Even though breast implants are proven to be a safe option for breast augmentation, there is always the risk of the so-called failed implants. If diagnosed in a timely manner, the implants can simply be removed without causing any problem. However, if a capsular contracture occurs and remains undetected for a longer period, it can lead to deformity, pain, and discomforts. If a breast implant has ruptured, the procedure to remove the implant is relatively sophisticated and requires more time and surgical expertise. While many patients get their breast implants removed each year, majority of the patients find it difficult to decide whether they should also remove the scar tissue that has developed around the implants. Capsular contracture In order to understand implant removal and capsulectomy, it is important to first understand capsular contracture. Capsular contracture occurs when the scar tissue that develops around the breast implant thickens and contract, causing the breast to harden. As the capsule continues to tighten, it can change the shape and feel of the breast in addition to causing pain and discomforts. Capsular contracture is an unpredictable problem that may occur after the breast implant surgery. While the reason for the occurrence of capsular contracture in some women and not in others is yet to be determined, removing the capsule may become necessary in many patients. If the pain and discomforts associated with capsular contracture become unbearable for the patient, or if the condition severely deforms the breasts, removing the scar tissue along with the breast implant may become necessary. Breast capsulectomy Breast capsulectomy is an operation to remove the scar tissue that has developed around the breast implant. Unlike the breast capsulotomy, which cuts into the capsule to release the contraction within the breast, the capsulectomy completely removes the entire capsule. This procedure has been found to be very effective in getting rid of the thick, hard capsule that develops around the breast implant. Since capsulectomy is a complete surgical procedure, it entails all the risks and potential complications involved in all other surgeries. The good news is that capsular contracture occurs in a very small percentage of breast implant patients, so it is a rare case when a patient will need to undergo the capsulectomy procedure to treat the condition. Breast implant removal and capsulectomy Breast implant removal is a very common surgery. Many patients decide to get their breast implants removed for different reasons, two of which are capsular contracture and implant rupture. In order to treat a capsular contracture, it may become necessary to remove the breast implant along with the scar tissue that has formed around it. Performing breast implant removal and capsulectomy simultaneously can treat the condition. Furthermore, if a breast implant rupture has occurred along with a capsular contracture, your plastic surgeon would probably recommend you to undergo implant removal and capsulectomy. It is important to understand here that the goal of a breast implant removal is to take out the existing implant from inside the breast while that of capsulectomy is the surgical removal of the hard scar tissue surrounding the breast. Depending on the severity of the problems a patient might be facing, a capsulectomy may be enough to treat the condition. The capsulectomy procedure normally gets rid of the abnormal scar tissue, without tampering with the normal breast tissue. However, in rare cases, while removing the scar tissue, some of the normal breast tissue may be inadvertently removed along with the capsule. The surgery takes between 2-3 hours. It is important to know that your body responds to the breast implants by forming a capsule of scar tissue around them as a natural defense. This tissue may become very hard like a ball. When complications like capsular contracture or implant rupture occur, the plastic surgeons will base the recommended treatment options on the severity of the issue. Some surgeons prefer to carry out a capsulectomy, leaving the implants intact while others prefer to remove or replace the implant along with a capsulectomy. There are also some cases where only a part of the capsule is removed to treat the condition. Breast implant removal and capsulectomy have remained a basically ignored aspect of surgery. Very few surgeons know exactly when to carry out capsulectomy singly and when to combine it with an implant removal. When should capsulectomy accompany implant removal? A capsulectomy should be performed along with a breast implant removal when it has been determined that replacing an implant is next to impossible. Furthermore, this treatment option is also used in cases where the surgeon believes that a new breast implant will take an unusual position within the breast muscle. Not removing the scar tissue in such a case may trigger the formation of liquid-packed fissures. This can invite potential infections. Also, implant removal and capsulectomy should be performed when the surgeon is sure that a larger implant can replace the existing one. Moreover, if the scar tissue has hardened after implant replacement, the new breast can be smoother and better if a capsulectomy is carried out. Combining implant removal with capsulectomy is also effective if: • The capsule surrounding the implant has thickened or calcified • A silicone implant rupture has occurred • The implant, the tissue surrounding the implant, and the capsule are all infected • A tumor has formed near or within the capsule Capsulectomy with implant removal is not recommended in cases where the capsules are fragile or the implant is in contact with the skin. A capsulectomy must be avoided if silicone implant rupture has occurred and the gel has moved into the armpit, because it can cause more injury to your healthy tissues, blood vessels and nerves. Conclusion If your breast implant has ruptured, or if it has developed capsular contracture, you should see your plastic surgeon to know your candidacy for implant removal and capsulectomy. The procedures can treat a number of breast implant complications. It must be underscored that you should choose a highly qualified, well-experienced, Board-Certified plastic surgeon to perform the surgery because it is a more complex procedure than a simple breast augmentation surgery. Your plastic surgeon will be able to determine if you qualify for a breast implant removal along with capsulectomy after examining your current condition, complications, discomforts, and breast shape and health condition.