What is scoring during breast implant placement?

Question

I have a 15 year old saline implant placed at the time of a radical mastetomy for breast CA. I was never radiated. I have a grade 3 capsular contracture. I will not get a silicone implant or a DIEP (I've had 4 ABD surgeries). I want another saline implant, smooth round. I've heard a term scoring at the time of implant placement can reduce another contacture. What is this and is it true?

Stephen M. Davis, MD, FACS · Answer

Thanks for writing,I agree with my colleague; scoring which is a serial of relaxing incision inside the capsule allows the capsule to expand and open like an umbrella. This creates more space for another implant or a flap (TRAM, DIEP).  Unfortunately these scarred sacs (capsules) often recur. Remember: one can compress gases but one cannot compress liquids, when the capsule compresses the implant (silicone or saline) they become hard.Cohesive implants that can be shaped can help. Sometimes the use of ADM (acellular dermal matrix) can help keep the scored capsule more relaxed. I hope this helpsStephen M. Davis, MD, FACSGreen Hills Plastic Surgery

Peter E. Johnson, MD · Answer

Scoring refers to a release of the capsule with multiple cut in the implant capsule. Capsular contracture can recur frequently however. Other options to consider are cohesive anatomic implants which hold a better breast shape in reconstruction. Also capsule release with an allograft might offer a solution.

What is scoring during breast implant placement?

Answers (2)