undergo removal of the implants alone.

Whether or not you'll be happy with the final result, with or without the capsules removed, is a separate issue.  You should speak with your plastic surgeon about what you can be expected to look like depending on which of the options you choose.  And even if you are not happy with that result, there will be options going forward.

You should of course discuss this with your own plastic surgeon to go over the choices, including the advantages and disadvantages of each.

I hope that this helps and good luck,

Dr. Alan Engler
Member of #RealSelf100

Capsulectomy

A capsulectomy is sometimes performed with implants removal. I would not recommend that under local.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Capsulectomy and #breastexplant

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.

Lu-Jean Feng, MD
Cleveland Plastic Surgeon
4.5 out of 5 stars 84 reviews

Do I need to removed my capsules? Can I do local anesthesia?

Capsulectomy is a relatively painful procedure. Whether you should have that done or not would depend on a conversation with your surgeon, but I would not suggest doing that under local. You would not be very comfortable. Best of luck! 

Mathew A. Plant, MD, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 21 reviews

Explantation

The peer reviewed literature in plastic surgery recommends total capsulectomy in order to avoid complication later including with the MG.  This cannot be done in most cases under general anesthesia.

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

Removal of Implants

Removing the implants under local would depend on your surgeon and the type of implants you have.  If you have gel implants they should be removed under general anesthesia.  Saline implants can be removed under local in some cases.  If the capsule is removed, general anesthesia should be used.  Discuss your options with your Plastic Surgeon.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 55 reviews

Implant removal over the muscle under local anesthesia...considerations for success

Thanks for sharing your question.

Your question brings many valid points. Local anesthesia allows surgeons to work in limited spaces were sensation is interrupted temporally. When removing an implant the access point could be numbed easily, however the rest of the cavity will stay sensate.

If you have a saline implant and you do not want to remove the capsules, then the local anesthesia could be a viable procedure.

If you have silicone implants, injecting the anesthesia might perforate the implant, making the silicone to diffuse through the breast space, requiring thorough cleaning afterwards.
If there is any doubt, do the general anesthesia. It will take less time and your surgeon could do a better job.

This is especially true, if you do not want significant deformity of your breast afterwards.

Finally, make sure that you have a consultation with a board certified plastic surgeon that specializes in breast revisions.

Wishing you the best in your journey

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.