Breast Implant Removal Question From Boca Raton

At Atlantic Coast Aesthetics, we love a good question! This week’s ACA Question of the Week comes from Boca Raton and it really interested our founder and Chief Medical Officer, Dr. Thomas A. Pane, because of the detail and the possible directions in which this question could go. The question is, “My implants are 15 years old and one has ruptured. Why do some surgeons remove the capsule around the implant and others not? Which procedure is more common? What are the risks of not having a capsulectomy? Also, is there a risk of mold or infection with a saline implant? If so, is removing the capsule a must?”

Dr. Pane points out that for strictly cosmetic surgery, the answers may vary slightly than with reconstructive surgery, as might occur after a mastectomy or similar procedure. However, the basics remain largely the same as far as the implants go.

It is not fully known or understood why scar capsules form around implants, despite a great deal of research and study on the topic. Because of this, what risk factors and recurrence rates may adhere to cutting down the scar capsule are still largely unknown, unlike the risk factors for the implants themselves. What is known is that the body does form a scar capsule around anything that is not native tissue. Generally, a scar capsule consists of a very thin “filly” tissue between the implant and the interior of the breast.

When the implants are exchanged later due to rupture or time-of-life failure, most cosmetic surgeons will release the capsule to permit the scar capsule to expand. This reduces the risk that the scar capsule will compress the implant, leading to an unnatural breast shape. If the capsule becomes very hard, thick or eggshell-like, then the capsule may be removed altogether. In many cases, such a capsule will have undergone calcification and interfere with the placement of a new implant. However, Dr. Pane says that developments like this may be dependent upon the technique used by the original surgeon to place the implants and that such side effects almost never occur in his patients.

Some risk factors for hard scar capsule development include leaving the implants in for too long without having them changed out and improper or out-of-date implantation techniques. Because cosmetic surgery is always evolving, there are techniques in place now that may help reduce the risk of hard capsule formation. However, since the exact mechanism by which a scar capsule develops is not fully understood, it is difficult to pinpoint how or why these calcified capsules form in some patients. In general, Dr. Pane says, it is best to disrupt the capsule as little as possible if it can possibly be avoided, as this can lead to other postoperative complications that are best avoided. When it comes to scar capsules, the least possible amount of interference is always preferable.

He also noted that 15 years is a long time to have an implant in place. It’s usually a good idea to have them changed out about every 10 years, depending upon the patient. While implant lifespans range from a couple of years to 25, a great depends on the patient, how they tolerate the implants and whether there has been any trauma, leakage or rupturing of the implants, as well as the condition of the scar capsule.

With regards to infection from saline implants, Dr. Pane says this is very rare. Some people believe that a low-grade infection may be the underlying cause of scar capsules, but he reiterated that this is not clear. However, with proper surgical techniques and disinfection of the interior of the breast while placing the implant, infection, mold and other risk factors should be minimized to the greatest possible degree. Proper aftercare and follow-up after having breast implant surgery will go a long way to reducing postoperative complications and ensuring the best possible outcome for the procedure.

If you have a question you’d like to ask Dr. Pane or the staff of ACA, we invite you to call us at (561) 422-4116, email us at https://acplasticsurg.com or follow our Facebook page! The only bad question is the one you don’t ask, and you might even help others who have the same question if your question becomes ACA’s next Question of the Week, answered in a live Google Hangout by Dr. Pane himself. We love well-informed patients and great questions, so ask us anything related to cosmetic surgery to get the straight answers you want!