Capsular contracture on both breasts using 425cc HP mentor memory gel dual plane. What's my next steps? (photo)
Doctor Answers 8
Treatment for Capsular Contraction...
Optimal Treatment of Capsular Contracture
Capsular contracture is caused by chronic inflammation, almost always due bacterial biofilm contamination. This is one reason why periareolar incisions put patients at higher risk than inframammary incisions. Changing planes is an old, outdated concept that should be left in the plastic surgery history books. There are two effective ways of treating capsular contracture: total en bloc capsulectomy with new implants or total/subtotal capsulectomy with the use of an acellular dermal matrix (ADM) like Strattice, also using new implants. Regardless of your current incision, either of these surgeries should be performed through an inframammary incision.
My preference is a total en bloc capsulectomy. Although technically more challenging, if done precisely will eradicate any bacterial biofilm and prevent re-contamination of the implant pocket with bacteria. It avoids the need for a very expensive ADM product, and avoids the absolute need for a drain, which along with being inconvenient, can cause recontamination of the implant pocket with bacteria.
Best of luck!
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Capsular contracture on both breasts using 425cc HP mentor memory gel dual plane. What's my next steps?
Based on what I see, I can share the following:
Changing planes and going above muscle might not be best option as it seems your soft tissue thickness is low in the upper pole and the implant edge would be visible and rippling might be very noticeable long-term.
I don't think changing implant brand will significantly impact capsule formation but going to textured implants might be of benefit.
It is difficult to assess need for a lift purely based on photos because the quality and elasticity of your tissues need to be assessed as well. I think considering your age, you might be able to avoid a lift with dual plane lift and implant replacement and capsulectomy. You would not be as perky as you want but it would be compromise.
Look for an expereinced and properly trained plastic surgeon certified by the American Board of Plastic Suergy. See more than one consult and make a well informed decsion.
Capsular contracture (especially early capsular contracture) is typically managed surgically. At our East Bay practice we typically would recommend implant exchange and capsulectomy. Including dermal matrix can further reduce the chance of recurrence.
In many cases, not replacing the implants may increase the chance of capsular contracture recurrence.
You may also need a mastopexy to really improve your breast appearance as some of your residual sag likely won't be helped by treating the capsular contracture.
I hope this helps!
Need a lift.
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