Can the "Capsule Switch Procedure" Be Used in Reconstruction for Capsular Contracture?

I had lumpectomy and radiation 18 months prior to my mastectomy. I currently have tissue expanders w/alloderm and am doing well, but am concerned about capsular contraction since I had rads. I was reading about the "pocket protector" and the Capsule Switch Procedure using e-PTFE. I don't want to get a latissimus flap if this happens. Is CSP an option? Or is that just used in augmentation cases?

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candidate technique tissue expander

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4 Doctor Answers | Asked by Kitty_L in Miami, FL

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Further reconstructive options are always available

There are always further reconstructive options available to you--of which fat grafting and pocket changes may help. But you are doing well and may never need anything further. Your surgeon has done an excellent job. Congratulations.

Alloderm may help reduce your incidence of capsular contracture.

The "capsule switch procedure" sounds like using a graft to replace a portion of the capsule. I would be wary of using a non-biologic mesh to decrease contracture. Alloderm is a dermal matrix which is acellular at the time of placement. In essence, the Alloderm does not form a traditional capsule and it is theorized that the disruption of a circumferential capsule limits contracture effects. This has shown a contracture rate in reconstruction of less than 1%. In radiation, the... more

David Bogue, MD

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Boca Raton Plastic Surgeon

www.drbogue.com

Prevention of capsular contracture after radiation

Dear Kitty_L, I am not aware of any published articles on the use of e-PTFE in the treatment of capsular contracture in the plastic surgery literature. There is however mounting favorable experience with the use of dermal grafts(Alloderm) as your surgeon apparently utilized in your case. Using your own tissues (flaps) may become more of a tenable option if you do develop capsular contracture. You sound like your on the right track. Good luck more

Breast Reconstruction

You already have Alloderm which has been OBSERVED to rduce the incidence of capsular contracture in reconstructed breasts. I believe your surgeo is up to date and have used the Alloderm to protect you..