Capsular contracture always returns after implant exchange - is there an expert or technique I should seek out?

Question

I got implants and had capsular contracture. Over the course of a decade I’ve had the implants replaced three times, and every time the capsular contracture returns. If I have them exchanged again, is there an expert or technique I should seek out? My surgeon is very skilled and I understand it’s not his fault. Before the implants, I did have a breast left. Thank you.

Daniel Barrett, MD · Answer

Dear AEW1983,
capsular contracture happens. In fact, every implant has a capsule form around it, its just a certain percentage develop thick capsules. There is a lot we don't know about it actually. Some think that bacteria that gets on the implant during insertion can increase the risk. Thats why we use a Keller Funnel in our practice to reduce that possibility. Our capsular contracture rate is less than 2% because we use a keller funnel as well as meticulous operating room techniques.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Some women make capsules. I would suggest going with a smaller capsule. If your present capsule is not too old or too hard, consider oral Accolate and external ultrasound treatments. For any any repeat surgery, be sure and stay on Accolate for least 3 months.

Jason Pozner, MD · Answer

Was the same procedure done each time when the capsule returned?
We have a very specific capsular contracture protocol with a recurrence rate of under 5%. It entails:

complete capsulectomy
submuscular conversion if currently over the muscle
wash with hypochlorous acid and triple antibiotic betadine solution
new implants
strattice
drain
specimens are sent to microgendx for pcr and next generation sequencing and if bacteria positive we put on antibiotics specific to the organisms for 4-6 weeks

Douglas Taranow, DO, FACOS · Answer

Recurring capsules contractures is not uncommon. My main question is did your surgeon use ADM (acellular dermal matrix) with your latest revision and have you considered saline implants (not optimal but a little less contractures)?

Richard P. Rand, MD, FACS (retired) · Answer

You might go to NYC and visit Dr. Hidalgo. He wrote a paper using mesh materials that got the CC rate way down.

Capsular contracture always returns after implant exchange - is there an expert or technique I should seek out?

Answers (5)

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