During implant exchange, will having a capsulotomy or capsulectomy reduce my chances of getting capsular contracture?

I'm 5'9", 160lbs, BWD 15. I wish to upgrade from 400cc textured anatomical implants (Natrelle 410) to 700-800cc smooth round implants. What are the most important factors in mitigating the risk of capsular contracture. Is it best to remove the whole capsule when performing an implant exchange? Do I significantly increase my chances of CC by upsizing to implants in 700-800cc range?

ANSWERS FROM DOCTORS (2)


Answered by The Institute of Aesthetic Surgery

While there is no clear consensus as to the cause of capsular contracture, the current thinking is that it develops as a function of low-grade contamination.

When considering an exchange, some factors that play a role include: pocket plane (submuscular has lower rates of contracture), implant type (textured devices have slightly lower rates than smooth devices, although these differences are much less significant when placed in the submuscular plane), incision choice (infra-areolar rates are higher than IMF approaches).

Capsular removal is only necessary in the presence of a contracture. In this case, the abnormal capsule is removed before replacement. However, once you have a contracture, your rate for recurrence is relatively higher.

As always, discuss your concerns with a board-certified plastic surgeon (ABPS).

Published on Dec 13, 2018

Answered by The Institute of Aesthetic Surgery (View Profile)

While there is no clear consensus as to the cause of capsular contracture, the current thinking is that it develops as a function of low-grade contamination.

When considering an exchange, some factors that play a role include: pocket plane (submuscular has lower rates of contracture), implant type (textured devices have slightly lower rates than smooth devices, although these differences are much less significant when placed in the submuscular plane), incision choice (infra-areolar rates are higher than IMF approaches).

Capsular removal is only necessary in the presence of a contracture. In this case, the abnormal capsule is removed before replacement. However, once you have a contracture, your rate for recurrence is relatively higher.

As always, discuss your concerns with a board-certified plastic surgeon (ABPS).

Published on Jul 11, 2012


Answered by Zenn Plastic Surgery

If you do not currently have capsular contracture, you will likely not require removal of your capsule. It is always better to keep a nicely formed capsule than take the chance that the new capsule may have contracture.

That said, your size increase is quite large and you will need to have your capsule opened or removed just to make space for such a large implant. Things that may cause capsule contracture are bleeding around the time of surgery and infections.

Modern treatment for size change and implant change would include a discussion about a hybrid technique of increasing the implant size by a smaller amount and fat grafting to add soft, healthy tissue. This would help hide implant problems like contracture and give a more natural appearance.

You should discuss this with your surgeon.

Published on Dec 13, 2018

Answered by Zenn Plastic Surgery (View Profile)

If you do not currently have capsular contracture, you will likely not require removal of your capsule. It is always better to keep a nicely formed capsule than take the chance that the new capsule may have contracture.

That said, your size increase is quite large and you will need to have your capsule opened or removed just to make space for such a large implant. Things that may cause capsule contracture are bleeding around the time of surgery and infections.

Modern treatment for size change and implant change would include a discussion about a hybrid technique of increasing the implant size by a smaller amount and fat grafting to add soft, healthy tissue. This would help hide implant problems like contracture and give a more natural appearance.

You should discuss this with your surgeon.

Published on Jul 11, 2012


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