How Do I know the doctor has removed my capsule after implant removal?

Question

Hi: I'm going to be having implant removal with capsulectomy Soon and I'm wondering for the docs who take photos of the capsule removed, how can I be sure that the photo that is being taken is actually of mine and not someone else's? I want to ask my doctor myself, however, I don't want to offend anyone. If someone were asking you this, how would you prefer that they ask it so that it doesn't come off as you're questioning their ethics? I need full closure after my procedure. Thanks!!

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 your board certified PS has already determined that a capsulectomy is required, and you allow a video to be made during surgery, you can request to review the removal of the capsule. However, you may need to find another board certified PS you trust.

Daniel A. Medalie, MD · Answer

HI,I guess the answer to your question is that you need to find a doctor that you trust. The other answer is that in most patients the capsule does not really need to be removed. If it is firm or calcified then removal is a good idea, but otherwise after an implant is removed the capsule just shrinks and does not really pose a problem. I hope this helps.All my best,Daniel A. Medalie, MD

Donovan Rosas, MD · Answer

Capsulectomy is warranted in a few situations:
-Capsular contracture
-Ruptured silicone implants
-Suspicion of BIA-ALCL in the setting of a textured device
A thin, soft (non-calcified) capsule in the setting of an intact silicone implant does not necessitate removal. If you do choose to have the capsule excised, it is not advisable to proceed under local.
With regards to your specific question, there must be a certain level of trust between patient and surgeon. Most will have documentation standards in order to ensure accuracy. Yet if we are being completely honest that can be manipulated. Ultimately you must place a certain degree of faith in your surgeon that what they are showing you is true.
As always,discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Verified Member
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Christine Rodgers, MD · Answer

Hi Natural,If you do not trust your doctor to tell you the truth, perhaps you need to find another doctor. I typically will take a picture of the capsule with the patient's name on the ID sheet in the OR. I think that is the best I can do as it is forbidden in our hospital to take a picture of the patient asleep. Hope this helps a bit,Best,Dr. Christine Rodgers

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question. One part of the surgeon selection process involves trust in the individual to ensure they do the appropriate work.  I would feel confident that the surgeon you selected will do what you both discussed.

Daniel Barrett, MD · Answer

Dear Naturalbound12,
generally speaking, implants can be removed alone in case that capsules are thin. In case of capsular contracture or thick capsules, they should be removed together. You should fully trust your plastic surgeon. I would suggest you to discuss this with your plastic surgeon. 
Daniel Barrett, MD

Camille Cash, MD · Answer

It is important that you feel comfortable and confident in your surgeon and surgical plan.  If you do not trust your surgeon to remove your capsules if that is the agreed upon procedure, then you should find a surgeon whom you trust.  You sign consents prior to surgery which will detail the planned procedures.  In addition you can request a copy of your surgical report which will explain in detail what was done during surgery.

Connie Hiers, MD, FACS · Answer

When you go for your consultation, just let your surgeon know you would like the capsule removed as well as the implants. Most capsules can be removed unless too stuck down to bone, or too little breast tissue is left and removal might damage the skin. Capsule removal is not done under local anesthesia.

Karol A. Gutowski, MD, FACS · Answer

You can ask your surgeon to take a picture of the capsule along side your name and date written on the background.

Tom J. Pousti, MD · Answer

Keep in mind that you are not alone: these days every patient undergoing breast implant removal surgery (with concerns regarding breast implant illness symptomatology) is interested in viewing photographs taken during surgery. Although I understand your concerns, questioning whether or not the pictures that was taken is of your capsules (or that of another persons) may be offensive to some plastic surgeons. Frankly, it is not a question that needs to be asked, assuming careful selection of plastic surgeon.

My best advice: select your plastic surgeon carefully based on experience and ethical reputation. Then request that photographs be taken (possibly remind your plastic surgeon and his/her staff on the day of surgery as well). No need for further questioning along those lines.

Best wishes.

My best advice: select your plastic surgeon carefully based on experience and ethical reputation. Then request that photographs be taken (possibly remind your plastic surgeon and his/her staff on the day of surgery as well).   No need for further questioning along those lines.

Best wishes.

How Do I know the doctor has removed my capsule after implant removal?

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