Breast Implant Removal and En Bloc Capsulectomy

Women may decide at some point to have their breast implants removed.  The reasons a woman may choose to proceed with implant removal vary, but the most common reasons are:

  • They no longer want to be that size
  • Their breast shape has changed over the years
  • Capsular contracture
  • Implant rupture/leak
  • Concern about the safety of breast implants

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Depending on the reason the implants are being removed, the procedure to do so will also vary.  In some cases, the implants can be removed by themselves, while in other cases the implants are removed with the surrounding capsule.  Following removal of implants, new implants can be placed or the patient may consider a breast lift or reduction to further shape the breasts.

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What is a capsule?

Whenever a foreign material or device is placed in a person’s body, the natural process is that the body will develop a rim of scar tissue around it.  This is referred to as a capsule and it is the body’s mechanism to keep anything it recognizes as “foreign” separate from the surrounding tissues.  In the case of breast implants, a normal capsule is a very thin layer of smooth scar tissue.

Capsular Contracture

Sometimes a woman’s body will develop an overgrowth of scar tissue around her breast implant.  This can happen early in the healing process after surgery or many years later.  In the milder forms, the implant may feel just a little firmer than normal.  In more severe cases the implant may feel hard or look too perky.

The reasons why a contracture may develop are not completely understood, but it’s generally believed that inflammation around the implant stimulates the body to develop too much scar.  This may be due to the presence of a small number of bacteria and their byproducts (biofilm) that are not enough to cause an infection but enough to create inflammation.  Another potential cause of contracture is leaking of a silicone implant.  There may be other reasons for contracture as well, but most of the time we don’t really know why it develops in some breasts and not others.

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