Can total capsulectomy be performed through the areolas only?

Question

I got my implants through my areolas and now I want to explant. Can the Dr perform total capsulectomy through areolas only? I don't want additional scars.

Gary M. Horndeski, MD · Answer

Explantation alone frequently results in dissatisfaction of the hanging skin, empty appearance and requires a lift. Unfortunately, you have not provided photographs or told us your bra size. However, there are 2 alternatives to consider. One is explant with a mini lift. Using a circumareola incision, the implants are removed, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. The other is explant using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired. I would need more information to access what technique you would be a candidate for.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear hlnyun83,
most plastic surgeons prefer to use the same incision that was used for breast augmentation. generally speaking, it is possible to do total capsulectomy using periareolar incision. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for sharing your question.  A total capsulectomy would be very difficult to perform through an areolar incision alone.  Often a counter incision offers better access.

Kenneth Hughes, MD · Answer

To prevent another scar, the same incision could likely be used again to remove the implants if a capsulectomy is not required and the implants have not ruptured. Pros of periareolar incision for removing bilobed mammary gland: scar can be camouflaged; easier to control bleeding during surgery; periareolar incision point can be reused in future surgeries on the breast. Cons of periareolar incision for removing mammary gland: scar may not heal well; surgeon must be careful not to sever milk ducts and nerves; causes a greater risk of capsular contraction.

Connie Hiers, MD, FACS · Answer

Yes, your implants and the capsules can be removed from your current scars and avoid new scars. I would suggest discussing this with your surgeon.

Garrett A. Wirth, MD, MS, FACS · Answer

While it can be done, it is more difficult than an incision under the breast.  If the goal is a true total capsulectomy, be prepared for the new incision or a discussion of a longer operative time and potential increased cost as well.  I recommend you work with a Board Certified Plastic Surgeon.

Can total capsulectomy be performed through the areolas only?

Answers (6)

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