Hello! Thanks for taking the time to view/answer my question. I have CC in my left side. I am thinking that it will always want to come back so am considering an explant. My PS recommended a capsulectomy and a new implant with strattice to reduce chances to 1%. What do you think of this and If you leave the capsule in there and remove implant only, what would happen? Another girl had the CC and the doc explanted and left capsule in. Thank you!
CC with Explant and Leave in Capsule?
Doctor Answers (6)
Capsular contracture treatment
Thank you for your question. Recurrence rates after treatment of a capsular contracture are unpredictable and variable. Typical treatment would include a capsulectomy, or removal of the capsule, and implant replacement. The rates of capsular contracture with the addition of strattice or other acellular dermal matrices are thought to be lower, though scientific evidence with its use is in its infancy. I think that predicting a 1% recurrence rate as you have been told is a bit hopeful.
The treatment options for you would include capsulectomy, and implant exchange with or without strattice, or explantation with or without capsulectomy. If your implants are not replaced, your breasts will deflate and may sag. However, this does elimenate the problem of future capsular contracture. The reason for removal of the capsule during an explantation is to remove the thick, firm capsule and leave behind the pliable normal skin. If the capsule is not overly thick, parts can be left during an explantation.
Optimally, you would have the implants exchanged with a capsulectomy and placement of strattice. This will give you the best chance of having breasts that are the size and shape that you wanted all along. You may want to consider the addition of Singulair, an oral medication which has been shown to have some effectiveness in preventing CC.
Best of luck with your breasts. You certainly have a lot to think about.
Capsular contracture options
It sounds like you would like to keep your implants if there is a good chance the capsular contracture wont come back, but you would like to get rid of them if it's going to happen again. That's a very reasonable way to approach this.
I cannot give you an accurate statistic for your chances of having another capsular contracture, but capsulectomy, new implant and strattice are the best we can do to minimize the chances of capsular contracture. Also ask your surgeon about Singulair to prevent capsular contracture.
Its perfectly ok to leave the capsule when removing the implant. It will do no harm, and you wont even be able to feel it since it will be behind your breast (and behind your muscle if submuscular implants) stuck against your chest wall.In fact, removing it increases your chances of complications after surgery.such as hematoma and seroma and it unnecessarily increases operating time.
Capsular Contracture and Explant
Implants can be explanted and the capsule left in. However, if the capsule is distorting the remaining breast tissue it should be removed or dissected free from the breast tissue.
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Capsular contracture can be unpredictable. I would recommend changing the implant and /or the pocket. Textured implants may be an option
Breast Implant Contracture
If you keep implants, your chances of not having the capsule come back are much better if the capsule is removed and a piece of strattice is sewn inside the implant space. You could alternatively remove your implants to prevent the capsule, but it is unlikely that you will like having your breasts much smaller. Also, you are likely to need a breast lift if the implants are removed which would result in additional incisions.