The Case Against Capsulectomies When Removing Silicone Breast Implants

Requests for removal of silicone breast implants are increasingly common. Often patients request a capsulectomy in either a total or “en bloc” form. Capsulectomy adds time, cost, and morbidity to removal of implant procedures. This article examines the reasoning given by practitioners for undertaking the procedure, and reviews the literature to examine the validity of those arguments. Except where pathology of the capsule is demonstrable (Breast implant related anaplastic large cell lymphoma, BIR-ALCL), there is currently no indication for prophylactic removal of capsules following removal of breast implants. Given the potential risks, and lack of evidence for the procedure, both patient and surgeons should be aware of the potential consequences.