Capsular contracture, do I need complete new implants, if I am undergoing surgery for a capsular contracture?

Question

I recently was informed by my surgeon that i have a capsular contracture . Mind you, i just had my breasts (saline, under muscle, high profile) done in march 2015. My concerns are do i need complete new implants to replace the capsulated one? Each video i see posted on you tube surgeons are using new implants to replace the old one. I would rather pay more for brand new implants than to have to re do them a third time. What are the chances of it forming again? . Please help.

Kyle Song, MD · Answer

Yes, you do need new implants.  This is because one of the main reasons of developing cc is a mild, smoldering bacterial contamination of the implants, and so any revision needs brand new implants to minimize the chance of recurrence.  If you have new implants, all 3 manufacturers offer cc protection plans and you may be eligible for free replacement implants.  Best of luck.

Gerald Minniti, MD, FACS · Answer

Hello,I would like to clarify something here.  There has been a wealth of literature looking at revision and primary breast augmentation with regards to capsular contracture. The only controversy is in surgeon's heads. The data is clear, and its all about bacteria:1. Revision surgery should be performed through an inframammary incision, even if a periareolar scar exists.2. Total capsulectomy en bloc (all in one piece, no holes made while extracting it) should be performed with the implant discarded. 3. Triple antibiotic irrigation with half strength Betadine, followed by re-cleaning skin and re-draping operative field.4. Delivery of a new implant via a funnel.When the surgery is performed in this manner, your risk of recurrence is no more than when primary breast augmentation is performed in the most optimal way, approximately 2%.  Therefore, there is no need for expensive ADMs like Alloderm or Strattice.  In fact, this surgery is so effective, that the resulting capsule is frequently softer than the non-problematic side, and consideration preoperatively should be made to perform bilateral capsulectomies. Revision surgery is much different than primary, and you might benefit from getting a few second opinions. Best of luck!

Thomas S. Taylor, FACS · Answer

The goal for a capsular contracture surgery is to re-create an entirely fresh pocket: remove the old implants, remove the thickened scar tissue entirely, replace with new implants, use drains, and consider the use of an ADM if this is your third time with this problem.  Good luck to you!Thomas Taylor, MDPasadena, CA

Ira H. Rex lll, MD · Answer

There is no single correct answer for this. We suspect that in most cases of capsular contracture, a slow infection, called a biofilm, is present. So theoretically the implant is contaminated and perhaps should not be used. Some doctors will exchange implants in a more severe contracture but consider reusing the implants after a bath in antibiotics, with a lesser contracture.

Michael J. Brown, MD · Answer

Hi,

Thanks for posting your question. I am happy to try and help
you. It is important to remember that a board certified plastic surgeon will be
your best resource when it comes to an accurate assessment of your situation,
and concerns.

Having said that, capsular contracture is a very unfortunate
condition that may develop after breast augmentation surgery. The cause is an
enigma and we have some suspicions that it may be caused by subclinical
bacterial infection, or excessive bleeding during or after surgery. The
treatment is also complicated and some PS will through the kitchen sink at it
trying to make it go away. Some times it works, other times it does not.
Ultrasound, asthma medications, reoperating, scar tissue removal, changing to a
different breast pocket, new breast implants and even implant removal have been suggested to treat
it. The other problem is that it may go away after all of these heroic efforts
only to have it return. In other cases, one of these may work and it does not
come back. It is a tough problem.

I hope you found this helpful. Best wishes

Capsular contracture, do I need complete new implants, if I am undergoing surgery for a capsular contracture?

Answers (10)

Answer: Implant replacement with capsular contracture repair

Answer: Implant replacement with capsular contracture repair

Answer: Capsular contracture and new breast implants

Answer: Capsular contracture and new breast implants

Recommended reading

Everything you need to know about Capsular Contracture Treatment

Our mission is to create a world where every investment in modern beauty is Worth It.

Capsular contracture, do I need complete new implants, if I am undergoing surgery for a capsular contracture?

Answers (10)

Answer: Implant replacement with capsular contracture repair

Answer: Implant replacement with capsular contracture repair

Answer: Capsular contracture and new breast implants

Answer: Capsular contracture and new breast implants

Browse related questions

Recommended reading

Everything you need to know about Capsular Contracture Treatment

Our mission is to create a world where every investment in modern beauty is Worth It.