Hi! I have subglandular breast implants that are both of them capsular contracted. As i have read a capsular contracture is a capsule of skin that sorrounds the implant. These capsules get attached to the breast tissue? A capaulectomy involves removing breast tissue? I plan to breastfeed again in the future.
What Does a Capsulectomy Involve?
Doctor Answers 2
What is a Capsulectomy?
The capsule that forms around a breast implant is a natural formation of scar tissue to surround the foreign body from your natural tissue. In most cases the capsule remains soft and so do the breasts. Occasionally a firm capsule will form that will distort the breast. The most probable cause of the hard capsule is a subclinical infection. The capsulectomy involves removal of the scar tissue and the implant. This does not involve removal of the breast tissue and there should be no effect on future breast feeding. If you desire breast implants again you may want to consider having the implant placed into a partial submuscular plane that may help prevent redevelopment of a capsule in the future.
Capsulectomy - How Do You Do It?
Capsulectomies remove scar tissue and rarely, if any, breast tissue, and therefore, this should not affect breast feeding in the future.
The body always forms a scar around any foreign body inside of it. If this scar contracts inward towards that foreign body forcing it into a small space, it is known as a capsular contracture. There are basically two types of capsular contractures: thick contractures made up of scar tissue, mostly collagen, or thin contractures made up of mostly muscular cells called myofibroblasts.
To remove this scar, the best incision is at the base of the areolar because it gives the surgeon the greatest ability to get the upper and lower poles of the capsule out and stop any bleeding that may occur. In my practice, I would do an anterior capsulectomy because, in your sub glandular pocket, the posterior aspect of your capsule is sitting on your pectoralis muscle. If you take the capsule off the muscle itself, you can weaken the muscle and make it less useful in what the surgeon has to do next.
Whatever caused this capsule, you are better off switching to a different pocket, i.e. sub pectoral. To do this, your surgeon must obliterate the existing pocket, open the sub pectoral space, and then put your new implant in this space.
Obviously, this is a complex surgery requiring a Board Certified Plastic Surgeon with extensive experience with capsulectomies and pocket switching.