Breast implant removal

I had posted a question a few days ago regarding breast implant removal.  You mentioned that you would recommend removal with a capsulectomy.  What is a capsulectomy?  And why would you recommend implant removal without one?
Thank you!

[Howard Rosenberg, MD]

The capsule is the scar tissue lining of all implant cavities that forms approximately ten days after implants are placed (the pocket is initially just raw muscle and adjacent tissue).  The capsule appears as a smooth glistening membrane that is adherent to the muscle and other tissues.  When an implant is simply removed and the pocket collapses, the capsule ultimately disintegrates in the absence of the foreign implant.  Rarely, a seroma forms as a complication of implant removal.  This may require needle aspiration. If it persistently re-forms, a formal capsulectomy may be needed, leaving a raw, slightly bloody surface that hopefully heals without reformation of a seroma.  I advocate the simple removal of the implant without capsulectomy, avoiding a larger, more bloody procedure.  If a persistent seroma forms, then I deal with it as necessary.