Question: Is it damaging to the heart and/or lungs to have breast implants and capsules removed with no cushioning or fat protection remaining to shield against cold or trauma? Also, is cushioning with fat done during capsulectomy or with a later, second surgery?

I am scheduled to have my Naturelle textured implants (placed 3/2014) removed in February. This is b/c I fear Lymphoma (my mother had breast Ca x2 and Lymphoma). I'm 67 with negative MRI, 190 lbs. and 5'8". My surgeon plans to remove the implants and capsule from both breasts. I don't want further implants b/c the thought of replacement surgery in 10-15 years seems unwise. I am ok with an unattractive chest but don't know how common it is to have future discomfort with a hollowed-out breast zone.

Answer: Thank you for your question. Based on your question, I am assuming that you had implants placed for breast augmentation. Please correct me if that’s not true. In that case, you still have your natural breast to cover your chest just as you did before the surgery. Regardless of whether you still have your natural breast tissue, it is the ribs and chest muscles that protect the heart and lungs from trauma and cold. So unless your surgeon removes your chest muscles during capsulectomy, you should be more comfortable and without the worry of Lymphoma. Implant rupture or other implant-related problems. You also won’t need to worry about getting regular MRIs to ensure your implants are not leaking.

I hope this answers your question.

- Dr. Craigie


Continued below…

Dr. Craigie,

My fault for giving an incomplete history. I had bilateral mastectomies in 12/2013 for cancer of the right breast (thankfully no need for chemo or radiation). Four months later, I had reconstruction with textured implants.

Thank you for answering my question about the potential health impact post capsulectomy. My plastic surgeon mentioned a concave appearance of the chest wall, which made me worry about the lack of protection for underlying organs. It's reassuring to hear that a layer of soft tissue cushioning over the heart and lungs isn't necessary.

Very grateful!

Ok, thank you for the additional information. Since you had bilateral mastectomies, things are a little different. I’m glad to hear you did not need radiation or chemo.

Regardless, you still have multiple options after you have your implants removed. Your question was spot on regarding adding some of your own fat to your chest area where the implants were. A small amount of your own fat can be “grafted“ to add some padding and comfort if you have any problems. This is not reconstructing the entire breast, which could be done, but it is a much more involved procedure. In most circumstances, the fat would need to be “grafted” at a second surgery, after the implants have been removed and your breast area heals after the capsulectomy surgery.

I’m sure your plastic surgeon will be glad to discuss this with you.

I hope this helped!

-Dr. Craigie