Who Does the Squeeze Release of Breast Encapsulation

Question

Larry S. Nichter, MD, MS, FACS · Answer

Closed Capsulotomy - BewareClosed capsulotomy procedures are not recommended as they can cause implant rupture, internal bleeding, distortion and other complications. Off label usage of Singulair may be your best bet and if this does not work capsulectomy, change of implant and its pocket and other options are more acceptible techniques to deal with your problem. Discuss with a board certified plastic surgeon.

Kenneth Dembny, II, MD · Answer

The answer to your question is&hellip;.&rdquo;Hopefully no one.&rdquo;

	Closed capsulotomy has not been performed for many years and is a barbaric way of addressing a capsular contracture. In addition, it was not very successful as the recurrence rate for capsular contracture was high, and there was additional risk for hematoma, implant rupture, and extracapsular gel migration.

	Capsular contracture is best managed with a controlled surgical capsulotomy and/or capsulectomy, and implant replacement if required.

	Best wishes.

Robert W. Kessler, MD, FACS · Answer

Squeezing an encapsulated breast implant in the hopes of resolving a capsular contracture is of historic value only. This practice fell out of favor over 15 years ago. The idea of applying force to tear open the capsule caused bleeding, implant rupture and on occasion would force silicone into the breast tissue further complicating the problem and eventual required surgical correction.

	It is a bit concerning that you even know what this is. Do not allow anyone to perform this on you. Seek out a board certified plastic surgeon to help you with this problem.

	Good luck

Jerry Lugger, MD · Answer

I know of no one that is currently practicing this technique; the hope was that by applying sufficient force manually, that one could break or release the tight capsule about the breast implant. Unfortunately, the release if effective was only short lived, and often produced additional problems including rupture of the implant, bleeding, hematomas, as well as voiding the warranty from the implant manufacturers. Currentlly patients are better served with open capsulectomies and replacement of implant if appropriate.

Paul Gill, MD · Answer

This is an older technique where the doctor would fracture the capsule around the implant in hopes of relieving pain and giving the patient aesthetic improvement.   It was found that patients had a high risk of bleeding from the tear in the capsule and that the problem would frequently recur.  

	We now recognize the underlying problem, and recommend a capsulectomy (scar removal procedure), which has a very high success rate in treatment of capsular contracture with a much lower recurrence rate in comparison to the closed (squeeze release) technique.

	I wish you a safe and healthy recovery.

Steven Wallach, MD · Answer

Closed capuslotomies are not recommended anymore. They are frought with complications like hematomas, ruptured  implants, and a high rate or contracture recurrence. It can even injure the surgeon.

Peter A. Aldea, MD · Answer

Tightly squeezing / crushing a breast with capsular contracture in the hope the scar tissue around the implant would be torn by the pressure was referred to as a CLOSED CAPSULOTOMY. It was a "procedure" done in the surgeon's office after the patient was given a sedative and the surgeon applied force to the breast with both palms locked on the breast until a tearing or popping sound was heard / felt. Unfortunately, the success rate was very short-lived and it was associated by a high rate of implant rupture and bleeding.  As result of which implant manufacturers would void the warranty and refuse an implant burst by application of this medieval technique.

	If anyone offers you this solution be aware you are dealing with a Dr. Rip Van Winkle who is out of touch with the current practice of Plastic Surgery.

	Dr. Peter A Aldea

Peter E. Johnson, MD · Answer

Many years ago with subglandular silicone gel breast implants a squeeze release of the capsular contractures was very common. The result was rupture of the implants with gel escaping into the breast tissue and further scaring and breast deformities. The closed capsulotomy is now an obsolete technique and best avoided.

	Best of luck,

	peterejohnsonmd

Bruce E. Genter, MD, FACS (retired) · Answer

The squeeze release of capsular contractures, or closed capsulotomy, has been discredited for years. There is a high chance of implant rupture as well as injury to the surgeon's hands. An open capsulotomy or capsulectomy is the standard treatment. Personally, I have had more success with capsulectomy, removal of the capsule.

John Whitt, MD (retired) · Answer

I am not certain of exactly what you are referring to when you state "squeeze release". I think that you may mean a closed capsulotomy in which the capsule is broken up by directly squeezing on the scar which forms around the implant and is the capsule. This has been declared a procedure which should not be performed by the FDA for fear of rupturing the implant and is no longer practiced.

Who Does the Squeeze Release of Breast Encapsulation

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