Capsular Contracture & Rupture?

Hi I have CC & a Rupture on my right breast (mcgahn allergan implants) & my surgeon wants to do a capsulotomy on this breast, I'm concerned as I had the surgery done 6 years ago & if I only have the right side done will they ever even out? One surgeon told me to leave the left side alone & the other said I must do both. The surgeon also wants to make a new incision under the breast, previously done on the aerola due to a lift being done. I'm very confused & need some advice. Thank you in advance.

Doctor Answers (9)

Capsular contracture and rupture

+2

If you are going to keep the same shape and size of implant when you exchange the ruptured one and you are happy with the other side, then it is not essential to exchange the opposite breast.  Many women will choose to exchange both and, if you have a warrantee, exchange of both may be covered.  Often times a patient will use this opportunity to change the implant size. If you are happy with things however then this is not necessary.

Without evaluating you in person, it is difficult to tell whether your old incision could be used or whether a new incision would be preferable.

Good luck with your decision,

Dr. Doug Hargrave 


Albany Plastic Surgeon
5.0 out of 5 stars 18 reviews

Capsular contracture and rupture

+2

As you have learned from the different opinions you have received, there is no right or wrong answer, making it really confusing for you.  Typically, if you have rupture and capsular contracture of only one breast, and your implants aren't that old, it is perfectly reasonable to leave the left one alone -- "if it ain't broke, don't fix it."  Others may say that at six years, your implants are relatively old, and it may be better to replace both.  Keep in mind that if you have surgery on both breasts, the risks will also go up.  

 

With regards to incision location....the inframammary incision is usually considered a better incision for revisionary breast surgery because it provides direct access to the implant.  Some also believe that capsular contracture is caused by a low grade infection or biofilm on the implant; and the inframammary incision avoids going through breast tissue (breast tissue is glandular tissue and can increase the risks of an infection).

 

I would suggest that you discuss these issues with your plastic surgeon.  Make sure that whomever you choose is board certified by the American Board of Plastic Surgery.  Good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 10 reviews

Should I change one or both implants?

+2

Hi there.  I am sorry that you feel that you are getting conflicting advice.  There are no rights or wrongs.  If there is no problem with the left side, then it is reasonable to leave it alone.  However, I can see that there is an argument to say that you may develop problems such as a capsule in a few years and so by changing it now, then you will have 'reset the clock' on both sides.  You do, however, double your chances of complications by having both done.

Again, I can see why you would have wanted to have the same areolar incision used to minimise the scarring, but I can understand why they have suggested making a new one.  Many surgeons (myself included) prefer to use an inframammary incision when changing breast implants as it is well hidden and provides good access to the space where the implant is in.  This is another area where there is no clear right and wrong.

It is great to get several opinions, but you often get conflicting advice based on the surgeon's experience and expertise.  Make sure that you are seeing a suitably qualified surgeon (look for FRCS (Plast) and membership of BAPRAS and/or BAAPS) and go with someone you feel comfortable with and can trust.  Good luck!

Jonathan J. Staiano, FRCS (Plast)
Birmingham Plastic Surgeon
5.0 out of 5 stars 9 reviews

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Capsular Contracture & Rupture?

+2

If the other side is OK and you are not planning a size change, I would leave it alone. As far as incision, it is hard to comment without an exam or at least a photo. I suspect either incision is satisfactory, and I would choose your surgeon on a overall  basis  concentrating more on getting the result you want, less on incision. Thanks and best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
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Right Side Capsular Contracture and Rupture and Left Side No Problems

+1

   For the right sided rupture and capsular contracture, removal and replacement of the implant with anterior and posterior capsulectomy or a replaning procedure is appropriate through the same incision.  There is no need to make another incision in the IMF unless additional skin from the fold needs to be removed for an implant that has bottomed out.  For the left side, nothing is needed if there is no implant malposition, rupture, or capsular contracture.  Kenneth Hughes, MD Hughesplasticsurgery Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 230 reviews

What to do after a capsular contracture and rupture?

+1

Hello.

Thank you for your inquiry.

Without a physical examination, it is not possible to provide you with a definitive advise.

Nonetheless, it sounds more beneficial to undergo a revision surgery in both breasts to have better chances of maintaining a relative symmetry. Also, you would have replaced both at 6 years after your first operation.

That being said, you may choose to have your surgeon operate on the right breast only if you absolutely like the way your left breast looks and you do not want to take any risks tempering with the old results.

With that perspective, please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.
I hope this helps and please feel free to check the website below.

Thank you for your inquiry.
The best of luck to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 125 reviews

Hello

+1

If your happy with the other breast you should leave it alone. If Your PS is only removing your CC, your results should be the same as before. Nothing is 100%, how your body will react. If your thinking on changing the size, then doing both would be the best.

Stuart B. Kincaid, MD, FACS
San Diego Plastic Surgeon
4.5 out of 5 stars 7 reviews

Rupture and contracture

+1

 i advise my patients to exchange both sides at the same time. It gives you the opportunity to upgrade implants or to reset the clock on both att he manufacturers expense for the most part.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 13 reviews

REvisionary cosmetic breast surgery - listen to your surgeon !

+1

I personally would encourage you to replace both implants with similar implant devices. Typically capsular contracture is treated with capsulectomy. I prefer to do this through an infra-mammary incision because its technically easier to do.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 39 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.