I want to have my Becker implants exchanged with smooth silicone gel implants. My implants were always firm but now they feel like a piece of cement; especially the left breast. I would appreciate advice on my situation. Also, I don't believe in general anesthesia. I will do a twilight anesthesia. Thanks
BA with Becker Textured Implants Have Hardened?
Doctor Answers (6)
Implants Have Hardened?
This is a classical description of capsular contracture. IV sedation can be done along with local anesthesia to treat this. Implants will be removed, as will the hard capsule that has formed around the implants.
The new implants will probably be positioned under the pectoral muscles if they are not already there. Your surgeon may recommend adding a piece of "Strattice" which is a matrix of dermis without any cells, which will be populated by your own cells.
Thanks for your question, and best wishes.
Possible Capsular Contracture
From how you described it, it appears that you could possibly be suffering from an unfortunate sequelae known as a capsular contracture (although positive diagnosis would have to be confirmed through a physical examination). Capsular Contracture is an overproduction of scar tissue that can sometimes form around the pocket where the implant has been placed. Often side effects include pain (depending on the level of the contracture), implant hardness, disfiguring of the implant, and resulting implant asymmetry. The following Baker Classification is a scale that was implemented to help determine the severity of the capsular contracture:
Baker I: the breast is soft, it feels and looks natural
Baker II: the breast is slightly firm, mild asymmetry in palpability, but with no visible variations
Baker III: the breast is significantly firm, there is a visible change in the appearance of the breast
Baker IV: the breast is very firm, there is significant visible changes in the shape and location of the breast, pain with normal activities or mild palpitation
Generally, the treatment for a capsular conracture would be a capsulectomy or capsulotomy. These are surgical procedures done under general anesthesia where the implant and the capsule surrounding the implant are either removed or scorred in an effort to remove or release the capsule. Depending on the wishes of the patient, an implant can be replaced and any lifting techniques can be done at the same time.
You should take into consideration, that although this is treatment for the current capsular contracture, reoccurence is common. It is important to follow all post-operative instructions given to you by your doctor (including physical exercise limitations and massaging).
Good luck with this, and I hope I have been of assistance.
Fadi Chahin MD, FACS
Plastic and Reconstructive Surgery
Diplomat, American Board of Surgery
Diplomat, American Board of Plastic Surgery
Breast Capsulectmy and replacement
You describe a very common situation. The solution is complete capsulectomy and replacement of the implants. Under the muscle is best and general anesthesia is the only way in would perform this surgery. Removeing the scar can be very difficult. goog luck
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It sounds like you have a capsular contracture and may need that to be treated if it is bothering you. A consult would be necessary for a proper evaluation.
Hardened Textured Implants
Assuming that you have capsular contracture based on your description, the only corrective measure involves surgical removal of the scar tissue. Most surgeons will advocate that you change out your implants as well, and there is a high chance that the implants are ruptured anyway if the implants are old. Placing the implant in a new pocket and/or the addition of what is called acellular dermal matrix are also beneficial to help reduce that chance that the excess scar tissue will return. Best wishes!
Treatment for “Hardened” Breast Implants?
Without direct examination or viewing pictures it is difficult to give you much accurate advice. Based on your description, it sounds like you are dealing with severe breast implant encapsulation; capsulectomy and breast re-augmentation may be indicated. Otherwise, details of specific maneuvers that may be helpful to you ( such as positioning of breast implants and/or need for additional surgeries such as breast lifting) will be best determined after careful history, physical, and a full communication of your goals.
I would suggest that you meet with board certified plastic surgeons; ask to see lots of examples of that work helping patients in your situation.