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Breast Implant Removal (Explant) – Should I Have a Total Capsulectomy? 

Wednesday, December 20, 2017

There are many reasons why women have their breast implants removed. These include rupture, leakage, rippling, malposition, capsular contracture and extrusion. Some women however, have their implants removed because they believe they are suffering from “Breast Implant Illness”.

Although the official line is that there is no proven association between silicone breast implants and autoimmune disease, many woman develop a variety of symptoms and illnesses following breast augmentation. These include fatigue, muscle weakness, aches and pains, hair loss and a general feeling of not being healthy. More seriously, women with textured breast implants, especially the macro textured implants manufactured by Allergan and Silimed, are at risk of development of Anaplastic Large Cell Lymphoma (ALCL), which refers to a cancerous change in the capsule surrounding the breast implant.

So, when removing breast implants, should the capsule be removed or should it be retained?

The only situation in which a total capsulectomy must be performed is when the patient has ALCL (Anaplastic Large Cell Lymphoma). In most cases, a total capsulectomy will completely cure this disease.

However, in other instances, such as when the woman believes she is suffering from Breast Implant Illness or when the capsule is heavily calcified, a total capsulectomy may also be suggested. Although some capsules are relatively easy to remove, in others, removing the entire capsule can cause devastating scarring of the breast and risk a hole in the chest wall (pneumothorax). This risk occurs because the capsule is very adherent to the surrounding tissue such as the chest wall, the muscles, and the breast tissue itself. Often these structures are damaged when the capsule is removed. So the answer for these women is that the capsule should be removed as long as it is safe to do so.

There are also benefits to be gained from retaining the capsule, if it is thin and not itself diseased. For example the capsule provides a firm foundation upon which to graft fat if this method is chosen to provide a natural breast augmentation. The remaining thin capsule is then harmlessly absorbed by the body.

It is important to note that, when the capsule is retained, it is still possible to wash out the capsule with Betadine solution and so dissolve any remaining silicone. .

So if you are thinking of having your implants removed make sure you discuss with your surgeon whether or not the capsule should be removed.

Learn more about the removal of your implants, and replacement options here

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