Explant - when to remove capsules?

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.

When removing implants the decision has to also be made whether or not to remove the capsules. When a silicone implant has ruptured or if the capsules are thickened or causing issues it is recommended to have them removed. If they are thin and not causing issues then it is an option to remove them or leave them behind. Your surgeon can help you determine what is best for you.

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon