Most breast pocket revision surgeries including capsulorrhaphies in which sutures are used to tighten the capsule of the pocket involve removing the implant, completing the pocket revision, and replacing the existing or a new implant. Trying to complete any significant pocket revision that requires tightening or suturing should be done with the implant removed for appropriate visibility and to minimize the risk of causing damage to the implant. There is one technique that I know of that involves simply touching the inner wall of the capsule with a cautery pencil that does not involve using sutures. This theoretically could be completed with the implant still in place, but it would still be preferable to remove and replace the implant in order to optimize symmetry and an effective result.
Dear jennaloveatl,I understand your concern. However, without a proper assessment it would be difficult to determine what is wrong and what needs to be done. It is best that you visit your plastic surgeon for further assessment. Only after thorough examination you can get proper recommendations and advice.Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery