Yes it is ok to keep the same breast implant

Sirish Maddali, MD answers: 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?

14 months ago

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 common practice. Even if the implant were older, it would be a safe procedure to keep the same implant.

Your situation is a little different in that your implant is not available in the US. You should have a contingency plan in place if during your procedure your surgeon feels that your implant has in fact ruptured.

It would be wise to have a replacement silicone implant (even though it is different from the one in Costa Rica) picked out and available in the operating room for such a situation. Good luck.

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More answers to “Putting back the same implant after capsulectomy?”

A: Replacing breast implants

14 months ago

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.

To reduce the possibility of this happening again, we would recommend the implants being replaced (the biofilm on the old implants may be impossible to sterilize). That is not to say that re-using the old implant is improper, but in our experience, it may increase the possibility of recurrent capsular contracture.

To answer your new questions - mixing the implants (as long as they are both silicone for consistent feel) should be ok. Be sure to remember that the sides may feel different even if the same implant is used because of the additional surgery on the breast with the capsular contracture. Depending on the extent of the capsulectomy - your old implant may not be enough to give you symmetry.

Be sure to discuss all these issues with your surgeon before your surgery.

I hope this helps!

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Sirish Maddali, MD answers: Putting back the same implant after capsulectomy?

A: Replacing breast implants

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