American Society of Plastic Surgeons
For Medical Professionals
2 months ago

Capsulectomy necessary with rupture?

I recently was found to have a ruptured silicone implant seen on an MRI done for a regular cancer screening. The two PS’s that I’ve seen don’t feel I need to have the capsule removed when I have my implants replaced but most of what I’m reading is that’s recommended. I am having some mild pain recently and minor swelling on that side but no suspected CC and no other symptoms.

Procedure: Breast Implant Revision
Location: Millersville, MD

Replies 4

Ellis Tavin
ASPS Surgeon
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If the capsule is not thickened or otherwise abnormal and you do not have textured implants with a late seroma, there is no reason to remove the capsule. Removal of the capsule may distort the breast and increases the risk of bleeding after surgery. Sounds like the advice you received from your plastic surgeon is correct.

Daniel Allan

If the gel has infiltrated the capsule, the capsule should be removed. Some gels are very cohesive, that is, they don't stick to the tissues, in which case it is reasonable to leave the capsule. A "normal" capsule is very thin and translucent-blood vessels are visible through it.

Alfred Antonetti
ASPS Surgeon

There are some indications for removal of the capsule and reasons for leaving it alone. In your surgeon's opinion there is no need to remove the capsule. The final determination will be made at the time of surgery. If you insist in having the capsule removed I am sure you can find someone to do it but the two surgeons you saw told you correctly.

Rahul Vemula
ASPS Surgeon
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This is an excellent question. Unless there is some abnormality with the capsule such as thickening showing capsular contracture a full capsulectomy is not necessary. If not necessary, a full capsulectomy adds risk to the procedure. Please be very careful of the resource you read on the internet. The best source is this website, the American society of Plastic Surgeons which has the most reliable resources with the best scientific evidence. Please be very careful of resources such as facebook groups, instagram and tick tock posts which often are highly individualized stories any may not apply to your particular case. Please also make sure that the plastic surgeons you are seeing are ASPS members and board certified by the American Board of Plastic Surgery.

Best wishes for a safe operation to achieve your goals

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