Capsulotomy vs capsulorrhaphy: is a new pocket often done while removing scar tissue?

Question

Is implant pocket re-adjustment (capsulorrhaphy) a procedure that would often be considered separate from a capsulotomy or capsulectomy or is the creation of a new pocket often done while removing scar tissue via the capsultomy/capsulectomy?

Urmen Desai, MD, MPH, FACS · Answer

I new pocket is not performed when adjusting the capsule (Capsulorraphy).   I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Curtis Wong, MD · Answer

and you do have to be careful of those surgeons that want to make everything ala carte (and increase their fees).  If a re-augmentation fee is higher than the virgin fee, it suggests capsulotomies are included in that fee.  Pocket work is also part of a 're-augmentation' and should not generate more fees.  But if you need the entire capsule removed (capsulectomy), then that is truly a separate procedure that should incur a cost of its own.  This is how I see it for my patients.

Vincent P. Marin, MD, FACS · Answer

All three of the procedures you describe are different and used for different purposes. Some can be done in combination and some not. It is important to discuss with your surgeon what was done and why as there are dozens of possibilities. You should continue to follow up with you doctor to ensure you progress as planned.
Best of luck,
Vincent Marin, MD
San Diego Plastic Surgeon

Lawrence N. Gray, MD (retired) · Answer

A capsulotomy is done to enlarge an implant pocket usually for a capsular contracture. A capsulectomy can be performed instead but results in a greater risk of bleeding. A capsulorrhaphy is usually performed to reduce the size of the implant pocket because the implant is falling to the wrong position. These are very different procedures.  Most surgeons would include either of these fees with the cost of the procedure.

Capsulotomy vs capsulorrhaphy: is a new pocket often done while removing scar tissue?

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