Reasons for Capsulectomy
The capsule around a breast implant may encounter capsule contracture (hardening of the capsule). If this is the case, a capsulectomy may be one of the best treatment options available.
Additionally, the capsule around a breast implant may harbor any of the causative agents or bacteria associated with Breast Implant Illness (BII). We know that a large number of patients have colonization of bacteria around the implants and capsule. That said, we all have billions of bacteria throughout our system and our immune system is able to keep them at bay. Still, breast implant removal alongside capsulectomy may be the best course of action for a patient experiencing BII.
The Procedure
There are an enormous variety of types of capsules that develop around an implant. Some are thick, leathery and well defined. Some are calcified like an eggshell. These two types of capsules tend to be found in patients with older, pre-2006 implants. In Dr. Schneider’s experience, post-2006 capsules tend to be thinner. These thinner capsules can vary in thicknesses and pliability.
Many capsules are fairly easy to remove as one entire block, or what is called en bloc dissection. Others, that are much thinner and tear easily, may not come out as an entire unit. The key to a successful capsulectomy procedure is removing the implant and the capsule, while not damaging the remaining breast tissue.
Once the capsule and implant are removed, the remaining pocket is vigorously washed with an antibiotic solution. Patients undergoing a capsulectomy do not require drains. Most patients’ breasts will return to their pre-augmentation state without any additional treatment to the breast.
Some patients do request a breast lift at the same time though, and this can help the breast shape. Some patients also request fat transfer which can be performed.
The procedure is performed with a twilight anesthesia, and can usually vary in time from 1 – 3 hours depending upon the complexity of the capsule, whether the patient’s implants are ruptured, the age of the implants, and if a breast lift is being performed.
