Can capsulectomy and capsulorraphy be performed at the same time?

Dear thatgirl225,
generally speaking, it is possible to combine capsulectomy and capsulorraphy. 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

The combination of needing ALL the capsule out to treat capsular contracture and having an implant overriding the sternum is a textbook case for a neosubpectoral pocket. This technique allows the entire scar capsule to collapse on itself by separating it from the overlying muscle. This allows a new pocket to be created with a medial border that is not so close to the midline that doesn't have biofilm to contaminate a new implant. If this concept has not occurred to your surgeon, than you really need to see someone else.

On the area where the pocket needs to be tightened, the capsule present will be used to do this closure. Actual breast tissue may be too soft to hold well. Sometimes mesh is used to reinforce this closure. For the rest of the pocket, your surgeon can tell if the capsule needs to be opened, removed, or kept in place.

Your situation sounds pretty complicated.
A complete capsulectomy will loosen the breast substantially.
It will drastically change what the breast looks like initially after the surgery.
This would be a good time to close the medial aspect of the pocket since removing the capsule will loosen the pocket substantially.
A lot depends on the degree of capsular contraction and if your surgeon is planning on doing a complete capsulectomy.
There are no yes or no right or wrong answers to your question.
There is only easy and difficult situations and good and less talented surgeons.
The procedures would ideally be done together and not as separate procedures. I suppose we can answer that part of your question. It would be very difficult to close the medial aspect of the pocket if you don’t manage the capsular contraction or decrease the implant size.
I suggest focusing your efforts on making sure you’re in the hands of the right provider.
A unilateral complete capsulectomy can be a bit of a roller coaster because it can have a pretty major impact on what the breast looks like afterwards.
Often the breast will change overtime as a new capsule is established.
It’s also important to differentiate individuals who are pronto chronic capsular contraction since this can be a condition related to bacterial contamination, which is not possible to test or treat.
The bacteria that is the probable culprit for chronic capsular contraction is called Staphylococcus epidermidis. Having a capsular contraction does not mean that you’re contaminated with this bacteria, but those who develop capsular contractions again and again most likely are.
Hopefully your procedure will be easy and straightforward.
Best,
Mats Hagstrom MD