Should I insist on having a full capsulectomy even if it is very thin?

Dear Dr. Kolb,

I had explanat surgery nine days ago and my surgeon told me that he had undrtaken a full capsulectomy on my right side which had had a thick capsule around a capsular contracted silicone implant. I am not clear if this implant had ruptured or not but it was shiny and intact in the photograph he showed me.

However, on my left side, he said that the implant had ruptured in a different way. This had a sticky outer layer of microscopic silicone leakage. There had been no contraction on this implant. He said that for this, he had undertaken a partial capsulectomy, removing the thin capsule against the breast tissue but he left the thin layer against the chest wall. I asked him why he hadn’t removed it all and he said it was because that’s what he does with thin capsule like this.

Should I now insist that this is removed as a precaution against any potential future issues? The implants were above muscle, were 260cc and were 13 years old, non-smooth silicone. I am back to my 34AA size on my left side, with the right larger or just more swollen at present.

I really appreciate your advice.

Thank you.

Explantation

Removal of the complete capsule, any silicone laden axillary lymph nodes, antifungals for several months, immune and endocrine support, detoxification, and treatment of any co infections which are common is the treatment for this problem. Removal of thin capsules is done only by surgeons who understand the importance of removing them, which is very rare.