While breast implants have been established as safe for use in breast augmentation, the risk of failure is always a possibility. If implant failure is diagnosed early on, your surgeon can remove and replace it without any complications. However, when a capsular contracture remains undiagnosed for several months or years, your breasts may become deformed and cause pain and discomfort. A ruptured breast implant, on the other hand, can be removed via surgery, which poses its own risks and complications. Every year, a large number of women go under the knife to remove their breast implants, and most of them are unable to decide whether to remove the capsule that has developed around the implant. What is capsular contracture? Capsular contracture is a common complication that occurs after breast implant surgery. The condition occurs when the capsule that normally grows around the breast implant starts to solidify and contract. The contraction squeezes the breasts, making them very hard. As the scar tissue (capsule) continues to contract, it leads to changes in the appearance and feel of the breasts, as well as creating physical discomfort for the patient. Capsular contracture can occur any time after the breast augmentation procedure. Though the underlying factors that lead to the development of capsular contracture may be apparent in some patients, it may not be clear in others. Majority of patients are required to get the capsules removed. If you have developed capsular contracture and the pain is becoming severe or your breasts are losing shape, your doctor may even recommend breast implant removal along with the capsule removal. What is breast capsulectomy? Capsulectomy is a surgery to remove the scar tissue that has formed around the breast implant. Capsulectomy is different from capsulotomy, where the scar tissue is slashed to liberate the shrinkage inside the breast. On the contrary, capsulectomy is used to get rid of the thick, hard scar tissue that has started to contract around the implant. As capsulectomy is a full operation, there are a number of risks, side effects, and potential complications associated with the surgery. Fortunately, capsular contracture occurs in rare cases. Breast implant removal and capsulectomy Breast implant removal is one of the common surgical procedures performed in the US. When you undergo the breast implant surgery, you must be prepared to remove and replace the implant in the future. Some patients are required to have their implants removed earlier, especially when capsular contracture and breast implant rupture occur. The capsulectomy will rid your breasts of the unusual capsule, without meddling with the normal breast makeup and anatomy. In some situations, the normal breast tissue may be unintentionally taken out together with the scar tissue. This procedure can be performed in two or three hours. Patients should understand that their bodies react by developing a scar tissue (capsule) around the implants. This is a perfectly natural occurrence. However, the scar tissue may become hard over time and resemble a ball. If a capsular contracture or implant rupture happens, the doctor will first examine the condition’s intensity before recommending treatment. Many doctors prefer to perform a capsulectomy instead of removing or replacing the implant along with the capsule. The medical community, for unknown reasons, has neglected breast implant removal surgery and capsulectomy. Only a few plastic surgeons are experienced in performing capsulectomy and breast implant removal. Why is it necessary to combine capsulectomy with explant? The capsulectomy procedure should be combined with explant if the surgeon finds that breast implant removal and replacement is not possible. Additionally, this operation is mostly used where the doctor foresees that a new breast implant would occupy a rare locus inside the breast. If the scar tissue is not removed in this case, it may lead to the development of fluid-packed cracks, which carries the risk of contracting infection. Additionally, implant removal and capsulectomy should be carried out together in cases where the plastic surgeon is confident that a larger breast implant can be used in place of the one that needs to be removed. Also, if the capsule has become harder after the replacement of implants, your new breasts will look good only when a capsulectomy is performed. Breast implant removal and capsulectomy can also be used in combination when the scar tissue has become very thick or calcified or when the silicone implant has ruptured. Other cases that may necessitate combining implant removal with capsulectomy include severe infection and the formation of tumors around the scar tissue. However, combining the two procedures is not recommended when the scar tissue is feeble or the breast implant is attached to the skin. Conclusion Patients who have experienced breast implant rupture or capsular contracture must contact their surgeons to check whether they qualify for implant removal and capsulectomy. These surgeries can help relieve you from a number of complications and associated health issues. However, you should make sure to seek treatment only from a board-certified plastic surgeon who has already performed similar surgeries in the past. These procedures are complex and require skill, so make your decision carefully. The surgeon will assess the condition of your breasts and your overall health before recommending you a solution.