Replace implant after partial capsulectomy?

Had BA revision 6 months ago, switched to silicone & now have mild CC in 1 breast. Will have partial capsulectomy soon but Doctor wants to reuse the same implant. Should I request a new implant or go with the dr's recommendation? What risks are associated with reuse? Will Partial alleviate the tightness? What questions should I be asking?

Doctor Answers (5)

Capsulectomy and implant replacement - Los Angeles

+2

I perform many capsulectomies and would now opt for a near complete to complete capsulectomy. A new implant is preferred in some cases.

Raffy Karamanoukian Los Angeles


Los Angeles Plastic Surgeon
5.0 out of 5 stars 47 reviews

Treatment for Capsular Contracture

+2

Hello,

Although I agree with Drs. Bandy and Rhee, it is not a black and white situation. We do not know if bacterial biofilm is the cause of all capsular contracture, and sometimes capsular contracture is mild and non-progressive, and sometimes its rapid and progressive. In general, 'definitive treatment' is total capsulectomy and replacement with a new implant through an inframammary incision. However, many women have gotten long term resolution of a slightly high riding implant that is minimally firmer (mild signs of capsular contracture) with a partial capsulectomy or even capsulotomies. Being able to detect which capsular contracture will respond to what treatment is more guess work then science, but if your implant is just 'slightly firmer' and has not progressed for many months, then it may be possible to treat definitively with less aggressive removal of scar, and/or even reuse of the implant. In general though, I always prefer to use a new implant, even though it is another cost burden on the patient.

Best of luck.

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

Replace implant after partial capsulectomy?

+2

In general, a new implant should be used, and anterior and posterior capsulectomies should be performed.

Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast augmentation revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 209 reviews

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Replace implant after partial capsulectomy?

+2

I agree with the post below. Additionally, I would recommend complete removal of the capsule, as you will have the best chance of not getting another CC. Biofilm is one thing that is being looked at very carefully in CC formation. That is when there is a bacteria that has contaminated the capsule, and has formed a film that is very resistant to your bodies immune system- thus stimulating inflammation leading to capsular contracture. If you only remove a portion of the capsule, the biofilm will spread to the raw surface area and stimulate new CC formation. If you are looking to save $, then an ounce of prevention is worth it. If your surgeon is going to re-use the implant, then it should at least be re-sterilized by autoclave- but a new implant is the best.

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 85 reviews

Replace implant after partial capsulectomy?

+2

Given that you are having revisional surgery for a capsular contracture, in my opinion, you should not have your implant re-used.

We know that one potential cause of capsular contracture relates to bacterial contamination of the implant. Other than a potential cost savings (which does not translate to a cost savings if another capsular contracture occurs), there is no reason to re-use the implant in this scenario.

Cost is always a factor in cosmetic surgery, but most plastic surgeons are going to tell you that the risk outweighs the benefit in this case.

Paul H. Rhee, MD, FACS
Castle Rock Plastic Surgeon
5.0 out of 5 stars 4 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.