How Do I Find a Doctor Who Is Highly Experienced in Dealing with Capsulectomies and Implant Switches?

My submucular saline implants are 2 years old. I've deleloped a cc in my left breast. It has gotten slightly worse even with taking vitamin E and singulair. It is getting more noticeable so I am beginning my research to find a surgeon in the new york/new jersey area that specializes in cc. I'd like a doctor who performs a lot of Capsulectomies and implant switches AND, most importantly, has a low incidence of cc recurrence (even a few years after the surgery). Also, use of matrix maybe?

Doctor Answers 6

Breast augmentation revision

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Thank you for the question.

You are absolutely correct in that choosing your surgeon carefully will be critical to the success of your operation.  unfortunately, there is nothing that will substitute for due diligence. Start with the American Board of Plastic Surgery and concentrate on doctors who have had extensive experience with revisionary  breast augmentation surgery.  You will get a good idea of who those doctors are by visiting their websites and their offices in person. You may want to speak with previous patients who've had similar surgery performed by the surgeon.


Before proceeding with revisionary  surgery It will be very important to communicate your  goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.

I hope this helps.

Finding a Doctor Who Is Highly Experienced in Dealing with Capsulectomies and Implant Switches

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The American Board of Plastic Surgery (ASPS) and the The American Society for Aesthetic Plastic Surgery (ASAPS) will be able to provide you with a list of qualified, board certified plastic surgeons. Consult with 3 - 4 experienced and expert board certified plastic surgeons to explore your options.

Look at before/after photos

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The most important thing to look for is the before/after photo gallery; make sure the surgeon your looking at has a category that is only for breast implant complications and has a lot (at least 20) patient's photos on there with at least 3 views (front, quarter turn and profile views) from each patient.  If you don't see this then assume you are not in the right place.  And I agree you want to see someone who is board certified plastic surgeon, is nice, has nice staff and etc...

Capsular Contracture - An Unpredictabke Problem

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The problem is not the implant.  It is your body's reaction to it.  Implant exchange may or may not solve the problem.  Capsulectomy is like chess, easy to say, difficult to do well.  It can be bloody, it reduces breast volume as tissue is removed, and you still have a higher than average (20%) risk of developing another capsular contracture.

Another option, drastic as it may seem is to remove your implants.  The good news is that in many cases you can have simultaneous replacement of breast volume using your own natural fat, which is transplanted into the breast over the empty breast implant pocket.  See the embeded video.  This is a new option for women who dont want to deal with implants.  And there is evidence that the regenerative aspects of fat are beneficial for capsular contracture and scar, probably more beneficial than a sheet of cadaver skin, or what some call matrix, or Alloderm

Best regards,


Dr Del vecchio


Looking for a surgeon experienced in revision breast surgery?

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Unfortunately, capsular contraction is too common. Unlike some of my colleagues, I believe cc is 80% technical error (bleeding, infection, foreign material like powder or lint) and 20% genetics or bad luck.  Correction includes removal of the capsule, exchange of implants, and placment in a new pocket. Recent studies have shown that the use of acellular dermal matrices can help prevent recurrence of cc, especially when combined wtih good ("no-touch") surgical technique and early use of anti-inflammatory medications. As my cosmetic breast implant pracgice continues to grow, I find myself doing less "primary augmentations" and many more "revisional" surgeries. Surgeries like the one you need, now encompass 25% of my breast practice. My consultations are free and I look forward to seeing you. Take a look around my website, and certainly "google me". 

Matrix (Alloderm) is definitely indicated to prevent recurrence of early capsular contracture.

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Tips on picking a Plastic Surgeon
Article by George J. Beraka, MD
Manhattan Plastic Surgeon

1) Is the surgeon a member of the American Society for Aesthetic Plastic Surgery? Members usually do a lot of cosmetic surgery.

2) Did you sense a commitment to excellence in the office. Did the surgeon spend a lot of time with you? Someone who rushes through the consultation may rush through the surgery.

3) Were you treated as an individual? Did the surgeon present you with a surgical plan tailor made for you?

4) Plastic surgeons have to have a good eye and meticulous technique.  Did the surgeon show you A LOT of before and after pictures, and did you love the results?

5) Talk to other doctors you know. Established plastic surgeons have a reputation in the community, good or bad.

6)  Ask to speak to a patient who has had the procedure you want.  You are looking for a surgeon who does a lot of what you want.   Many  patients are eager to share their experience.  Privacy is preserved by having the patient call you.

7)  If you are having breast augmentation, ask if the surgeon has a large inventory of different size and shape breast implants available in the operating room.  A surgeon who does a lot of breast surgery will have an inventory.  This way, the final implant choice does not have to be made in advance.

8)   With office surgery, make sure the surgical facility is ACCREDITED.   Very important safety assurance.

9)   Make sure the anesthesia is given by a BOARD CERTIFIED ANESTHESIOLOGIST.  Another very important safety factor.

10)  Make sure the office has trained nurses available for hands-on post operative care.  This can really speed recovery.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.