Why Do I Need a Capsulectomy?

Long story short, I developed an infection from my first Breast Augmentation and the implant needed to be removed. During this surgery the surgeon performed a Capsulectomy, and I have been healing for over a year now. I have surgery scheduled to replace the impant with a new surgeon in two weeks, and he wants to perform another Capsulectomy. Is this necessary and if so why?

Doctor Answers 4

Is a repeat capsulectomy needed?

In my opinion ,  there should not be a capsule if it was removed.  The pocket will need to be developed
again.

CAPSULECTOMY/CAPSULOTOMY
One of the most common problems with #cosmeticsurgery is #breast #capsularcontracture or the development of thickening, and contracture of the capsule that exists around the breast implants. Severe capsule contracture probably occurs in less than 15% of augmentation patients. Every woman has a breast capsule around their #implant and this is a normal phenomenon. The capsule itself could be as thin as Saran Wrap but may also become calcified and thickened. As it thickens and shrinks, the patient may develop a feeling a firmness of the breasts and in its worst situation, the breast may become painful and abnormal in appearance, achieving a very round, hard, and uneven appearance. There may be distortion and possible breakage and leakage of an older implant, but may also include a newer implant. Nicotine users, such as smokers, have up to a 30x increased risk of capsular contracture.
#Salineimplants may deflate spontaneously. When the patient has significant symptoms, complete or partial leakage of their saline implant, or concerns regarding silicone leakage, it is recommended that the implant is removed and exchanged. Frequently, this is performed on both sides depending upon the age of the implant. #Capsulotomy or opening of the capsule may be required or frequently #capsulectomy, which is removal of the scarred capsule, is recommended to ensure adequate pocket dimensions.
New implants may then be placed in the same existing position or may undergo a change of placement frequently from submammary to subpectoral position and, on occasion, the other way around.
NEOPECTORAL POCKET
This is sometimes used as a technique to provide a stronger more secure placement. In this case, the implant is removed and the capsule is dissected from the muscle, creating a new or “neo” pocket for the implant.
EXPLANTATION OF IMPLANTS
Explantation is the term that has been given to describe the removal of the breast implant.
What does explantation involve? Two choices exist for explantation:
1. Implant removal while leaving the capsule. This is a simple procedure and requires local
anesthesia, IV sedation, or (uncommonly) general anesthesia. It is relatively inexpensive. Microscopic amounts of gel may remain in the capsule.
2. Capsulectomy: This will enable the surgeon to remove as much silicone as reasonable without creating significant deformity. This operation may require a larger incision. The surgery and recovery time will be longer. General anesthesia is usually necessary and subsequently all of the costs associated with this operation will be higher.


Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Capsulectomy Necessary?

Thank you for the question.

Your current plastic surgeon will be in the best position to explain the planned procedure. Online  consultants can only speculate. Clarify with your plastic surgeon and seek second opinions in person if in doubt.

Best wishes.

Capsulectomy?

If you had a previous capsulectomy, there should be no capsule at present to remove.  Obviously a new pocket has to be created for the implant.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Need for a second capsulectomy

In theory, if you had a capsulectomy at the time of your implant removal you should not need a second one as there should be no capsule present. Perhaps you have scar tissue present that will need removal. Ask your surgeon to explain his/her rationale. If you are not given a satisfactory answer get another opinion. Good luck!

Marcel Daniels, MD
Long Beach Plastic Surgeon
4.8 out of 5 stars 22 reviews

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