December 2009 Breast augmentation to a full B size with Smooth Cohesive gel implants & under the muscle. Dec. 2010 I received an open Capsulotomy- left breast only. 7 months after left breast begins hard capsule again. This July I'm going in for a Capsulectomy, flying back to same surgeon. I need any advice possible on how to not get another capsule! Does Vit. E work months after? Anything I can take to reduce bacteria which typically causes bad capsules? Can't afford Strattice so not an option.
Tips for Best Results After Capsulectomy?
Doctor Answers 4
Best Results for After Capsulectomy
Optimally, doing an anterior capsulectomy and implant replacement below the muscle using a textured saline or silicone implant will give the best result.
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Hello and thanks for the question.
Capsular contracture often times is a difficult situation to deal with, especially when you fall into the category of patients that have repeat episodes. It is a frustrating situation for both the patient and surgeon.
While the understanding of biofilm and theorized treatments continues to evolve, the management of capsular contractures for the most part, has remained unchanged for a long-time. That being said, your best option for success are as follows: 1 ) Capsulectomy - the implant scar or capsule should be removed in its entirety, if possible, as remnants of it may house biofilm which could act as a nidus for future capsules. 2) The implant should be replaced. Why ?: Evaluation of implants which have had overlying capsular contractors indicate that they too are impregnated with biofilm and hence could act as a source for recurrent capsular contractures. 3) There is data to suggest that changing the implant pocket location ( i.e. going from sub muscular to sub glandular or vice versa) may lessen the changes of a repeat event. This is an option you should discuss with your surgeon, as there are implications of doing this as well.
As my colleague suggested, an option would be to rest the breasts, and have the implants removed for a time period. A lot of patients don't like this option due to its inconvenience and non-guarentee of a repeat scenario of capsular contracture in the future. Lastly, another option is the use of Accolate which is an anti-inflammatory medicine initially developed for the management of asthma, now largely replaced by Singulair. While studies suggesting that this medicine may lessen the chances of capsular contracture development, the information was largely based on animal studies in a laboratory. I can tell you that I know of several surgeons who have used Accolate in their armamentarium of treatment modalities for capsular contracture - results have been variable - that being from negligible to complete reversal of capsular contracture. Accolate can potentially affect the liver adversely, so the medication, if used, requires close monitoring.
I hope this information assists you.
Best of luck to you,
Glenn Vallecillos, M.D., F.A.C.S.
Multiple capsular contractures
It sounds like you may need to give it a rest. Take the implants out for a few months and start over. Some would suggest strattice and remove the capsule and place new implants. Tough choice.
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How to reduce the risk of capsular contracture
This is a very unfortunate situation. There are several several techniques that try to prevent it from happening. Washing the implant and pocket with triple antibiotic solution during surgery, wearing breast band, breast massages are all used to prevent it from happening. Other method such as the use of anti-inflammatory or anti asthma medication have to be discussed with your plastic surgery. As for Strattice, there reports that show it is useful in preventing recurrence of contracture.
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