Breast revision surgery occur for several reasons which are usually changing implant size, improving the natural feel or appearance of the breasts, and correcting capsular contracture.
What is capsular contracture, and what causes it?
When breast implants (or any foreign object, such as pacemakers or artificial joints.) are placed into the body, the body forms a fibrous tissue lining around it. Many surgeons refer to this lining as the “capsule”, “tissue capsule”, or “scar capsule”, although it is not exactly the same as scar tissue. This is the body’s natural healing response after breast implant surgery and is to be expected.
Capsule contracture, the most common complication of breast augmentation surgery, can happen at any time, but seems to be more common in the first several months after surgery. During the initial operation, a pocket is created for the implant underneath the breast. During the healing process a capsule forms, which is comprised of fibrous tissue. As the healing process continues during the first year after surgery, the scar tissue within the breast and around the implant will remodel and sometimes will shrink somewhat. Under normal conditions the pocket remains open, allowing the implant to look and feel natural. However, some people can have an exaggerated healing response in the breast tissue during which the capsule will tighten, and squeeze the implant. This may cause the breast to feel hard, and to appear distorted. In severe cases, the implant feels very firm, may become painful, and can take on a “ball-like” look. It’s important to remember that it’s not the implant that has hardened. The shrinking of the capsule compresses the implant, and causes it to feel firm/hard, but once the implant is removed, it’s just as soft as it was the day it was inserted.
Currently, the causes for capsule contracture are still very unclear. Click here to see what may put you at higher risk:
Baker Grading System – 4 Grades of Capsule Contracture
- Baker Grade I – The breast is normally soft, and looks natural.
- Baker Grade II - The breast feels a little firm, but appears natural.
- Baker Grade III - The breast feels firm, and is beginning to appear distorted in shape.
- Baker Grade IV - The breast is hard, and has become distorted in shape. Pain or discomfort may be associated.
Breast Revision Surgery: Capsulectomy and Capsulotomy
In this procedure, the surgeon forcibly squeezes the implant, in hopes of “popping” the scar tissue (opening it up). Breast implant manufacturers do not recommend this, as it can lead to possible rupture of the implant. You are awake for this, and receive no local anesthesia. And yes, it can be painful, but thankfully, it only lasts a few seconds, and then it’s over. This procedure is not recommended, since it has a very low success rate, and again, puts you at risk for breast implant rupture.
In this procedure, the surgeon goes into the pocket and “scores”, or cuts, the scar tissue, in order to release the capsule’s hold on the implant. The scar tissue is not removed.
This is the most successful treatment for capsule contracture. In this procedure, the surgeon goes in and actually removes the scar capsule. This is a lengthier surgery, but is well worth it, especially when it’s successful. Once the capsule is removed, your body will form a new capsule around the breast implant. Occasionally, Dr. Brenner will perform this procedure at the same time as implant pocket relocation to the submuscular position for women who have developed capsular contracture with their implants place above the muscle.
Click here to view Breast Lift, Breast Reduction & Breast Revision Surgery Before and After Photos
Call our office in Beverly Hills to get more information on breast revision surgery. Dr. Kevin Brenner is a board certified plastic surgeon and specializes in breast revision surgery. You will be in safe hands when you or your loved ones decide to undergo breast revision surgery.