I had Breast augmentation done 8 years ago. I think I need capsulectomy, Breast lift and another breast augmentation done. Am I correct? How can I avoid another set of potential complications?
Breast Surgeries to Correct Capsular Contracture?
Doctor Answers 12
Ready for Revision and Breast Lift (Mastopexy)
If your breasts feel hard, then capsulectomy should improve this. To reduce recurrence your surgeon may consider (1) saline implants, (2) subpectoral placement, (3) new implants, even if those are fine. If your breasts have grown or you no longer wish to be that size, go without implants, and there won't be another contracture. (You would probably want a lift in that case.)
To address the sagging appearance, I would recommend a breast lift (mastopexy). This could elevate your nipple and areola, make the areola diameter smaller, and tighten the lower pole looseness. To reduce complications your surgeon may consider (1) lift without implants, (2) the option for second stage augmentation (this would give you the most effective lift and enlargement).
Choose an experienced board-certified plastic surgeon.
You need both a capsule repair and a lift
From your photos, you are exactly correct in neding the capsules removed, new implants placed and a full lift for the best shape. There is n way to totally prevent the capsule issues again, but the lift should be relatively permanent if done well.
I think you're ready to practice plastic surgery
You seem to already have good insight as to your condition and how to correct it. I agree wholeheartedly with your plan for a capsulectomy, lift and transfer of the implants to the submuscular plane. You could use the same implants if they are intact, but they have already lived over half of they're expected average lifespan. The present appearance of your breasts demonstrate the long term effect of heavy silicone gel implants placed in the subglandular position. Good luck!
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Correcting Capsular Contracture
Many options for revision augmentation mammaplasty
Your photos reveal glandular ptosis, possible capsular contracture, and asymmetry with the right larger and lower.
Depending on the in initial procedure and the type and location of the implants as well as your intial versus current breast size, several options are potentially open to you.
However, it does appear that you will need a lift, possible right sided reduction, and possible capsulectomy with implant removal and replacement. A capsulectomy is not necessarily required and some use a new pocket while they retain the old capsule.
It is not unusual to gain breast tissue volume over an 8 year period and perhaps a smaller or no implant can be used.
You have a condition that will require a lift and capsulectomy and augmentation mamoplasty.
While many say it is safer and it is to do a two staged procedure, I feel that in almost all cases it is a good approach to remove the implants with a capsulectomy,, perform a breast lift and place a new silicone textured implant under the breast tissue at the same time. Yes you could have to have a procedure to keep the implant from coming out, more often than not you can succeed with a single operation. I have found that putting the implant under the muscle doesn't give as good or as natural looking result. By using a textured implant you can get the implant to stay higher and with less chance of harding but you do get a little greater chance of ripples. I have also found that to use only a lollipop incision, around the nipple areolar complex and the down the middle of the breast will often leave a unattractive bulge of breast tissue on the lower pole of the breast. It does work well in patients that don't have much drooping of their breast but in most cases and I believe you are one, i find that the results are much nicer and more attractive if you use a more extensive incision, and anchor incision, which goes around the nipple areolar complex, down the middle of the breast and the a curved incision on the bottom of the breast. Yes there is more scar and some increased risk but the end result is much better and you will be living with the long term result for ever.
Have the implants removed and have a short scar breast lift
Capsular contracture is one of the undesirable results of augmentation. Looking at you photos, I would advise removing the implants and doing a short scar breast lift. This involves more than just placing a lollipop scar on the breasts. I completely rearrange the breast tissue by creating three flaps and only skin is removed. Yes your breasts will be somewhat smaller, but you would have a better shape, softness to the breasts and smaller areolae. You will never have implant related issues again in the future. If at a future date you decide that you would like to be larger than an augmentation is easily done. This way I have more control over the outcome with long lasting results. I got away from augmentation and breast lifts done at the same time years ago, since this combined procedure has a lot of potential complications and many times involves further surgery. Best of luck.
A revision breast augmentation and breast lift will give you a great result.
Here's what you need:
1) Since you have severe capsular contractures, you really cannot leave your implants alone. You need partial capsulectomies, and new implants. Just don't get bigger implants. 300 cc's to 350 cc's seems right. Big breast implants age terribly.
2) You need a good "lollipop scar" breast lift at the same time (around and under the nipples) . No scars under the breasts, because you don't need them, and also because they increase the risk of complications with implants.
3) Your areolas need to be made quite a bit smaller.
4) Unfortunately, there is always a small risk of complications with surgery. Pick a good surgeon. My web site has links to the plastic surgery societies, where you can get names near you.
Breast implants and lift?
Yes, it looks like you will need a breast lift procedure. If you want to maintain the volume, you will need implants. Since these have been in for 8 years, I would suggest replacing them.
You answered your own question
Cosmetic breast surgery is an exercise in compromise and trade-offs. Implants gave you the size you like but also produces some of the undersirable effects you mentioned. Certainly a breast lift of sorts is the most reasonable first. What to do with the implants is an entirely different and more complex issue.
Once you have an implant, you inherit all the side effects and complications until you remove them. What you suggest is certainly reasonable but potentially difficult to achieve. You will need a significant lift and that jeopardizes the nipple and healing potential when you also add manipulation to the capsule. Moving from subglandular to submuscular sounds easy but may require suturing the muscle to the gland to prevent it from displacing excessively and allowing communication between the subglandular space and submuscular space. This might prevent a large, projecting implant to be placed. Sometimes it is safer and more predictable to remove the implant and do the lift and then come back to reimplant an implant. Each surgeon and situation will lead to a different plan. Be sure your surgeon reviews all alternatives and risks with you. You could end up with the breasts you desire, or a major complication if your surgery is not planned or executed well. Good luck.
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