Putting back the same implant after capsulectomy?

I had a Brachioplasty and Breast Lift with implants this past Septemeber. My right breast now has a painful Grade IV contracture resulting from a hematoma. To make matters worse, the particular model of Mentor cohesive gel implants that I have are not yet approved in the US.

My local surgeon wants to perform a capsulectomy and just replace with the SAME implant. I mentioned to him that everything I read indicated standard practice was to replace with a new implant. He said that I would be fine since I hadn't had the implant in very long. I am very indebted to him because he was willing to consult with me when other surgeons blasted me for going overseas. They could care less that I had lost 169 lbs and had debilitating excess skin. My Costa Rica surgeon told me to come back so he can perform the capsulectomy and replace it with a new implant, however, I'd like to avoid travelling back to Costa Rica if at all possible.

What should I do at this point? Any advice would be helpful! I am almost positive this hematoma occurred as a result of strain and is not ruptured. Yet and still, should I be leery of my US surgeon wanting to replace with the SAME implant?

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16 answers to “Putting back the same implant after...”

A: So many options for capsular contracture

By Otto Joseph Placik, MD - Chicago Plastic Surgeon

The real problem is we really cannot definitively identify the cause nor can we provide a consistent recommendation regarding the management of capsular contracture. In my mind you have a few options and of course some of this is based on my personal practice experience over 15 years now: My most... more

A: A mixed bag

By Scott E. Kasden, MD - Dallas Plastic Surgeon

I agree that there is no "standard" practice in this situation. I feel that the hematoma led to the contracture. It is probably better to use a new implant with the capsulectomy. Mentor also likely has a suitable legal replacement as well. If your surgeon feels that it would be ok,... more

A: Silicone gel breast implants can last ten years or more

By Peter E. Johnson, MD - Chicago Plastic Surgeon

I am sorry that you had to go abroad in order to afford corrective cosmetic surgery after your extraordinary weight loss. This globalization of healthcare has affected patients requiring cosmetic surgery, hip replacement, and even heart surgery. I am also sorry to hear that you had difficulty finding a surgeon... more

A: Replacing breast implants

By Steven H. Williams, MD - Bay Area Plastic Surgeon

I agree with Dr. Moelleken that any surgery around an intact implant where the end result includes having an intact implant in place should have implants available. In my practice we believe that a major cause of capsular contracture (hard or firm breast implants) comes from subclinical bacterial contamination... more

A: No right answer

By Brent Moelleken, MD - Beverly Hills Plastic Surgeon

I would personally not agree to perform surgery on a patient unless I had backup implants available. That is not to say it is wrong, just my opinion. What if during surgery an infection was discovered? Or a damaged implant? Or something bizarre, like an inferior quality implant? All... more

A: Capsular contractures are a tough problem

By Jeffrey Zwiren, MD - Atlanta Plastic Surgeon

I agree with the comments already made to you. It is possible that you have a Style 410 implant from Allergan or an implant made by Silimed. The Allergan Style 410 is a shaped, textured gel filled implant. This style is not yet available in the US but is currently available in Canada. There is information... more

A: Re-explore with contingencies discussed beforehand....

By John P. Di Saia, MD - Orange County Plastic Surgeon

Hello, There may be a number of things going on in the setting of a rapid development of contracture and infection is included. Seeing as you are perhaps going to a new surgeon, he may or may not know much of the surgery that preceeded the one he is offering you. You need to be re-operated with a good... more

A: It would be best to change the breast implant

By Sanjay Grover, MD - Orange County Plastic Surgeon

It is possible that the hematoma did lead to your capsular contracture; however, there are other possible causes as well. A subclinical (non-obvious) bacterial infection around the implant could have contributed. If this is the case, a film (thin layer) or coating may exist on your implant and... more

A: Yes it is ok to keep the same breast implant

By Sirish Maddali, MD - Bay Area Plastic Surgeon

I'm sorry to hear that you have a bad capsular contracture so soon after your procedure. It is very likely related to the hematoma. If your surgeon feels that the implant has not ruptured, then it is perfectly ok to remove the implant, remove the capsule, and then replace the SAME implant. This is a very... more

A: New vs old breast implant

By Richard P. Rand, MD - Seattle Plastic Surgeon

Your implant is almost new so assuming that it appeared normal during the capsulectomy it would not be unreasonable for your surgeon to use their judgement and re-use it and save you the money. However, that is "technically" not the right thing to do even though many surgeons would do it that... more

More answers to Putting back the same implant after capsulectomy?
Los Angeles - Implant not the problem
New York City - OK to keep the same breast implants if your plastic...
Sacramento - Change implants and remove the entire capsule
Sonoma Valley - If you replace one implant you may need to replace both

Comments

jcandace
3 posts
11 Jan 2009

Thank you so much for you responses! I am truly grateful because I truly felt as though I was flying blind. I just wanted to clarify that my implants are submuscular. My surgeon here in the states feels it's okay to use the same implant; however, I understand that this may change once he opens me up. In the event that I do need a replacement implant, this will result in a different model impant in the right breast, than the left (since the particular model of cohesive gel implants I have aren't approved in the U.S. yet). Should I be okay with mix-matched implants? It also concerns me that during a few consults with different surgeons (including him), when I mention that I have cohesive gel implants, they've each pulled out sample implants showing me what they think I have. But my implant looks NOTHING like these. The interior of my implant is firm and solid. It has a gummy bear consistency which you could make a clean cut through; whereas the implants they've show me are more gel-like consistency. I'm not trying to major on minor, I only endeavor to make an informed decision. So if having different types of implant in each breast is inconsequential, then I don't mind not having the exact same implant in both breasts. Advice?

April from RealSelf
1216 posts
24 Feb 2009

Hi jcandace, I posted your follow-up question here: OK to have mismatched breast implants? You should also be able to see this question in your RealSelf account. Thanks for posting!

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