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Charles A. Messa, III, MD, FACS

“Capsule-What?” Understanding Capsulectomy and When You May Need One After Breast Augmentation

Posted December 20, 2023 in Breast Revision Surgery

5 Minute Read: 

Capsulectomy is a technique performed during breast implant removal or breast revision surgery to remove the fibrous scar tissue that can form around the implants.

While you may never have heard the term, it’s far more common than you might think.

close up of woman in a bra, holding two silicone implants in one hand

In fact, it is almost always used in cases of severe capsular contracture, a condition that may develop after breast augmentation surgery and should be discussed during your breast augmentation consultation.

Breast Implant Removal and Revision

A crucial step in understanding capsulectomy is to know the basics of breast augmentation with implants and how long the implants typically last. Although breast augmentation is generally considered to be a long-lasting procedure, breast implants are not meant to be permanent. Breast implants can last around ten years before needing to be replaced or removed. It is entirely up to the individual if they would like to replace or remove the implants altogether, and you may even choose to opt for a different implant size during a replacement.

When is it time for removal or revision? This depends on your personal circumstances. If you have no issues with your implants and are satisfied with your results, perhaps you’ll wait until the ten-year mark before replacing them. Or possibly you’ve experienced an implant complication such as displacement, rupture, leaking, capsular contracture, etc. In that case, that is a definite sign to get them taken out, even if it has been less than ten years. Finally, if you are unsatisfied with the way your breast implants look, then that can certainly be enough of a reason to get them taken out for good or just replaced with a different size/shape that you prefer.

What Is Capsular Contracture?

Breast implants can be an excellent option for women who desire larger breasts; however, they do come with their complications. Capsular contracture is one of the more common implant complications to watch out for.

After receiving breast implants, a scar tissue capsule will form around the implants. This is a normal part of the healing process that all breast augmentation patients with implants experience, and it is beneficial in keeping the breast implants from shifting out of place.

Occasionally, the capsule hardens and tightens around the implant, leading to cosmetic issues and painful breasts. This issue is known as capsular contracture.

Capsular contracture is so common that one in six breast implant recipients experience some degree of the condition, though not every case requires capsulectomy.

The following grading system determines the severity of this condition:

  • Grade 1: The patient is asymptomatic, and the augmented breasts look and feel soft and natural.
  • Grade 2: Breasts appear normal but feel unusually firm.
  • Grade 3: Cosmetic changes have developed, often appearing rounder, the nipples may be distorted, and the breasts feel harder.
  • Grade 4: Breasts are very hard and misshapen. At this stage, women usually experience significant breast pain.

Capsular contracture grades 1 and 2 don’t require surgery, while grades 3 and 4 are typically treated with a capsulectomy or a capsulotomy to relieve pain and restore the breasts’ natural feel and appearance.

Most cases of capsular contracture occur within the first two years after breast augmentation; however, capsular contractures can develop several years following breast implant surgery. When this happens, it is commonly caused by a rupture in one or both implants.

Besides Capsular Contracture, What Other Reasons Require a Capsulectomy?

Capsulectomy is also the treatment of choice for these conditions:

What Happens During a Capsulectomy?

General anesthesia is administered before your surgery, and a breathing tube may be placed to keep your airway clear during surgery.

Incisions are made in the creases of your breasts for the scar tissue and the implant removal process proceeds. There are three types of capsulectomy: Complete capsulectomy, partial capsulectomy, and en bloc capsulectomy.

Complete or partial or capsulectomy and implant removal: An incision is made in the fibrous capsule, and the implant is removed. The capsule is then completely or partially removed in large sections.

En bloc capsulectomy: During surgery, the entire capsule is separated from the surrounding breast tissue with the breast implant still inside. Then, the entire capsule containing the implant is removed as one unit.

Both implants are typically replaced after the capsulectomy is completed. A biological surgical mesh called an acellular dermal matrix (ADM) might be placed in the breast pocket to reduce the chances of capsular contracture from occurring or reoccurring.

If needed, drains are placed, and the incisions are closed with sutures or a strong medical adhesive.

This surgery usually takes two to three hours to complete.

What Is a Capsulotomy?

In some milder cases of capsular contracture, a capsulotomy may be recommended. This procedure involves removing part of the capsule or opening it up to allow additional space for the breast implant. Implants may be removed, re-inserted, or replaced with new implants during a capsulotomy.

Your Weston, FL Capsulectomy and Breast Revision Expert

At Weston Cosmetic Surgery Center, Dr. Charles Messa, a well-respected, board-certified plastic surgeon, regularly performs breast implant removal surgery, breast revisions, and capsulectomy for patients in Weston, Florida, and all surrounding areas. If you don’t live in the area, that’s not a problem; our website has a whole section dedicated to out-of-town patients.

Call us at (954) 659.7760 or (877) 250-8117 to schedule your cosmetic breast surgery consultation, or scroll down to contact us online. Consultations are entirely confidential and scheduled promptly.

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2823 Executive Park Dr, Weston, FL 33331