CAPSULAR CONTRACTURE BREAST CORRECTION
Before & After Gallery
CASE #1
This 42 year old woman had breast implants in place for a number of years and presented to our office with breast asymmetry, breast drooping (ptosis), a retracted periareolar scar on the left side and bilateral capsular contracture (Baker grade 3), causing spherical deformity and upper pole fullness. Treatment consisted of bilateral removal of her implants, capsulectomy to remove the scar tissue lining around the implants, bilateral circumareolar or Benelli mastopexy to improve the aesthetics of the nipple and areola, correction of the depressed scar, and insertion of a brand new pair of 325 cc High Profile round silicone gel filled breast implants. The patient’s postoperative result is shown six months after surgery.
CASE #2
This 44 year old woman, who has had multiple prior breast implant procedures, including breast augmentation, capsulotomies for contracture and bilateral Benelli or circumareolar mastopexies, presents with severe breast deformity. The right breast is characterized by Baker grade 3 capsular contracture with a high-riding appearance. The left breast has a subtle “double bubble deformity” as well as an abnormal configuration. The patient’s circumareolar scars are very visible. Her corrective surgery consisted of removal of the implants, capsulectomies, reconfiguration of the pocket, insertion of a new pair of 275 cc Moderate Profile Plus silicone gel filled breast implants and bilateral Benelli or circumareolar mastopexies. Her postoperative result at one year reveals pleasing improvement in the contour of the breasts, improved symmetry and better aesthetics of the nipple and areola.
CASE #3
This 51 year old woman has had multiple previous breast implant procedures and experienced a variety of different complications. At the time she presented, she had breast asymmetry, capsular contracture on both sides, distortion of both nipple and areolar complexes and a subtle “double bubble” on the left side. The patient underwent revision surgery consisting of removal of her implants, capsulectomies. reconfiguration of the pocket, insertion of a Strattice ADM graft on the left side and insertion of a new pair of 300 cc Moderate Profile Plus round silicone gel filled breast implants. The patient’s postoperative result is shown six months after surgery at which time it is noted that she had complete correction of capsular contracture, much better symmetry and improvement of the aesthetics of the nipple areolar complex.
CASE #4
This 29 year old woman had breast implants in place for approximately eight years and presents with severe right-sided periprosthetic capsular contracture, causing spherical deformity to the breast, a high-riding appearance, firmness and tenderness to touch. The patient underwent bilateral removal of her implants, bilateral periprosthetic capsulectomy to remove all of the scar tissue and insertion of a new pair of 350 cc Moderate Profile Plus silicone gel filled breast implants in the subpectoral position. The patient also had bilateral circumareolar mastopexy to improve the position of the nipple. Her postoperative result is shown at one year.
CASE #5
This 32 year old woman had breast implants in place for six years. She presents with severe periprosthetic capsular contracture on the right side and deflation of her left breast implant. The right breast is characterized by spherical deformity and abnormal fullness of the upper pole. The left breast is characterized by loss of volume. The patient underwent bilateral removal of her implants, bilateral capsulectomy to remove all the scar tissue and insertion of a new pair of 350 cc High Profile silicone gel filled breast implants. Her postoperative result is shown at eight months after the corrective surgery.
CASE #6
This 33 year old woman had breast implants 15 years prior. She presents with a severely contracted right breast implant (Baker grade 4), causing spherical deformity, a high-riding appearance, firmness and tenderness of the right breast. The left breast is characterized by a Baker grade 3 capsular contracture, causing spherical deformity. The patient underwent bilateral removal of her implants, bilateral total capsulectomies and insertion of a new pair of 275 cc Moderate Profile Plus round silicone gel filled breast implants. She had excellent improvement with complete relief of her scar tissue contracture and improvement in the aesthetics of her breasts as well as improved symmetry. Her postoperative result is seen nine months after the corrective operation.
CASE #7
This 28 year old woman had large implants placed elsewhere. She developed capsular contracture Baker grade 3, causing a high-riding appearance. She had stretching or distortion of the nipple and areolar complexes. She underwent corrective surgery which consisted of removal of the existing implants, insertion of a smaller pair of silicone gel filled breast implants (275 cc round High Profile implants) and bilateral periareolar mastopexy to reduce the diameter of the areola and to improve the position of the nipple. Her postoperative result is seen at six months with dramatic improvement in breast and nipple aesthetics.
Patients who have undergone reduction mammaplasty (breast reduction surgery) may have complications related to wound healing, including undesirable scarring, loss of part of the nipple and areola and the formation of firm nodules from fat necrosis. All of these conditions can be improved by corrective surgery. Patients who have undergone prior breast uplift (mastopexy) may also have problems with wound healing, circulatory problems to the nipple and areola resulting in loss of tissue, persistent breast asymmetry and unsatisfactory correction of their breast drooping. Most of these problems can also be corrected effectively by revision surgery performed by Dr. Handel.
One common complication that sometimes occurs after breast implant surgery is “capsular contracture.” This refers to the phenomenon where the scar tissue lining that forms around the implant begins to contract or shrink causing the breast to feel too firm and even to become distorted, painful and tender. Capsular contracture is a problem that can always be repaired but usually requires reoperation. In most cases, the tightened scar tissue capsule is “released” or removed altogether, and a brand new breast implant is inserted.
A number of adjunctive measures can be undertaken by Dr. Handel to try to reduce the risk of recurrent capsular contracture. This can involve things like pocket “conversion” where a subglandular implant is converted to the subpectoral position or, conversely, a subpectoral implant is converted to the subglandular position. There are also new surface textured breast implants that seem to have a lower risk of capsular contracture. There are adjunctive measures such as pocket irrigation with antibiotics, iodine solution and chlorhexidine that may also reduce the risk of capsular contracture. Dr. Handel is careful with his surgical technique to do everything possible to avoid capsular contracture and to prevent it from recurring in patients who already have the complication.
Another problem that may be seen in association with breast implants is implant “malposition.” Breast implants can be malpositioned in a variety of different directions. Implants can be too high (often seen in conjunction with capsular contracture), they can also be too low (a condition sometimes known as “bottoming out”), they can be too far off to the side or they can be too close to the midline (a condition known as synmastia). Implant malposition is something with which Dr. Handel has had extensive experience. He has performed hundreds of corrective procedures for all types of implant malposition and customizes the operation to employ the appropriate methodology and implant to best ensure a successful outcome and to reduce the risk of recurrence of the deformity. If you suffer from implant malposition, Dr. Handel will be happy to provide you with all of the details about exactly what procedure he feels worked best in your situation.