Is Breast Implant Capsule Removal Necessary?

Silicone breast implants with micro textured surface shown next to implants with a smooth surface. If you no longer want breast implants, does the breast implant capsule need to be removed? The easy answer to this question is NO. However, like most things in life, there are exceptions, and the decision requires consideration of many factors. There is renewed interest in the removal of breast implant capsules because of the recent awareness of a rare breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) that has been described with the use of textured breast implants.

Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

Our current understanding of BIA-ALCL is improving with time. This T-cell lymphoma reveals itself as a swelling of the breast or a mass that is seen a decade after placement of the textured breast implants. The treatment of this lymphoma is removal of the implant and the implant capsule and possibly the addition of adjuvant therapy, which can include chemotherapy, radiotherapy, or a stem cell transplant. BIA-ALCL doesn’t behave like the typical “cancer” we are familiar with. It rarely spreads elsewhere and behaves more like a localized skin cancer.

Textured Breast Implants and BIA-ALCL

Millions of women have textured breast implants. They are understandably concerned this may happen to them. How should you manage your risk for this rare cancer? If you have no issues with your breast implants, but you are concerned about breast lymphoma, you can remove the breast implants and replace them with smooth walled implants. Smooth walled implants are not implicated in the BIA-ALCL. You can also remove your implants entirely if you prefer. It is not mandatory to remove the implant capsule at the same time.

Exchanging breast implants is often a simple procedure performed with local anesthesia. Removing an implant capsule is much more involved — adding time, cost, risk, and complexity. This procedure requires general anesthesia and often the use of post-operative drain. However, if you want to remove the implant capsule for peace of mind, your plastic surgeons will certainly be familiar with this option.

Saline Breast Implant Removal Surgery Using Local Anesthesia

The Decision is Yours

If you are considering exchanging or removing your implants, or would simply like to know your options, I would love to help. You can get in touch using my popular Online Consultation feature that lets you submit pictures and medical history using your phone and hear back from me via email, all without leaving your home.

— Robert Caridi, MD
Diplomate of the American Board of Plastic Surgery
Fellow of the American College of Surgeons (FACS)
Member of the American Society of Plastic Surgeons (ASPS)
Member of the American Society for Aesthetic Plastic Surgery
Founder of the Austin Gynecomastia Center