I had my original breast aug on 4/15/11 with 400 cc silicone implants to fix tubular breasts. Three months ago I was told I had grade 3 capsular contracture in the left breast and had my revision surgery 1/17/11. I was told a new implant would be used if needed. My surgeon said he removed the implant along with a lot of scar tissue but there was some under the ribs which he left in place and then replaced the original implant. Is this dangerous? And what are the chances of this reoccurring?
Can Leaving Scar Tissue from Capsular Contracture Be Dangerous?
Doctor Answers 3
Recurrent capsular contracture
If you have formed a capsule once, you are more likely to form another one than someone in the general patient population. The jury is out on whether the entire capsule or a large portion of it should be excised. Sometimes, given the thinness of the breast tissue, it would be impractical to excise the entire capsule and leave you with insufficient coverage for the implant. Capsules are not dangerous in and of themselves although they can be painful and aesthetically unpleasing. Let's hope that your capsule does not recur and that you go on to have an excellent recovery! Dr K
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Capsule recurrence after augmentation
The cause of capsular contracture is incompletely understood, and cutting the capsule (capsulotomy) maintaining the same implant can work about 40 to 50% of the time. This means that over half of the time a capsular contracture will recurr. The rate can be improved modestly by removing the capsule completely (capsulectomy) if possible, and giving the implant a fresh start. A new implant also may reduce the chance of bacterial biofilms remaining and reduce the capsular contracture rate further. Hard numbers though are hard to come by. Dangerous to leave some capsule? no.
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Removal Of Capsular Contracture
Whether or not to remove all or part of a capsular contracture is a contoversial area in plastic surgery. There are sound arguments which can be made for either side. More important than removing all scar tissue is to place the new implant into a virgin area. Removal of the capsule over ribs may be more risky than leaving it in place.