Complications such as capsular contracture may sometimes require breast implant removal or replacement for patients who have undergone breast augmentation cosmetic surgery. If the patient chooses the option of breast implant removal, the surgeon will have to decide whether or not to remove the breast capsule that envelopes the implant.
The plastic surgeon will discuss these aspects with the patient during the initial consultation. Board certified plastic surgeon Dr. Hisham Seify provides breast implant removal and replacement procedures to patients in Newport Beach, Orange County, CA, and surrounding locations.
What is a Breast Capsule?
The capsule is essentially the body’s natural response to the surgically placed implants as a part of breast augmentation plastic surgery. The capsule may comprise silicone shell fragments, silicone gel, calcification, bacteria, and inflammatory cells that have been stimulated by the body’s immune system to react to different components of the breast implants.
Research has shown that when the implant is removed, the capsule will not disappear on its own. Some patients may experience pain in the implant area, which can occur due to the pulling effect of the scar on the surrounding tissue and muscle. If the presence of implants is causing health risk and discomfort, the capsule removal may be necessary.
Avoiding Capsule Removal
While capsulectomy or capsule removal appears to be the most appropriate choice when the cosmetic surgeon decides to perform implant removal, it is not always necessary. The surgeon may place a surgical drain to provide vacuum pressure in order to remove any residual fluid. When the implant has been removed, most capsules will gradually shrink in volume, though they will never be entirely eliminated.
The option of capsulectomy surgery should be chosen only when it provides tangible benefit in comparison to other solutions. Dr. Seify will carefully review the patient’s condition before determining the optimal solution. He receives patients from Newport Beach, Orange County, CA, and nearby areas for capsulectomy and implant revision.
When is Capsulectomy Necessary?
Capsulectomy in conjunction with implant removal may be necessary in the following situations:
- When the breast implants are required to be shifted from a sub-glandular (above muscle) plane to a sub-muscular (below muscle) plane. In such a case, if the sub-glandular capsule is left in its place, it will most likely interfere with implant expansion and make the implant feel hard.
- When the patient has experienced an extra-capsular rupture of the silicone gel breast implant. In this situation, the silicone gel may have penetrated through the implant capsule into the surrounding breast tissue. The surgeon may perform at least a partial capsulectomy to clean out the silicone gel from the area.
To simplify the guidelines, the patient should note that if the breast capsule is very thick and causing distortion of the shape of the breast, or is calcified, it should be removed. On the other hand, if the patient has saline implants or undamaged silicone implants, and the capsule thickness is normal, it can be left alone without the need for capsulectomy.