I do a lot of breast implant surgery to remove implants. When I remove implants, I always remove the capsule as well. Sometimes it is “en bloc,” where I remove the capsule in one piece with the implant inside, sometimes not, depending on each case. Last week I did two en bloc breast implant removals with vertical lifts. I did another capsulectomy the week before. I just got the pathology reports, and thought it would be interesting for you to hear-
When we remove the capsule and send it to pathology, what do we find?
The first patient had a grade III / IV capsular contracture on the left side, with mild capsular contracture on the right. Her implants were old silicone. In surgery when I looked at the capsules, they did not look thick or calcified, but the capsules were tight around the implant, causing shape distortion of the implant.
- PATH: the right breast, which was softer than the left, was “Benign breast capsule with fibrosis and mild chronic inflammation.”
- PATH for the left breast, which had the obvious hard capsule, ” Benign breast capsule with fibrosis and chronic inflammation with foreign material consistent with silicone.”
Patient two: She was removing the implants, though she had no problem with them. She wanted to be smaller and lift her breasts. She also had silicone implants. In surgery, her capsules looked thin and pliable. Her implant appeared intact.
- PATH: “Benign breast capsule with fibrosis, granulomatous inflammation, and foreign material consistent with silicone.”
Patient three: Removing the implants because she did not want them anymore.
- PATH, “Benign breast capsule with fibrosis.”
For most of my patients when I remove the capsule, the pathology shows fibrosis and inflammation. We see silicone at times, but not as commonly. Both of the patients with silicone findings had older implants. Visually the capsules vary a great deal in how they look, from thick and calcified to see through and pliable.