20 Year Old Saline Implants, Capsular Contracture in One Breast. Will It Be Straight Forward to Removed Them Both? (photo)

Thanks for your question. It is difficult to assess your case accurately as the photos are not ideal. However, it is usually relatively straightforward to remove breast implants (with or without the surrounding capsule). If you do not want to have breast implants any more then sometimes implant removal is combined with a breast uplift procedure to maintain an aesthetically pleasing breast shape. The pros and cons of different techniques should be discussed with a plastic surgeon with a specialist interest in breast surgery.

Removing your old implants along with the surrounding scar tissue capsules should be a fairly straightforward proposal.  Some capsules are easier to remove than others.  If your implants were not placed under the chest muscle originally then I might suggest putting them under the muscle when you have them replaced to minimize the risk of future capsular contractures.

Capsular contracture is a complication that can occur after breast augmentation surgery, when the scar tissue around a breast implant tightens and hardens: ExplanationThe body forms a thin, pliable, and translucent capsule of scar tissue around a breast implant as a normal response to the foreign object. However, in capsular contracture, the capsule thickens and tightens, squeezing the implant and causing the breast to feel hard and painful, and look abnormal. SeverityCapsular contracture can range in severity from mild to severe. The Baker Scale is used to grade the severity of capsular contracture: Grade I: No contracture or asymptomatic Grade II: Mild contracture that is painless and almost undetectable Grade III: Moderate contracture with some firmness and discomfort Grade IV: Severe contracture that is painful and can be diagnosed by observation alone PrevalenceAbout one in six women who have breast augmentation surgery will experience some degree of capsular contracture. CauseCapsular contracture is caused by anything that leads to inflammation of the capsule. TreatmentPlastic surgeons can perform breast augmentation revision procedures to treat capsular contracture.

With saline implants it is seldom difficult to remove the implants and capsules if needed. When capsule tissue is left behind it usually resorbs, provided it is not too thick. Both sides seem to have capsular contracture as I view the photos. 

Best wishes

 

Thank you for the question and pictures.  Given your history of very little change in body type over the years, it is likely that your breasts will “bounce back” relatively nicely after removal of breast implants. Of course, the breasts will be quite small;  hopefully you will be okay with the aesthetic outcome of this procedure.  You may find the attached link helpful to you;  patients who have undergone this procedure discuss their experience.

The procedure of breast implant removal itself should be quite straightforward and associated with minimal discomfort afterwards. Given that you have thickened capsule tissue, I would recommend that you have this tissue carefully removed at the time of breast implant removal also. Otherwise, this thickened tissue will remain in place, creating a firmer feel of the breast and potentially causing confusion when mammography is done.

 Select your plastic surgeon carefully.  Best wishes.

When you take out the implants and if possible remove the entire capsule you will be left with empty breasts. It might be a good idea to have new implants placed.

Breast implant removal after 20 years and capsular contracture will require removal of the capsule. If the capsule is very thin at time of surgery then cauterizing the surface will make both sides adhere. However leaving the capsule in may cause fluid accumulation in the pocket.