Textured silicone & severe tuberous breasts - is it possible to remove capsule & have fat transfer at the same time?

Hello @lattelaitu, thank you for your question. In case of an explantation with capsulostomy, my surgical procedure would imply a breast reconstruction, because taking out the volume that the prosthesis gave will require repositioning of the tissues. In this way, you would achieve an aesthetic result you would be happy with. If what you want is to do an explantation with capsulostomy you´re doctor is right, is not convenient to have fat transfer to breasts in the same procedure, it is advisable to wait 4 at 6 months to avoid the fat to die or risk of infection. In this case the incision would be periareolar in a L shaped to avoid making a T. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD, FACS. Best wishes!

Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Hello, thank you for your question. I would recommend to have the entire implant and capsule removed with either 100% total capsulectomy or EN BLOC removal of breast implants. I also do not recommend to have fat transfer as it can cause unnecessary worry during self monthly breast exams. If you are considering any additional procedures, I would recommend to wait as depending on your age, height, weight, and implant size/positioning, your skin and breast tissue may retract. I hope that this helps.

Dear lattelaitu,
it is hard to tell for sure without an examination. Generally speaking, it is possible to combine implant removal and fat transfer. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Combining the removal of textured silicone implants, treatment of capsule contracture, and fat transfer in the context of severe tuberous breasts can be a complex procedure that requires careful consideration and planning. It's important to consult with a board-certified plastic surgeon who has experience in addressing these specific concerns to determine the most appropriate treatment plan for your individual situation.

Here are some key points to consider:

Assessment of Tuberous Breasts: Severe tuberous breasts present unique challenges in terms of breast shape, size, and nipple position. A thorough evaluation by your plastic surgeon is essential to determine the severity of the condition and develop a comprehensive treatment approach.

Removal of Textured Silicone Implants: If you have textured silicone implants and are experiencing issues such as capsule contracture or dissatisfaction with the results, removal of the implants may be necessary. This procedure involves removing the implants and any surrounding scar tissue (capsule) that has formed.

Treatment of Capsule Contracture: Capsule contracture occurs when scar tissue around the implant tightens and squeezes the implant, leading to pain, distortion of breast shape, and discomfort. Treatment options for capsule contracture may include total or partial capsulectomy (removal of scar tissue) and implant replacement or removal.

Fat Transfer: Fat transfer, also known as autologous fat grafting, involves harvesting fat from one area of the body (such as the abdomen or thighs) through liposuction and injecting it into the breasts to enhance volume, improve symmetry, and reshape the breasts. Fat transfer can be a valuable adjunct to breast surgery, particularly in cases where additional volume or contouring is desired.

Sequential or Combined Procedures: Depending on the complexity of your case and your surgeon's recommendations, the removal of textured silicone implants, treatment of capsule contracture, and fat transfer may be performed as separate procedures or combined into a single surgery. Your surgeon will discuss the pros and cons of each approach and help you determine the most appropriate course of action based on your individual needs and goals.

It's essential to have a thorough discussion with your plastic surgeon to understand the potential risks, benefits, and limitations of each treatment option and to ensure that your expectations are realistic. Additionally, be sure to follow your surgeon's pre-operative and post-operative instructions carefully to optimize the results of your surgery and minimize the risk of complications.

You need to be evaluated to see if the capsules need to be removed. When the capsules removed, it devascularizes the breasts. The technique I recommend is explantation and lift 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.

Best Wishes,

Gary Horndeski, M.D.

For best survival of your fat, doing the two procedures is best. If a lift is needed after the removal, the fat should not be grafted at the same time.

If you no longer want implants you may want to consider having a lift alone. Fat that is transferred to the breasts can form calcifications that can potentially interfere with future breast imaging studies.