Implant removal 4 months post tuberous BA. Do I need a complete capsulectomy?

Question

I am looking to have breast implant removal, only 4 months post BA. I never felt comfortable with implants, but felt this was my only option due to my tuberous nature. I am experiencing headaches, fatigue, anxiety, and extreme tingling in hands and feet. I know breast implant illness is controversial, but my surgeon only wants to perform partial capsulectomy. My symptoms are not severe but I’m worried they could Drastically worsen over time if some of the capsule left in. Could symptoms worsen?

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Kenneth Hughes, MD · Answer

Leaving a capsule behind is preferred if it is thin and pliable. If there are calcific components, or silicone granulomatous material, or if the capsule is deforming the breast tissue, then removal of the capsule may be warranted.  If the capsule is left behind, the body will break down and remodel the scar tissue on its own.

Nelson Castillo, MD · Answer

Thank you for sharing your question and I am sorry to hear of your worsening symptoms.  After four months the capsule present will be minimal and can likely be cauterized rather than removed if desired.  Hope this helps.

Camille Cash, MD · Answer

I'm sorry to hear of the issues you are experiencing.  In the case of implant rupture or if the capsules are thickened then it is recommended that the capsules be removed at the time of explant.  If the capsules are thin and no implant rupture is evident then it is optional to leave the capsules behind.  The capsule is scar tissue that the body forms as a natural process around the implant.

Daniel Barrett, MD · Answer

Dear Witty5949,
As long as you don't have capsular contracture or thick capsules, you can get only implant removal. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Implant removal 4 months post tuberous BA. Do I need a complete capsulectomy?

Answers (5)