Capsulorrhaphy Revision...?

I had a capsulorrhaphy revision done about 6 weeks ago from lateral displacement, bottoming out, and a ruptured implant. What is the chance that the implant ruptures again and the "internal bra" to come apart or give out?

Doctor Answers (9)

Capsulorrhaphy Revision

+4

This is a demanding procedure, and requires more post-op patient cooperation than does the primary procedure. If your repair has held up for six weeks, chances are you have had a permanent fix. Wearing a bra that supports the repair during the early healing is essential. 

Returning to full activity is a decision to be made with your surgeon's participation. For most surgeries, 6 weeks is standard, since by that time the sutured areas have reached 90% of the strength they will attain. But it this setting we are talking more than just skin. When athletes have ACL repairs, they don't practice for months. I would lean toward at least three months before stressing the repairs with any upper body work out.

Chances of implant rupture should be very small, in the neighborhood of a few per cent over 5 to 10 years. 

Thanks for your question, all the best. 

 


Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

Breast Revision

+2

The implant rupture rate is quite low, on the order of 1 in 10,000 in 10 years.  The risk of the implants rupturing, of course, would be the same as the manufacturer describes.  McGhan implants have a slightly higher rupture rate than Mentor implants.  So, in that regard I will leave you look to the manufacturer’s published information for the specific data points there, as I do not know which brand of implants you received.
The bottom out dilemma is more significant.  The bottom out rate for a person who has already had this technical problem because of their tensil strength is always slightly higher than if they never had it at all.  But if you have already had a capsule tissue utilized for your suspension of your fold, then you still have probably a 5 or 10% chance of this happening again.  If you have been supported or supplemented with an Alloderm or implant material like Strattice, then your bottom out rate is significantly lowered even if you have chosen to use larger implants than your original surgery.  I would have your surgeon discuss this with you in a technical way because I am certain that he or she has data for you from their own practice if they do these with any frequency.

To your health and beauty,

Dr. Paul Vanek, Board Certified Plastic Surgeon in the Cleveland area

Paul Vanek, MD
Cleveland Plastic Surgeon
4.5 out of 5 stars 20 reviews

Capsulorrhaphy and Recurrence

+2

    Having performed this procedure many times, the repair is very durable or should be.  Larger implant size compromises results, and most plastic surgeons will not upsize implants and may even recommend downsizing implants.  Going back to exercise should be approached with caution, and your plastic surgeon will have the best answer for that.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 204 reviews

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Capsulorrhaphy risks.

+2

There is always a risk of a capsulorrhaphy failure. Technique is important and certain products such as acellular dermal matrix (ADM) may help reinforce the repair. Also, postoperative control of the pocket is important (ie - bras with cup support). Implant rupture depends upon the type of implant. Although "internal bras" do have a failure rate, in experienced hands this is a valid technique for correction of malposition.

David Bogue, MD
Boca Raton Plastic Surgeon
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Capsulorraphy

+2

Although I agree with both Dr. Rand and Dr. Zwiren, a critical part of the repair is what the surgeon does with the muscle on the other side (near the sternum.)  In my opinion lateral and inferior displacement of an implant is almost always due to inadequate release and weakening of the muscle opposite it.  A muscle that has not been released or weakened properly will usually result in lateral displacement.  In the revision surgery if that muscle is not addressed properly then the displacement will recur no matter how strong the capsulorraphy is done or the strength of the tissues.

Good Luck,

Ary Krau MD FACS

 

Ary Krau, MD, FACS
Miami Plastic Surgeon
5.0 out of 5 stars 37 reviews

Capsulorraphy breakdown

+2

A capsule repair for lateral and inferior displacement is not for the inexperienced surgeon.  Judgement and excellent technique and much experience are required for the best chance of success.  Also the quality of your tissues and your cooperation with postop restrictions plus not going bigger all are key to success.  Some patients need additional strength in the form of ADM to have success.  If you look good now and if you follow the surgeon's instructions specifically, your chance is greater than 80% success long term.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

Implant malposition

+1

Capsulorrhaphy, or breast pocket revision, can be done with several different techniques.  The technique of repair and the size of the implant will determine the risk of recurrence.  If a suture repair fails, then the next step would be to use a smaller implant and perhaps an acelullar dermal matrix for added support. 

Dennis Dass, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 55 reviews

Chances of recurrence after a surgery for implant malposition

+1

Capsulorraphy is a tricky surgery and is to be perfumed with caution with much ideal of shape appearing while the surgery performed. If the tissue where the surgery is performed are strong enough then perhaps it may not re dislocate. If you PS thought it to be week tissue he can always supplement it with some kind of synthetic layer to reinforce that area.

Ashok Govila, FRCS, MCh, MS
Dubai Plastic Surgeon
5.0 out of 5 stars 45 reviews

Chances of recurrence after a surgery for implant malposition

+1

Implant malposition is a difficult problem and its treatment is more complicated than the original breast augmentation.  The chances of a rupture are relatively low but the chances of recurrent lateral and inferior displacement will vary depending upon the quality of your tissue and the quality of your capsule.  Follow your plastic surgeons recommendations for activity restriction during the first 6 weeks after surgery.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.