Posts Tagged capsulectomy
I had breast implants and they have become hard over the last few years. Will capsulotomy surgery help?
Breast implants can harden (actually the tissue around the implants can harden) resulting in distortion of the breasts and at times pain. We have discussed the problem (Capsular Contracture) here before.
Significant breast implant hardening does not complicate all breast implant patients, but when it does additional surgery is the only good solution. The process involves the formation of a “capsule” of scar surrounding the breast implant. At times this capsule has an elastic consistency and at other times it can be “studded” by deposits of calcium that make it really rock hard.
Surgery to soften the hardened breast can involve scoring the scarred capsule to release the tension (Capsulotomy.) When the capsule is quite firm or studded with calcium, more involved surgery is in order. Capsulectomy involves the removal of all or parts of that scarred capsule.
Whether either of these treatments will work depends upon the cause of the contracture. Usually the implants can be replaced, but in really severe cases they need to be removed.
What you really need is a good evaluation by an experienced plastic surgeon to figure your best course of action.
John Di Saia MD
Originally posted 2011-07-06 07:30:03.
I have had a capsulectomy due to capsular contraction, but now it has returned. I want an explant because they are uncomfortable and look unnatural. My doctor said that since the capsulectomy did not resolve the issue, he recommends having an explant and waiting about 6 months to a year. After my body has healed properly, he said that I can get implants again and will not get capsular contraction again. Is this accurate? Am I less likely to get capsular contraction or will I be free of capsular contraction? I’m also looking for a doctor experienced in explants.
The subject of hardened breast implants (Capsular Contracture) comes up frequently as it is the leading cause of long term dissatisfaction with breast implants. If your breasts tend to hurt or look unnatural, you likely have severe encapsulation (Baker Grade III or IV.) When contracture redevelops quickly after capsulectomy (assuming the operation was thorough,) this is worrisome as it may indicate a high tendency for recurrence. The main question when severe contracture is present is whether or not a cause can be identified. Bothersome contracture doesn’t happen to all patients. This kind of reaction is associated with cigarette smoking, bleeding, infection, silicone gel implants, poor soft tissue coverage and radiation exposure as well as a previous history of contracture. Some of these issues can be minimized in an attempt to reduce the tendency for encapsulation. Preventing the problem is the best solution.
While removal of your implants for a time with later replacement might improve the problem, this is not a “slam dunk” nor is it guaranteed to completely solve it. The results vary substantially. Usually removal with a good capsulectomy is the best thing for comfort. Implant replacement at times is thwarted by recurrence of the contracture.
Then again if you leave the implants in place things will not likely improve as you have had a trial of capsulectomy and replacement already. It is true however that a woman who has had her implants removed and not replaced frequently has them put in once again down the road due to appearance issues. This is not invariably the case however. Some women actually like the look of their breasts without implants after capsulectomy and explantation. The results of such surgery vary though.
These cases need to be handled individually and with a fair amount of disclosure before surgery is performed, so that everyone comes out satisfied. I don’t have one treatment that goes for all patients on the issue due to their inherent variability.
John Di Saia MD
Originally posted 2011-05-31 07:30:35.