{"id":1104,"date":"2025-09-08T20:13:17","date_gmt":"2025-09-08T20:13:17","guid":{"rendered":"https:\/\/www.montrealexplantcenter.com\/10-reasons-for-a-complete-capsulectomy\/"},"modified":"2025-11-26T12:02:59","modified_gmt":"2025-11-26T12:02:59","slug":"10-reasons-to-do-a-complete-capsulectomy","status":"publish","type":"page","link":"https:\/\/www.montrealexplantcenter.com\/en\/capsulectomy\/10-reasons-to-do-a-complete-capsulectomy\/","title":{"rendered":"10 Reasons to do a Complete Capsulectomy"},"content":{"rendered":"\t\t
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According to the expertise of Dr. Nicolaidis<\/p>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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These 10 reasons to opt for a complete capsulectomy are worth the read!<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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1. Capsules and their importance <\/h4><\/span>\n\t\t\t\t\t\t\t\n\t\t\t<\/path><\/svg><\/span>\n\t\t\t<\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t
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We are just starting to become aware of the problems with breast implants. So the importance of the capsule and its removal are not known. However, numerous studies have now shown that the capsule contains a good deal of inflammatory reaction to breast implants, all of which must be removed for patients with BII in order to see maximum improvement of symptoms.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t

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2. BIA-ALCL <\/h4><\/span>\n\t\t\t\t\t\t\t\n\t\t\t<\/path><\/svg><\/span>\n\t\t\t<\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t
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BIA-ALCL<\/a> has been shown to originate between the implant and its surrounding capsule.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t

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3. BIA-SCC <\/h4><\/span>\n\t\t\t\t\t\t\t\n\t\t\t<\/path><\/svg><\/span>\n\t\t\t<\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t
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BIA-SCC<\/a> has also been shown to originate between the implant and its surrounding capsule and is associated with any type of implant, smooth or textured, saline or gel.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t

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4. Pocket will never stick together and close <\/h4><\/span>\n\t\t\t\t\t\t\t\n\t\t\t<\/path><\/svg><\/span>\n\t\t\t<\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t
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If capsule is left behind, it will never go away (as some Plastic Surgeons have been suggesting to their patients). Dr. Nicolaidis has explored patients years after implant removal and always finds capsule (as in the photos shown here).<\/p>

If enough capsule is left behind, a full pocket will remain. Because of the composition of the capsule, that pocket will never stick together and close, leading to loose soft tissues above. Fluid can also potentially collect in that pocket at a later time.<\/p>

\"ResidualResidual capsule four years after implant removal<\/em><\/p>

\"\" Capsule pocket two years after implant removal<\/em><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t
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5. Thickening and calcification <\/h4><\/span>\n\t\t\t\t\t\t\t\n\t\t\t<\/path><\/svg><\/span>\n\t\t\t<\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t
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Capsules will often thicken and calcify over time, especially with gel bleeds or older implants, as seen in these adjacent photos. Nobody wants to keep such a capsule in their body..<\/p>

\"\"Calcified capsule<\/em><\/p>

\"\"Thick capsule that oozes silicone when pinched<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"Dinosaur\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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\u201cBII is far from understood. So I approach it very carefully. There are some issues that are very clear while others that are completely uncertain. Also, different patients have different priorities with respect to their health, scars, etc. In such cases of uncertainty, patients should be listened to and understand the risks and benefits of the various options so that they can make an informed decision themselves.\u201d<\/p>

-Dr. Nicolaidis<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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6. Improve breathing and restore normal anatomy <\/h4><\/span>\n\t\t\t\t\t\t\t\n\t\t\t<\/path><\/svg><\/span>\n\t\t\t<\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t
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Wee et al in 2020 proved that breathing improves after complete capsulectomy. The thinking is that the posterior wall capsule (the very same capsule that is left behind by Plastic Surgeons who claim that it is too dangerous to remove for fear of pneumothorax) tethers the ribs so that they cannot fully open for deep breaths, sort of like if you glued something on the side of an accordion so that it can no longer be opened. When patients are able to breath easier, anxiety is decreased and patients can function better.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t

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7. Removal of silicone residue and bacteria <\/h4><\/span>\n\t\t\t\t\t\t\t\n\t\t\t<\/path><\/svg><\/span>\n\t\t\t<\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t
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Removing capsule ensures that any residual silicone or bacteria is removed along with the implant, particularly in the case of ruptured implants.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t

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8. Peace of mind <\/h4><\/span>\n\t\t\t\t\t\t\t\n\t\t\t<\/path><\/svg><\/span>\n\t\t\t<\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t
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A 2024 study by Kappel demonstrated gel bleed (silicone leaking out of the implant) into the capsule within a month of implantation, even with the latest generation implants like Motiva. A subsequent study by Pluvy et al found autoimmune markers in breast implant capsules. Patients want the \u201cpeace of mind\u201c in knowing that ALL the silicone has been removed.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t

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9. Improvement of certain symptoms <\/h4><\/span>\n\t\t\t\t\t\t\t\n\t\t\t<\/path><\/svg><\/span>\n\t\t\t<\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t
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To date, only one VALID study has looked at improvement of symptoms with respect to degree of capsulectomy. Dr. Zuckerman sent questionnaires to 792 patients with a 57% response rate and found that the best improvement in symptoms occurred in those who had en-bloc or complete capsulectomies. As mentioned above, the 2020-21 study funded by ASERF tried to look at the importance of capsulectomies; however, the surgeons and patients decided who would get what kind of capsulectomy, instead of that being randomly decided. This is called SELECTION BIAS, which renders a study INVALID.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t

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10. In experienced hands, this is not a dangerous procedure. <\/h4><\/span>\n\t\t\t\t\t\t\t\n\t\t\t<\/path><\/svg><\/span>\n\t\t\t<\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t
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Unlike most of his colleagues in Plastic Surgery, Dr. Nicolaidis argues that capsulectomy is not a dangerous procedure in experienced hands. Dr. Nicolaidis presented \u201cProspective Study of Complications Following 500 Explantations with Simultaneous Breast Lift\u201d for the first time in the world at the American Society of Plastic Surgeons meeting in October 2022. His total complication rate was 5%, compared to a 10% revision rate for breast augmentations.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t

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Good to know: explantation is covered, in 3 circumstances, by the government <\/h4><\/span>\n\t\t\t\t\t\t\t\n\t\t\t<\/path><\/svg><\/span>\n\t\t\t<\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t
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In Quebec, removal of breast implants and capsulectomy are covered by the government in three circumstances:<\/p>

  1. Polyurethane implants<\/li>
  2. Ruptured gel implants<\/li>
  3. Grade 4 contracture (in which the capsule becomes hard and painful with visible changes in the breasts).<\/li><\/ol>

    Authorization for capsulectomy requires documentation of the above with radiologic proof, if necessary, the operative protocol and a pathology report confirming the above. If anything is missing or cannot be found, the surgery is not reimbursed. Moreover, the government will never cover lifts, which are usually necessary at the time of explantation in order to minimize terrible skin folding. Lastly, Dr. Nicolaidis works at the CHUM super hospital, where his directive is complex reconstructions following cancer, etc. He does not have operating time to perform explantations.<\/p>

    For all of these reasons, Dr. Nicolaidis does not perform explantations in the public system; rather, he performs explantations at a private surgery center.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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    Need more information?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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    According to the expertise of Dr. Nicolaidis These 10 reasons to opt for a complete capsulectomy are worth the read! 1. Capsules and their importance We are just starting to become aware of the problems with breast implants. So the importance of the capsule and its removal are not known. However, numerous studies have now […]<\/p>\n","protected":false},"author":5,"featured_media":917,"parent":961,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1104","page","type-page","status-publish","has-post-thumbnail","hentry"],"yoast_head":"\n10 Reasons to do a Complete Capsulectomy - Centre d'explantation<\/title>\n<meta name=\"description\" content=\"Learn the top reasons to choose a complete capsulectomy for safe and effective breast implant removal with Dr. Stephen Nicolaidis.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.montrealexplantcenter.com\/en\/capsulectomy\/10-reasons-to-do-a-complete-capsulectomy\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"10 Reasons to do a Complete Capsulectomy - 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