Capsulotomy vs Capsulectomy: what is the difference?

Thank you for your question.  "Otomy" typically means to make a hole in that part of the body, for example, a Gastrotomy would be making a hole in the stomach, (for say, a feeding tube).  "Ectomy" means to take it out, (remove) that part of the body, or sections thereof, for example a Gastrectomy would be the removal of the stomach, or sections thereof.  A capsulotomy will make incisions in the capsule.  A capsulectomy will take the capsule, or sections thereof out.  "En-bloc: usually referes to taking whatever it is out in one piece.  Remember that it is important to be safe.  Sometimes the tissue may not allow this, (i.e.; thin tissue on the chest wall). Each surgeon is different as to use of drains.  It varies also by patient and case.  Please talk to your Board Certified Plastic Surgeon.  Ask them those questions that are on your mind.Jeffrey J. Roth, M.D., F.A.C.S.Board Certified Plastic SurgeonLas Vegas Plastic Surgery

Great question!  Medical and scientific vocabulary can be very confusing because so many terms sound so similar.  I will try to make it very simple:capsulotomy - cutting into or through the scar tissue, but NOT removing it.capsulectomy - removing scar tissue (in any way) and can be partial or complete depending on how much of the scar tissue is removeden bloc capsulectomy - removing ALL of the scar tissue and the implant simultaneously without opening the scar tissue to remove the implant.  This requires a much longer incision.capsulorrhaphy - suturing the scar tissue of the capsule in order to change the size or shape of the pocket.Ultimately, if you are happy with the results then it doesn't rally matter what was done with the scar tissue during your surgery.  It could also be a transcription error if your doctor dictated the operative note; those terms sound so much alike that the transcriptionist may have typed the word wrong.  I am unaware of any scientific, peer-reviewed articles that show a distinct benefit from an en block capsulectomy over leaving all the scar tissue in place.I hope this helps explain things.Richard H
Fryer, MD FACS
Board
Certified by American Board of Plastic Surgeons (ABPS)
member
American Society of Aesthetic Plastic Surgery (ASAPS)
member
American Society of Plastic Surgery (ASPS)

Capsulotomy: A fine incision is made in the scar tissue capsule. This method is effective not only when the capsule must be removed but also when the pocket of the implant must be re-centered.Capsulectomy: Surgical removal of the scar tissue capsule. This is the most effective method of capsule correction. The implant is either moved to a sub-muscular position or switched with another textured implant. This procedure does not eliminate the probability of the reoccurrence of capsulation but is the most effective method for limiting the recurrence. Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

Dear 
capsulotomy is a medical term for making an incision or opening in a capsule. And capsulectomy is a removal of capsule. If you have any questions about your surgery, I suggest you to discuss it with your plastic surgeon. 
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for sharing your excellent question.  A capsulotomy means incising or cutting the capsule while a capsulectomy refers to removal a portion, or all, of the capsule.  You would have to directly address this with your surgeon as he/she knows the full details of your operation.  

Dear LimoMB,Thank you for the question. A capsulotomy means creating a hole in the capsule. A capsulectomy means cutting the capsule out. An en-bloc capsulectomy removes the implant and breast capsule in one piece. I will usually leave drains after this procedure although not all surgeons use the same post-operative protocols.Good luck,Nirmal R. Nathan, M.D.

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgeons
Real Self Hall of Fame

Hello, and thank you for your question. A capsulotomy refers to an incision through the capsule. A capsulectomy refers to (partial or total) excision of the capsule. Even if the goal was to remove the entire capsule, there are situations in which this cannot be safely achieved. Hypothetically speaking, your surgeon may have removed 95% of the capsule but could not remove a small piece that was tightly adherent to your chest wall. Your plastic surgeon may have attempted to remove that final piece of capsule but was concerned that doing so might lead to significant complications (e.g., serious injury to your chest wall muscles, pneumothorax). That could be the reason. (I am not saying that was the case in your case.) If you have questions about your procedure, you should discuss them directly with your plastic surgeon. Best of luck!
Matthew A. DelMauro, M.D.

With a capsulotomy the capsule is cut into.  A capsulectomy refers to the removal of the capsule.  The use of drains varies by surgeon as well as by patient circumstances.  Often patients who have had implants in for long periods of time will require a lift after implant removal in order to improve shape.  I encourage you to discuss your surgery details with your surgeon to gain better understanding of what was performed.

Your surgeon is the best one to discuss what the findings were at the time of surgery, exactly what was done and why.   I do typically put drains in after implant removal, but all surgeons have different approaches that work for them.  If capsules are thickened I do removed them completely (capsulectomy).  If only part of the capsule needs to be removed, it will be a partial capsulectomy.  Capsulotomy generally means the capsule was opened, but not removed.   If you like your results then it sounds like the surgeon did a great job.  Best wishes.

I would suggest asking your surgeon about the specific details of surgery. He can explain how much of the capsule he was able to remove.