Has anyone dealt with grade 3 CC in both breasts within 5 months of surgery with no other complications?
Doctor Answers 3
Please visit a few other surgeons. Changing pockets is an old fashion technique, and as you pointed out, makes no sense when you have a higher risk of recurrence over the muscle. This was done in a time when we didn't know about bacteria/biofilm causing chronic irritation, which ultimately leads to CC.
You did not mention where your incision is, but periareolar incisions lead to CC three times more than inframammary incisions. Regardless, your revision surgery should be through an inframammary approach.
The surgery that will lead to the lowest recurrence is either a total en bloc capsulectomy with new implant replacement, or a subtotal capsulectomy using acellular dermal matrix (ADM) like Strattice with new implant replacement. My preference is the former, because in my hands no drain is necessary. It is technically more difficult however, and sometimes the entire scar capsule cannot be removed in one piece with the implant still inside (en bloc). The latter is easier, but requires a drain for the ADM to adhere to the pocket wall, something I try to avoid due to increased risk of recontamination of the implant via the drain site.
Please visit a few ABPS certified/ASAPS member surgeons expert in revision surgery.
Best of luck!