Does dense breast tissue (category c) affect capsulectomy?

Question

A mammogram showed I have category c breast density (I'm aware this is a normal finding). I am wondering if this will make it more difficult for a surgeon to perform a total capsulectomy? (I have capsular contracture from 275cc textured, silicone, subpectoral implants which are causing me a lot of pain, and is the reason for the capsulectomy).

Randal Haworth, MD, FACS · Answer

Hello, it doesn’t affect capsulectomy in general. Thin breast tissue is more challenging than thick breast tissue.

Robert M. Wald, Jr., MD · Answer

Removing the capsule in a patient with dense breast tissue makes it no more difficult than in a patient with less dense breast tissue. I would choose a surgeon who has performed many of these surgeries. The biggest technical issue is removing the capsule from the underlying muscle.

Ryan Rebowe, MD · Answer

Having dense breast tissue is unlikely to affect your capsulectomy procedure. There is a natural plane between the breast tissue and the capsule. This plan is often made more clear by the capsule present in capsular contracture because the hard, calcified capsule separates itself naturally from the breast tissue. Because of this, performing a complete capsulectomy on a breast that is has severe capsular contracture is often easier than performing a capsulectomy on someone that has a very soft capsule.

Shaher W. Khan, MD · Answer

The mammogram is meant to pick up breast cancer and any mass of the breast needs to be worked up at the breast center. Once breast cancer is ruled out, then one can plan on getting the proper explant. You do not want to be finding out at the time of explant that one has breast cancer. The breast tissue is above the muscle and the implants are below the muscle, so these are two different regions and the breast density will not affect the total capsulectomy/EN BLOC procedure.

Alan Gonzalez, MD, FACS · Answer

Hello @twotonebeauty, thank you for your question. Is does not affect capsulectomy if you are in safe and experience hands. Dense breast tissue can make it more challenging to perform the procedure because the tissue is more difficult to penetrate and dissect. Expertise, surgical technique, and knowledge are very important. In my opinion a breast implant removal should be combined with immediate breast enhancement to reposition the mammary tissue and improve projection of the upper pole and medial areas using the BRALAN Technique (Breast Reconstruction Anatomical Lift Augmentation) since the results will be adequate in terms of aesthetics and have a minimal scar in the shape of an L and that is the way I approach a Breast implant Removal. If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Robert M. Tornambe, MD · Answer

I am sorry you are having these issues, however, capsule formation after breast augmentation is not caused by dense breast tissue, and the fact that you have dense breast tissue should not affect your capsulectomy procedure. Sometimes capsulectomy alone may not be effective and other procedures, such as site change of the implants may be needed. Come see me or another board-certified plastic surgeon in our area to explore the best options for you. Best of luck.

Daniel Barrett, MD · Answer

Dear twotonebeauty,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you 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.  Breast tissue density does not affect the ability of performing a capsulectomy. Hope this helps.

Ahmad H. Ahmadi, MD · Answer

Capsulectomy is done to remove the breast capsule (scar) that surrounds a breast implant.  Accessing the capsule and removing it is not affected by breast tissue density.  A board-certified plastic surgeon will be able to assist you in the matter.  Good luck to you.

David Light, MD · Answer

Hello and thank you for your question. The density of your breasts will not make a capsulectomy more difficult. Your breast capsule is located around the implant and is dissected off of the overlying breast tissue. During the capsulectomy the breast tissue is not entered unless your are undergoing a breast lift so the density of the breast will not play a significant role. If you have textured implants, especially Allergan biocell textured implants, I would recommend having preoperative imaging to rule out an implant rupture and fluid collections around the implants that would raise suspicion for BIA-ALCL. I hope this helps. 
Good Luck,David Light, MD, FACS

Does dense breast tissue (category c) affect capsulectomy?

Answers (13)

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